A Guide to the Powassan Virus
The Powassan Guide is a primer on the Powassan virus.
What is Powassan Virus (POWV)?
The Powassan or Deer Tick Virus (DTV) is a member of the flaviviridae family of viruses. The family includes the familiar West Nile, Dengue Fever, Hepatitis C and tick-borne encephalitis viruses (TBEV).
How is POWV transmitted?
The Powassan/Deer Tick virus is transmitted by the same tick responsible for Lyme disease. Similar to Lyme disease bacteria, it is found mostly in the northeast United States as well as the Great Lakes area. Its family member, the tick-borne encephalitis virus (TBEV) is so common in Europe that national vaccination programs were instituted in the early 1990’s.
POWV can be transmitted by a tick bite in 15 minutes and all tick stages are capable of transmitting the infection. There is increased concern about the POWV because the geographic range of the deer tick is expanding. As Lyme disease expands so will POWV. According to some experts, this virus has the potential to become a greater health threat than Lyme disease.
What are the symptoms of POWV?
The symptoms of POWV infection are very similar to those of Lyme disease, but reportedly can be more severe. The Powassan virus attacks the nervous system and can cause encephalitis. Serious infections can result in muscle weakness, headache, confusion and even seizures. Ten percent of POWV encephalitis infections are fatal. Long-term neurologic effects that mimic those of Post-Treatment Lyme Disease Syndrome (PTLDS) have been reported.
How is the virus diagnosed?
Coppe Laboratories provides both a direct and indirect test for Powassan virus. A simple blood draw is all that is required. The RT-PCR test will detect acute infection with the virus. The serologic test panel provides important information regarding virus exposure.
Lyme testing through our CLIA-approved laboratory conforms to the Centers for Disease Control and Prevention (CDC) two-tier testing recommendations but provides some additional benefits.
- The Lyme Screening Test: IgG and IgM ELISA screening for multiple Borrelia burgdorferi strains. The test detects additional Borrelia species including: B. afzelii, B. garinii, B. miyamotoi
- The Lyme Confirmatory panel is a comprehensive array of diagnostically relevant Borrelia antigens including recombinant VlsE and OspC which increase sensitivity and specificity.
- The Comprehensive Lyme Panel includes both screening and confirmatory tests
- Turnaround time for testing is within five business days from the receipt of the sample.
- Coppe Laboratories will file insurance and any necessary appeal with the patient’s insurance company. Learn about our insurance and reimbursement
While Lyme disease is the most common vector-borne illness in the country, other diseases are increasingly being reported. Minnesota and Wisconsin rank in the top nine states for reported cases of anaplasmosis, the top seven for babesiosis and are ranked second and third only behind New York with reported cases of Powassan virus neuroinvasive disease.
Anaplasmosis, previously known as Human Granulocytic Ehrlichiosis (HGE), is caused by the bacterium Anaplasma phagocytophilum. Clinical symptoms can be non-specific, but typically include headaches, fever, chills, malaise and muscle aches. Without laboratory testing, the disease can be impossible to distinguish from Lyme disease, Ehrlichiosis, and other tick-borne illnesses.
Coppe Laboratories performs Anaplasma testing by IFA. This test will detect both IgM antibodies during the first few weeks of an acute infection as well as IgG antibodies later in the course of the infection. For more information please review testing for Anaplasma.
Babesiosis is most commonly caused by the parasite Babesia microti and less frequently by the closely related Babesia duncani. While the severity of Babesia infections can vary, most individuals present with flu-like symptom such as irregular fevers, chills, headache, nausea, body aches and fatigue. In severe cases, the disease can cause hemolytic anemia as the parasites infect and destroy red blood cells. Antibiotics alone will not treat Babesia and the disease can be life-threatening in immunocompromised patients.
Coppe Laboratories performs Babesia testing by IFA. The IFA test is the most sensitive method for detecting infected individuals with low levels of parasitemia and for diagnosis post-therapy. For more information please review testing for Babesia.
West Nile Virus
West Nile Virus (WNV) is a member of the Flaviviridae family. This group of viruses includes the familiar Zika virus, Dengue Fever, Powassan virus, Hepatitis C and tick-borne encephalitis viruses (TBEV).
How is WNV transmitted?
WNV is transmitted to humans (and animals) by an infected mosquito. Most infections occur during warm weather when mosquitoes are active. The period between the mosquito bite and the appearance of signs and symptoms ranges from two to 14 days. Most people infected with West Nile virus either don’t develop signs or symptoms or have only minor complaints–a low grade fever and mild headache. However, some people develop a life-threatening illness that includes inflammation of the spinal cord or brain.
What are the symptoms of WNV?
The symptoms of WNV infection are very similar to those of Lyme disease. About 20 percent of people develop a mild infection called West Nile fever. Common signs and symptoms include: fever, nausea and vomiting, body aches, fatigue, and diarrhea. Some people develop a rash.
How is the virus diagnosed?
WNV serologic testing is on a blood sample. The enzyme immunoassay (EIA) test done by Coppe Laboratories is a sensitive and specific, semi-quantitative assay for the detection of both IgM and IgG antibodies to WNV. Highly specific viral protein is used to detect the antibodies to WNV and limit cross-reaction with other similar viruses.
People with some chronic illnesses (including tick-borne illnesses) are at high risk of suffering additional viral and bacterial infections because of their immune system dysfunction.
CMV, EBV, HHV-6A and HHV-6B are all members of the human herpesvirus family. HHV-6 infects nearly all people before the age of 2 and in children it causes a disease called roseola. HHV-6 and the other herpesviruses establish life-long infection, and while they are usually maintained in a dormant or “latent” state, they can become active again especially during times of immune dysregulation. The symptoms of HHV-6 related illness closely mimic those of Lyme disease. For patients experiencing long-lasting symptoms, testing for these viruses is warranted. Because nearly every person has latent HHV-6, it is imperative that testing is done to establish if the virus is activated. Testing performed at most laboratories cannot distinguish between the latent virus and active HHV-6.
Coppe Laboratories performs testing that determines active infection for HHV-6 and is the only reference laboratory to provide that testing. For more information please review the testing for HHV-6.