Treatment and Prevention of Powassan Virus

Introduction:

Unlike most other tick-borne viruses, Powassan viruses' transmission can occur very quickly. The virus gets transmitted within 15 minutes following the tick attachment. Although rare, the number of people infected by the Powassan virus has increased recently. The virus got its name from Powassan, Ontario, where it was first discovered in 1958. Most people who get infected with the Powassan virus are unaware of it, as natural antibodies that neutralize the infection are formed in the body.

What Is Powassan Virus Disease?

Powassan virus disease is a rare tick-borne condition caused by the Powassan virus. This virus is an arbovirus that belongs to the family of Flaviviruses. Powassan virus disease can cause brain swelling and inflammation of the membranes around the spinal cord and brain. The neurological involvement of the disease was found when the Powassan virus was recovered from the brain tissue of a child who died due to encephalitis (swelling of the brain). Ticks contract the Powassan virus by feeding on infected rodents. People who get bitten by these ticks get infected with the Powassan virus.

What Are the Symptoms of Powassan Virus Disease?

Some people infected with the Powassan virus do not experience any symptoms, while others may experience symptoms after one to five weeks following the infected tick bite. The symptoms are as follows:

• Mild Symptoms:

  • Fever.

  • Chills.

  • Fatigue.

  • Recurring headaches.

  • Vomiting.

  • Weakness.

  • Body rashes.

  • Stiffness of the neck.

  • Dizziness.

• Severe Symptoms:

  • Confusion.

  • Depression.

  • Lack of coordination.

  • Difficulty in breathing.

  • Blurry vision.

  • Trouble in speaking.

  • Seizures.

  • Memory loss.

  • Loss of muscle mass.

  • Tremors.

  • Paralysis.

  • Coma.

How to Treat Powassan Virus Disease?

There are no specific medications or treatment methods to treat Powassan virus disease. The treatment often involves ways to manage the symptoms. Some people get well on their own with the help of supportive care. The available treatment options are as follows:

• Over-the-counter pain medications, rest, and fluids cure the symptoms in mild cases.

• People with severe infections require hospitalization. Medicines to reduce brain swelling, intravenous fluid administration, and breathing support are given in the hospital.

• Anti-seizure medications are given to infected people who experience seizures.

• Intravenous immunoglobulin or high-dose corticosteroids are given to severely infected people with brain swelling.

How to Prevent Powassan Virus Disease?

Currently, there is no vaccine to prevent the infection of the Powassan virus. Hence, care should be taken to reduce the risk of getting bitten by ticks.

• Tick Prevention on People:

  • Ticks are commonly found in wooded, bushy, or grassy areas. They are more active during the warmer months. Hence after spending time gardening or camping, clothing, camping gear, and boots should be treated with products containing 0.5 percent Permethrin.

  • Ticks found on the clothes should be removed immediately.

  • After coming back from woody or bushy areas, dry clothes should be put in a drier for ten minutes on high heat. Damp clothes should be put in the drier for a longer time.

  • Only hot water should be used for clothes that require washing, as cold water will not kill the ticks.

  • After coming indoors, a warm water shower should be taken within two hours. This reduces the risk of Powassan virus disease.

  • After coming back from a tick-infested area, body parts like under arms, belly button, ears, back of the knees, legs, hair, and waist should be checked for ticks.

  • While going to tick-infested areas, pants tucked into socks and long-sleeved dresses can be worn.

  • Wearing light-colored clothes helps in identifying ticks easily while in grassy and wooded areas.

  • Before going to woody areas, spray insect repellent containing DEET (N, N-diethyl-meta-toluamide) on all the bare skin regions.

  • Compared to normal footwear, closed-toe shoes provide more protection against ticks.

• Tick Prevention on Pets:

  • Among pets, dogs are more susceptible to tick-borne infections. Vaccinating the dogs for tick-borne infections can prevent the dogs from bringing ticks inside the house.

  • Use tick-prevention shampoos and soaps for bathing dogs.

  • Ticks found on the body of the pet should be removed immediately.

  • After spending time outdoors, the body parts of the pet, like the tail, eyelids, ears, neck, legs, and area between the toes, should be checked carefully for ticks.

• Tick Prevention in the Yard:

  • Using pesticides can decrease ticks. Hence, pesticides can be used in the backyards based on the regulations of pesticide application on residential properties.

  • Grasses and bushes in the yards should be cut short and maintained.

  • The yards should be free from leaf and dried twigs litter.

  • Old mattresses, furniture, and other trash which provide a home for the ticks should be removed from the backyard.

  • Wood should be stacked neatly in a dry area.

  • A wooden barrier or gravel should be placed between the wooded areas and lawns to prevent the migration of ticks.

  • Check unused outdoor equipment occasionally for the presence of ticks.

What Are the Ways of Tick Removal?

Ticks that are found attached to the skin should be removed immediately. Ticks can be removed as follows:

• Ticks can vary in size and can be as tiny as a sesame seed. Hence, it is important to check carefully for the presence of ticks on the skin.

• Ticks on the skin should be pulled upward by grasping them with a fine-tipped and dry tweezer. It is safe to remove the tick using a gloved hand.

• The tweezer should be pulled straight upward without twisting the tick. Twisting the tick while pulling the tweezer upward can make the parts of the mouth break and stay on the skin. If the mouth parts of the tick break off, it should again be removed using a tweezer.

• Following tick removal, the hands and bite site should be cleaned thoroughly, either by rubbing alcohol or cleaning with soap and water.

How to Dispose of the Tick?

A tick should never be crushed or squeezed using fingers as it may contain infectious fluids. Disposal of live ticks can be done in the following ways:

• Putting in alcohol.

• Flushing down the toilet.

• Wrapping tightly using tape.

• Putting in a sealed box or bag.

Conclusion:

Powassan virus disease is a rare tick-borne infection that often has flu-like symptoms. Avoiding tick exposure and prompt removal of attached ticks from the skin are the best ways of preventing this infection. Although there is no specific treatment, the symptoms are treatable when diagnosed in the early stages. But this infection should not be taken lightly as it can cause life-threatening complications in the later stages. Hence seeking immediate medical attention on the onset of symptoms can reduce the severity of the infection.