Lyme Disease and the Powassan Virus: Prevention, Detection, and Treatment

Lyme Disease and the Powassan Virus: Prevention, Detection, and Treatment

Ticks that can transmit illnesses are now being found in places they weren't seen 20 years ago.

When it comes to tick-borne infections, health officials are warning that this summer might be among the most dangerous on record. According to the Centers for Disease Control and Prevention (CDC), the tick population has grown exponentially in many states, and ticks are now being found in places they weren’t seen 20 years ago.

This rise in the tick population is especially dangerous because ticks carry Lyme disease as well as a potentially deadly virus, the Powassan virus (POW). It is now more important than ever to know how to defend yourself against tick bites.

What is Lyme disease?

Lyme disease is the most common tick-borne illness in the United States. According to the CDC, more than 300,000 new cases are diagnosed every year.

“Lyme disease is a tick-borne illness caused by the bacteria Borrelia burgdorferi. Lyme disease can cause symptoms and illness of the skin, heart, joints, or neurologic system, so it’s important for it to be detected early and treated with antibiotics,” says Nancy A. Shadick, MD, MPH, director of the Lyme Disease Prevention Program at Brigham and Women’s Hospital (BWH).

What are the symptoms and signs of Lyme disease?

Symptoms include a bull’s eye rash—which is distinctive enough to make a diagnosis, but absent in approximately 20 percent of those who are infected.

Other symptoms include cardiac abnormalities, most likely rhythm difficulties in the heart, such as dizziness, heart palpitations, or a slow heartbeat, as well as neurological symptoms and swelling of the joints.

The most definitive way to diagnose Lyme is the enzyme-linked immunosorbent assay (ELISA) test, which detects antibodies to Borrelia burgdorferi. If the ELISA test is positive, a western blot test is usually conducted to confirm the diagnosis.

“If you don’t develop a rash from Lyme disease, you can still develop meningitis or neuritis, such as Bell’s palsy, which is facial paralysis. You can also develop arthritis, which starts as migratory joint pain and then can evolve into a swelling of the larger joints of the body, particularly the lower extremity,” says Shadick.

What is the Powassan virus?

POW is a rare disease that, like Lyme, is spread through tick bites. The infection has serious complications, including brain swelling and other neurological symptoms. While patients with Lyme disease can be treated with antibiotics if the infection is caught early, there is currently no medical treatment for POW.

What are the symptoms and signs of the Powassan virus?

Jennifer Lyons, MD, chief of the Division of Neurological Infections and Inflammatory Diseases at BWH, says that while most infected people won’t show symptoms, some will have symptoms that feel similar to the flu.

“You basically feel nonspecific flu-like stuff [such as] muscle aches and pains; maybe you have a little rash on your skin, but almost certainly, you’ll have a fever and the headache,” explains Lyons. “If the virus worsens, it will do so very quickly and within days of the first symptoms.”

Symptoms of POW include difficulties maintaining consciousness and cognition, seizures, and the inability to breathe on your own.

“The virus is very serious,” says Lyons. “About 15 percent of patients who are infected and have symptoms are not going to survive. Of the survivors, at least 50 percent will have long-term neurological damage that is not going to resolve.”

How to prevent tick bites

The best way to avoid contracting Lyme and POW is to avoid being bitten by ticks. Thankfully, there are many ways to help prevent tick bites:

  • Avoid tick areas such as the brush, tall grasses, or forests with lots of leaf litter.
  • If walking through the woods or tall grasses, wear long sleeves and long pants with your pants tucked into your socks.
  • Use bug repellent with 100 percent DEET or pretreat your shoes and clothing with Permethrin, which kills ticks on contact but has no harmful effects on humans.
  • Do a tick check with a friend, partner, or family member every evening if you’ve been outdoors. Make sure to check your hairline, ears, armpits, and legs, including behind the knees.

Ticks are very small and almost impossible to detect, so awareness is key.

If you are experiencing symptoms of Lyme disease or POW, even if you have not found a tick bite, seek care from a medical professional right away. The key to treating tick-borne illnesses is early detection and intervention.

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