TABLE 13

Powassan virus infection

Tick vectors: Lineage I: Ixodes cookei; lineage II (also known as deer tick virus): Ixodes scapularis
Geographic distribution: Great Lakes and northeastern regions
Classic presentation: Fever, confusion, seizures, focal neurologic deficits, rash, gastrointestinal symptoms
Diagnosis: Cerebrospinal fluid testing for virus- specific IgM and neutralizing antibodies; serum antibody testing; nucleic acid amplification; immunohistochemistry on autopsy tissue and viral culture are options
Treatment: Supportive care