Yale study reveals concentrated clusters of tick-borne Powassan virus transmission in New England

In a significant breakthrough, researchers at the Yale School of Public Health (YSPH) have unveiled a startling discovery – the tick-borne Powassan virus is spreading in tightly packed clusters throughout various communities in New England. The implications of this finding are profound, offering a potential roadmap for local health officials to intensify their efforts in eradicating the virus and preventing the incidence of Powassan infections.

Unlike many other illnesses, Powassan virus currently lacks both vaccines and specific treatments, making prevention and control the primary means of managing its spread. While most individuals who contract the virus remain asymptomatic, for some, it can lead to serious complications such as brain swelling, and in severe cases, even death.

Chantal Vogels, a research scientist at the YSPH's Department of Epidemiology of Microbial Diseases, and one of the co-first authors of the study, emphasized the necessity of surveillance in understanding and combating this evolving threat. By leveraging advanced genetic analysis techniques, the researchers managed to meticulously decode the complete genetic sequences of the Powassan virus. This enabled them to trace its evolutionary journey from its initial appearance in the Northeast, highlighting the branches of the virus's "family tree" and the various routes it took through its hosts.

The study reveals that a major branch of the lineage 2 Powassan virus emerged in the Northeast sometime between 1940 and 1975. This branch, which accounts for the majority of Powassan cases in North America, initially surfaced in southern New York State and Connecticut. Subsequently, the virus spread via long-distance jumps, likely facilitated by infected ticks hitching rides on migratory birds or other vertebrate hosts. By 1991, the virus had made its way to Maine. However, the study suggests that the virus's proliferation began to stabilize around 2005.

Intriguingly, the virus appears to be exhibiting a pattern of either slow movement or a tendency to remain confined to specific hotspots, evolving independently within each localized cluster. The researchers observed limited evidence of viral mingling across a certain geographic range, underscoring the potential for focused intervention and education efforts in these areas. Additionally, regions beyond New England, such as the Great Lakes, have reported elevated numbers of Powassan cases.

Doug Brackney, a researcher at The Connecticut Agricultural Experiment Station and the YSPH's Department of Epidemiology of Microbial Diseases, likened these virus hotspots to being about the size of a football field, similar to those observed in related diseases.

Named after Powassan, Ontario, where it was first identified in the 1950s, the Powassan virus was initially relatively rare. However, since the mid-2000s, the number of diagnosed cases has risen significantly, hinting at a potential shift in human-tick interactions. Unlike other diseases transmitted by ticks, Powassan can be transmitted in as little as 15 minutes after a tick attaches itself to a host, leading experts to speculate that more people may have been exposed to the virus than the number of reported cases suggests.

Chantal Vogels stresses the urgency of early action to prevent a potential public health burden from the virus. She suggests that with continued vigilance, targeted interventions, and a focus on education, it may be possible to stem the impact of Powassan and safeguard communities against its growing threat.

The comprehensive findings of this groundbreaking study are published in the Proceedings of the National Academy of Sciences, with funding provided by institutions including the National Institutes of Health and the European Union Horizon 2020 initiative.