Now that summer is peeking over the horizon, those who live in
the Northeast are preparing for flea and tick season. Most of us are aware of
deer ticks and the potential for Lyme disease. But, there’s a new bug in town
that may be just as deadly as its sister. This one is known as Powassan Virus
The disease is relatively new and was discovered in Powassan,
Canada in 1958 when a 5-year-old boy died from encephalitis caused by the
Powassan virus. While very few cases have been reported in the past, the
incident rate is slowly rising with most of the cases coming out of Minnesota
and New York. According to the Centers for Disease Control and Prevention,
there have been 17 reported cases of the disease from 2004 to 2013 in New York
and 20 from Minnesota over the same time span. Pennsylvania reported only 1
case.
That doesn’t really tell the whole story. Those numbers only
represent those that were tested and reported. Cases of Powassan virus are
often mistaken for other health issues. The Powassan virus can act like Lyme
Disease but it can also cause two very distinct diseases: encephalitis and
meningitis. Both illnesses cause inflammation in the head and brain: encephalitis
is an inflammation of the brain itself and meningitis is an inflammation of the
membranes that surround the brain and spinal cord. Both are deadly.
There are various strains of encephalitis, but the one closely
connected to Powassan is TBE – Tickborne Encephalitis. The Powassan virus is
not always caused by TBE but the virus is often not tested for either. Of
interest, the focal areas of TBE are Europe and Asia with an average of 8,500
cases reported annually. For the most part, it is travelers who are at greatest
risk of bringing TBE back to the states, if they are infected.
While human cases of Powassan are low, there have been more
cases of the virus discovered in at least 38 other mammals including rodents,
woodchucks, skunks, dogs, and cats.
A blood or spinal fluid test would be able to determine if
the virus was in the body. This test must specifically look for antibodies that
the immune system would make in order to detect viral activity. Lyme disease is
very different from Powassan in that there is a treatment. Lyme disease is a
bacterial disease that antibiotics can effectively treat. Powassan is a
flavivirus similar to West Nile or Dengue fever and does not have a cure or
treatment regime.
The North American Powassan virus is being classified as coming
from a newly evolved subtype of the deer tick. According to the Expert Review
of Anti-Infective Therapy, a journal focused on infectious diseases, the
Powassan virus is specific to three tick species: Ixodes cookei, I. marxi and I. spinipalpus. To the general population,
the names are useless, but for those in the field, this provides crucial
information to track and monitor the potential spread of Powassan-carrying
ticks. As it appears that the disease incidence is slowly rising, it is critical
to stop the spread of the culprit ticks.
One of the keys to keep the Powassan virus at bay is through
routine monitoring and tracking. If we can avoid spreading the disease, we can
keep the incidence rates low.
Those at high risk for Powassan are those who live in wooded
areas, particularly the same locations as you might encounter ticks and Lyme
disease. What makes this virus so deadly is that it often doesn’t come with
symptoms. The person simply just develops encephalitis or meningitis after as
long as a one-month incubation period.
The best way to reduce infection is to avoid contact with
ticks – much like you would to reduce your risk of contracting Lyme Disease. Treating
skin and clothing with insect repellents while in heavily wooded areas are recommended
as well.
If you find a tick on your skin, remove it quickly before it
has a chance to bite. After being in the woods, it is best to do a full body
check before you walk into your home. Check all pets and equipment as well.
Then, shower within two hours after being outdoors.
If you have been or believe you have been bit by a tick, consult
your healthcare provider immediately. While it may not be Lyme disease or
Powassan virus, you certainly want to make sure.
Works used for this article:
Centers for Disease Control and Prevention. (2015). Powassan
virus. Retrieved from http://www.cdc.gov/powassan/index.html
EI Khoury, M. Y., Camargo, J. F., and Wormser, G. P. (2013).
Changing epidemiology of Powassan encephalitis in North America suggest the
emergence of the deer tick virus subtype. Expert
Review of Anti-Infective Therapy, 11(10), 983-985.
El Khoury, M. Y., Camargo, J. F., White, J. L., Backenson,
B. P., Dupuis II, A. P., Escuyer, K. L., Kramer, L., St. George, K.,
Chatterjee, D., Prusinski, M., Wormser, G. P., and Wong, S. J. (2013). Potential
role of deer tick virus in Powassan encephalitis cases in Lyme Disease-endemic
areas of New York, USA. Emerging Infectious
Diseases, 19(12), 1926-1933.
While public health is more aligned with population
well-being, professionals are keeping a watchful eye on the recent talk of the
first-ever human head transplant that has been in the news lately.
For those who may not have been paying attention to the
medical news lately, reports from various reputable sources have found that
Italian surgeon Dr. Sergio Canavero plans to conduct the world’s first human
head transplant within the next two years. He actually has his patient set and
ready to go. The donor body has yet to be identified.
Canavero first proposed the idea two years ago as a means of
extending people’s lives whose bodies have been riddled with illnesses,
cancers, or other incurable medical disorders. The first patient willing to
have his head transplanted onto a new body is Valery Spiridonov, a 30-year-old
Russian who suffers from Werdnig-Hoffman disease, a genetic disorder that
causes his muscles to deteriorate. A donor body will be attached to Spiridonov’s
head through spinal cord fusion, a process that has had some success in
animals.
The first successful animal head transplant took place in
1970 where the head of a monkey was transplanted onto the body of another
primate. The monkey lived for nine days before the body rejected the new organ.
However, in the 1970s, there were few processes and medications that helped to
keep transplanted organs from being rejected. Since then, the invention of
drugs that assist with the acceptance of transplants, such as with lungs and
hearts, can reduce the risk of rejection significantly.
For a head to be transplanted onto a new body, the spinal cord
of the donor body will have to be fused onto the spinal cord of the recipient’s
head. The process was described in a recent issue of the journal Surgical
Neurology International.
What are the consequences for society if we are able to
successfully transplant heads? Are we moving closer to the Frankenstein movies
of the past or the upcoming science-fiction movies that haven’t yet been
created?
Looking at the progression of organ transplantation, the
field has brought forth tremendous challenges, the biggest one being a shortage
of organs. As most people are aware, there is an organ transplant waiting list
for various operations: liver, kidney, lung, eyes, heart and so on. Then, another
big concern is the issue of organ trafficking and transplant tourism. In some
cases, organ donation was no longer a voluntary notion but one of coercion and
profit-making. That brought up the issue of organ trafficking. In Germany in
2012, a significant number of patient records were tampered with to increase
the number of organs that could be used for transplants. In other words, people
were donating organs that they had no intentions of giving up.
Earlier, organ trafficking involved the forced removal of
organs from people, mainly those in prison who were to be executed. The
practice was very common in China. It wasn’t until 2001 when the public became
aware of the unethical removal of executed prisoners’ bodies. Chinese authorities claim that the organ
harvesting took place after the execution with permission, but these official statements
are still questioned today. It was later discovered that some Chinese hospitals
were actually taking organs from living people without permission and under
torturous conditions.
What about head transplants? Could this possibly happen to
someone’s head? When a donor (with or without consent) provides a kidney, lung
or part of a liver, that person can still live and breathe. When a head is
removed from a person’s body, death is eminent. The ethical nature of head
transplantation could become a huge human rights concern if we aren’t careful
in how we handle it.
The ethics of the head transplantation project that will
likely take place a few short years from now must be investigated now before human
head trafficking occurs much like other organ harvests of the past. Bioethical
committees in many countries are now looking into the potential concerns that
will likely follow a successful head transplant.
Works used to create this article:
30-year-old Russian man volunteers for world’s first human
head transplant. (April 13, 2015). Retrieved from http://www.medicalnewstoday.com/articles/292306.php
Thomson, H. (Feb. 25, 2015). First human head transplant
could happen in two years. Retrieved from http://www.newscientist.com/article/mg22530103.700-first-human-head-transplant-could-happen-in-two-years.html
Trey, T., Caplan, A. L., and Lavee, J. (2013). Transplant
ethics under scrutiny – responsibilities of all medical professionals. Croatian
Medical Journal, 54(1), 71-74.
