{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:50:52Z","timestamp":1792525852081,"version":"4.5.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002377"],"award-info":[{"award-number":["UL1TR002377"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Powassan virus (POWV) is an emerging arthropod-borne flavivirus, transmitted by Ixodes spp. ticks, which has been associated with neuroinvasive disease and poor outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective study was conducted at Mayo Clinic from 2013 to 2022. We included clinical and epidemiologic data of probable and confirmed neuroinvasive POWV cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sixteen patients with neuroinvasive POWV were identified; their median age was 63.2 years, and 62.5% were male. Six patients presented with rhombencephalitis, 4 with isolated meningitis, 3 with meningoencephalitis, 2 with meningoencephalomyelitis, and 1 with opsoclonus myoclonus syndrome. A median time of 18 days was observed between symptom onset and diagnosis. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with elevated protein and normal glucose in the majority of patients. Death occurred within 90 days in 3 patients (18.8%), and residual neurologic deficits were seen in 8 survivors (72.7%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>To our knowledge, this is the largest case series of patients with neuroinvasive POWV infection. We highlight the importance of a high clinical suspicion among patients who live in or travel to high-risk areas during the spring to fall months. Our data show high morbidity and mortality rates among patients with neuroinvasive disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad454","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T12:10:29Z","timestamp":1691064629000},"page":"80-89","source":"Crossref","is-referenced-by-count":25,"title":["Powassan Virus Encephalitis: A Tertiary Center Experience"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3822-0669","authenticated-orcid":false,"given":"Maria Alejandra","family":"Mendoza","sequence":"first","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine News, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reece M","family":"Hass","sequence":"additional","affiliation":[{"name":"Departement of Neurology, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Vaillant","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine News, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek R","family":"Johnson","sequence":"additional","affiliation":[{"name":"Departement of Radiology, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elitza S","family":"Theel","sequence":"additional","affiliation":[{"name":"Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Toledano","sequence":"additional","affiliation":[{"name":"Departement of Neurology, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abu Saleh","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine News, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"2024012801060023400_ciad454-B1","first-page":"708","article-title":"Powassan virus: isolation of virus from a fatal case of encephalitis","volume":"80","author":"McLean","year":"1959","journal-title":"Can Med Assoc J"},{"key":"2024012801060023400_ciad454-B2","author":"Centers for Disease Control and Prevention","year":"2023"},{"key":"2024012801060023400_ciad454-B3","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0168-1702(01)00330-6","article-title":"Nucleotide sequencing and serological evidence that the recently recognized deer tick virus is a genotype of Powassan 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