{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:56:36Z","timestamp":1773395796400,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Powassan virus (POWV), a tick-borne flavivirus, poses a public health risk with an estimated case fatality rate of approximately 10%. Its limited surveillance results in underreporting. Using Lyme disease data as a proxy, we developed an exploratory simulation study that estimated 4649 POWV cases in the United States from 2018 to 2022, as opposed to 156 reported cases. We further estimated mortality rates (0.2%\u20131%), which were lower than reported rates (4.8%\u201321%). These discrepancies suggest that POWV cases go undetected, likely due to asymptomatic and mild to moderate presentations. Our findings emphasize the need for enhanced surveillance to accurately assess the public health impact of POWV.<\/jats:p>","DOI":"10.1093\/infdis\/jiaf368","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T07:36:16Z","timestamp":1751960176000},"page":"148-152","source":"Crossref","is-referenced-by-count":2,"title":["Leveraging Lyme Disease Surveillance to Simulate Powassan Virus Prevalence"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9166-9727","authenticated-orcid":false,"given":"James M","family":"McCluskey","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago , Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher S","family":"Wichman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham","family":"Degarege","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health, University of Nebraska Medical Center , Omaha, Nebraska"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7583-8495","authenticated-orcid":false,"given":"David","family":"Brett-Major","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health, University of Nebraska Medical Center , Omaha, Nebraska"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"2026031304520590300_jiaf368-B1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1146\/annurev-ento-112408-085446","article-title":"Update on Powassan virus: emergence of a North American tick-borne flavivirus","volume":"55","author":"Ebel","year":"2010","journal-title":"Annu Rev Entomol"},{"key":"2026031304520590300_jiaf368-B2","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":"2026031304520590300_jiaf368-B3","author":"Centers for Disease Control and Prevention"},{"key":"2026031304520590300_jiaf368-B4","doi-asserted-by":"crossref","first-page":"101540","DOI":"10.1016\/j.ttbdis.2020.101540","article-title":"The emergence of human Powassan virus infection in North America","volume":"11","author":"Campbell","year":"2020","journal-title":"Ticks Tick Borne Dis"},{"key":"2026031304520590300_jiaf368-B5","author":"Centers for Disease Control and Prevention"},{"key":"2026031304520590300_jiaf368-B6","doi-asserted-by":"crossref","unstructured":"McCluskey J . Data library, R code, and case data employed in McCluskey et al: Leveraging Lyme disease surveillance to simulate Powassan virus prevalence. Deposited 24 June 2025. 10.7910\/DVN\/GHHOJ3.","DOI":"10.1093\/infdis\/jiaf368"},{"key":"2026031304520590300_jiaf368-B7","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.3201\/eid2308.161971","article-title":"Serologic evidence of Powassan virus infection in patients with suspected Lyme disease","volume":"23","author":"Frost","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"2026031304520590300_jiaf368-B8","doi-asserted-by":"crossref","first-page":"e2350","DOI":"10.1093\/cid\/ciaa1183","article-title":"Powassan virus encephalitis following brief attachment of Connecticut deer ticks","volume":"73","author":"Feder","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2026031304520590300_jiaf368-B9","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1093\/cid\/ciad454","article-title":"Powassan virus encephalitis: a tertiary center experience","volume":"78","author":"Mendoza","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2026031304520590300_jiaf368-B10","author":"Centers for Disease Control and Prevention. Centers for Disease Control and Prevention"},{"key":"2026031304520590300_jiaf368-B11","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.ttbdis.2019.01.001","article-title":"Nymphal Ixodes scapularis questing behavior explains geographic variation in Lyme borreliosis risk in the eastern United States","volume":"10","author":"Arsnoe","year":"2019","journal-title":"Ticks Tick Borne Dis"},{"issue":"suppl 1","key":"2026031304520590300_jiaf368-B12","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.1093\/infdis\/jiae197","article-title":"Laboratory testing for Powassan virus: past, present, and future","volume":"230","author":"Klontz","year":"2024","journal-title":"J Infect Dis"},{"key":"2026031304520590300_jiaf368-B13","doi-asserted-by":"crossref","first-page":"118","DOI":"10.15585\/mmwr.mm7306a1","article-title":"Surveillance for Lyme disease after implementation of a revised case definition\u2014United States, 2022","volume":"73","author":"Kugeler","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026031304520590300_jiaf368-B14","doi-asserted-by":"crossref","first-page":"ofac023","DOI":"10.1093\/ofid\/ofac023","article-title":"Seroprevalence of Powassan virus infection in an area experiencing a cluster of disease cases: Sussex County, New Jersey, 2019","volume":"9","author":"Vahey","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"2026031304520590300_jiaf368-B15","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.3390\/v14071584","article-title":"Infection with Borrelia burgdorferi increases the replication and dissemination of coinfecting Powassan virus in Ixodes scapularis ticks","volume":"14","author":"Hart","year":"2022","journal-title":"Viruses"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiaf368\/63713750\/jiaf368.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/233\/1\/148\/63713750\/jiaf368.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/233\/1\/148\/63713750\/jiaf368.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:53:06Z","timestamp":1773391986000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/233\/1\/148\/8195852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,9]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,7,9]]},"published-print":{"date-parts":[[2026,1,17]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiaf368","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1,15]]},"published":{"date-parts":[[2025,7,9]]}}}