Powassan Virus Leaves New Hampshire Man Nonverbal. Here Is What Tick-Exposed Americans Need to Know.

John Reagan, 66, was walking his dog in New Hampshire when a tick bit him. He drove himself to an emergency room. His longtime friend Tom Wright told CBS News that when Reagan arrived, he was sitting up and talking. Within 24 hours, he was nonverbal and losing muscle control. Testing confirmed Powassan virus.

What Powassan Is — and Why It Moves So Fast

Powassan belongs to a group of viruses that can cause infection of the brain or the membranes surrounding the brain and spinal cord. Woodchuck ticks and deer ticks are the primary carriers.

The speed of transmission is what separates it from Lyme disease. Lyme requires a tick to remain attached for 36 to 48 hours to transfer the bacterium. Powassan can transfer in as little as 15 minutes. That window is short enough that a tick found and removed quickly — the standard advice for Lyme prevention — may offer no protection at all.

Symptoms don't always appear. When they do, they can look like flu: fever, headache, vomiting. Onset ranges from one week to one month after the bite. Severe cases escalate to brain or spinal inflammation, seizures, tremors, difficulty speaking, and loss of coordination. There is no specific antiviral treatment and no vaccine to prevent it. Doctors prescribe rest, fluids, and over-the-counter painkillers for most cases. More serious cases can require hospitalization for breathing support and to reduce brain swelling.

The Numbers

Powassan is rare. The CDC reported seven confirmed cases last year. The single-year record was 39 cases in 2019. Those numbers look small, but the CDC also reports that emergency room visits for tick bites jumped more than 25% nationwide in April compared to the same time last year. More bites mean more exposure risk across every tick-borne illness, including Powassan.

Cases that do occur carry brutal odds: about 10% of people with severe Powassan die, and 60% have permanent disability, according to the CDC. Survivors may have long-term health problems including headaches, memory problems, and a loss of muscle strength.

The Fair Counter-Concern

Some public health researchers caution against treating Powassan as an imminent mass-casualty threat. Because it is so rare, they argue, elevated alarm could divert attention and resources from Lyme disease, which is far more common. Those researchers have a point. A 25% rise in ER tick-bite visits does not translate directly into a 25% rise in Powassan cases, and widespread panic over a virus with fewer than 40 annual confirmed cases has real costs.

That said, "rare" is not the same as "safe to ignore." The 15-minute transmission window, the lack of treatment options, and the high rate of permanent neurological damage in survivors — 60% according to the CDC — make individual exposure to Powassan categorically more dangerous than individual exposure to Lyme, even if Lyme remains the much larger population-level burden.

Reagan's Condition as of This Week

According to CBS News, Reagan has shown improvement. He opened his eyes earlier this week and is now breathing without assistance, no longer on a ventilator. Friends and family have launched a GoFundMe to cover his medical costs and raise awareness. His friend Tom Wright noted that most people he's spoken to had never heard of Powassan before this happened.

What People in Tick-Prone Areas Should Know

The CDC says the only way to prevent Powassan and Lyme disease is to avoid exposure to ticks. That means using insect repellent with at least 20% DEET, picaridin, or IR3535, and treating clothing with products that contain permethrin. Full-body tick checks after outdoor activity remain essential. Because the 15-minute transmission window makes quick tick removal less reliable as a Powassan defense than it is for Lyme, the emphasis shifts toward preventing attachment in the first place.

Powassan is diagnosed through blood tests or cerebrospinal fluid analysis that detect antibodies. Anyone presenting with neurological symptoms after a tick bite — confusion, difficulty speaking, seizures — should tell the treating physician about the tick exposure immediately. Powassan is not a disease most ER physicians will consider first.

The open question now is whether the 25% spike in tick-bite ER visits this April reflects a genuine surge in tick population and activity, a change in human outdoor behavior, better reporting, or some combination. The CDC has not yet published a formal explanation for the increase.