Over the past ten years, there have been 75 cases of Powassan virus reported in the United States, according to the Centers for Disease Control and Prevention (CDC).  Most cases have been confined to the Northeast and Great Lakes region. That, however, may change. As Lyme disease continues to spread throughout the country, so too may this potentially deadly virus.
The risk that a deer tick may transmit Lyme disease rises the longer the tick is attached, according to a review by Eisen from the Centers for Disease Control and Prevention (CDC) published in the January 2018 journal Ticks and Tick-borne Diseases. 
Powassan Virus is a tick-borne infection that can cause encephalitis and meningoencephalitis. It most often presents with neurologic symptoms and has a fatality rate between 10% to 15%. It's estimated that between 1% and 3% of deer ticks in the northeastern United States may be infected with Powassan Virus.
Several studies have found that wearing permethrin-treated clothing can reduce the risk of tick bites. But very few studies have looked at the behavior of a tick when it comes in contact with permethrin-treated clothing. Does it climb onto the insecticide-soaked textile or avoid it entirely? Does permethrin actually kill ticks?
Researchers examined the prevalence of ticks in the Quebec region, along with the frequency of engorged ticks carrying Borrelia burgdorferi (Bb), the causative agent of Lyme disease. Their findings suggest that tick testing may not always be an effective tool in determining the risk of infection.
I will be discussing the case of a 65-year-old woman with abdominal pain, ileus/pseudo-obstruction and constipation due to Lyme disease.
“Although abdominal pain is generally not considered a sign of LD [Lyme disease], in this case report we describe a patient with unexplained severe abdominal pain that eventually turned out to be LD due to radiculopathy,” explains Stolk from the Haga Teaching Hospital in the Netherlands. 
Ticks patiently hold on to blades of grass and shrubs in a position known as “questing” as they await their next meal or host. “Almost blind, ticks rely on chemosensation to identify and locate hosts for a successful blood meal,” write the authors of “Behavioral responses of Ixodes scapularis tick to natural products: development of novel repellents.”¹
Welcome to another Inside Lyme Podcast. I am your host Dr. Daniel Cameron
. In this episode, I will be discussing a case involving a toddler with Lyme disease whose symptoms were mistakenly attributed to child abuse.
Researchers from Virginia Tech believe they have discovered another piece of the Lyme disease puzzle – How does the Borrelia burgdorferi bacterium cause inflammation and Lyme arthritis?