Rare tick disease poses a danger in Minnesota lakes area

GULL LAKE, Minn. — Tick populations are moving

north

this season, and there’s been an increase in tick-bite-related emergency room visits, according to state health officials.

The deer tick — also known as the blacklegged tick — can carry not only Lyme disease and other pathogens, but also Powassan virus, a fairly recent discovery which has no treatment and can leave behind permanent neurological damage.

From 2008-2022, Cass and Itasca counties ranked highest for reported cases of Powassan — at six to seven cases each, according to the Minnesota Department of Health, with the west side of Gull Lake considered a prime spot for the disease. During that same time, Aitkin and Morrison counties had two to three reported cases, and Crow Wing County had one reported case.

Elizabeth Schiffman, supervisor of the Vector-borne Diseases Group at the Minnesota Department of Health, said this lakes area presents a whole host of risks, especially this time of year, thanks to early summer weather with the combination of tick season and increased outdoor traffic.

“Traditionally, we kind of say the end of May through about the middle of July is the highest-risk time of year for ticks and tick-borne diseases,” she said.

Schiffman said diagnostics for Powassan are tricky because by the time someone may feel symptomatic enough to seek treatment, they may have already had the virus pass through their system, and those who are symptomatic largely tend to have more generalized symptoms like fevers, headaches or muscle aches.

“We didn’t detect our first case in Minnesota until 2008, so it’s still relatively uncommon,” she said. “It’s also not one that’s regularly included in a lot of the tick-borne disease panels that most providers use from commercial laboratories, so diagnostics can be a bit more limited.”

Schiffman said the peak year for cases in Minnesota was 2024, with 14 cases. Last year there were eight. The diagnostic process comes after more obvious explanations have been ruled out, and usually involves some kind of serologic testing, or looking for antibodies. Polymerase Chain Reaction (PCR) testing is also available.

“The bacteria that causes Lyme disease is found in about one of three ticks,” Schiffman said. “And something like Powassan is found in just maybe, like, you know, a couple percent of ticks. It’s a much smaller, much smaller proportion of ticks that are infected.”

Matthew Aliota, a professor at the University of Minnesota Twin Cities in the College of Veterinary Science, studies arthropod viruses.

Contributed / U.S. National Park Service

“In the state overall, we think about 5% of ticks are positive,” he said, regarding the proportion of Powassan-carrying ticks.

Aliota said its relatively uncommon but can leave debilitating aftereffects.

“It’s a virus that can invade the central nervous system and go to your brain, with severe outcomes,” he said. “If you survive, you can have long-lasting impacts to kind of your overall functioning from a memory standpoint and from a cognitive standpoint.”

Teal Johannsen said her father, Jeffrey, was a hunter, builder and business owner when he caught Powassan near Gull Lake as an otherwise healthy and active outdoorsman. He died in 2023 at age 69.

“My dad was a very healthy, strong guy, and he pretty much was never sick until this happened, and then it was pretty much just a multi-system collapse for him,” Johannsen said. “The virus and the aftereffects of the virus just affected everything.”

Jeffrey suffered neurological consequences — more specifically, as Johannsen indicated doctors told her family,

encephalitis,

or swelling of the brain. She said her family worked tirelessly to get care that would alleviate his symptoms. They consulted neurologists, sleep experts and infectious disease doctors.

“He couldn’t eat, he couldn’t sleep, he slowly stopped being able to … he wouldn’t want to talk to anyone,” Johannsen said. “He had horrible, horrible anxiety, which was totally unusual for him. He had a really hard time leaving the house. He stopped being able to make eye contact with people. It just kind of slowly took over his ability to just function independently and be himself.”

The Johannsens were not unfamiliar with Minnesota wilderness, and certainly not Jeffrey. Johannsen said her father taught her tick safety, and she has early memories of him instructing her how to stay safe on the property.

“We would always go out in the woods together, and he taught me how to be careful for ticks, so it’s not like he was unaware of how to be out in the outdoors in Minnesota,” Johannsen said. “He knew how to watch out for ticks, but we had never heard of this, and we definitely didn’t know how devastating it could be.”

There is no treatment for the Powassan virus, so Johannsen said there’s a real emphasis to place on preventive measures like wearing long pants and close-toed shoes outdoors, as well as utilizing effective repellents. She and her mother, Susan Johannsen, are working to educate their family members who share their multi-residence Gull Lake area property, including purchasing the pesticide

Permethrin

for use on the grounds.

Schiffman said she usually refers people to the Environmental Protection Agency website for guidance on which repellents are most effective. Permethrin is one of the proven acting chemicals. When shopping in-store, Schiffman said there is usually an EPA registration indicator on the back of these products.

“It says EPA reg number, and then a little series of digits,” she said. “If it has that on the bottle, you know that repellent has been tested, you know it’s going to work the way it says it’s going to work if you’re using it according to the label direction. Some of them you need to reapply more often, like a sunscreen; some of them last a bit longer. So really, the quickest way I would say is to look for that EPA registration number on the label, and if you’ve got that, you’re on the right track.”

Johannsen said she’s also since learned not all ticks that can carry Powassan are full-grown.

“Not all ticks are like the visible ones that you see crawling around,” she said. “The nymph stages can be as tiny as a poppy seed, and they can also carry the virus and infect people; they’re able to break skin and cause infection that way.”

Johannsen said her father is very missed. He was a dedicated builder and loved his job so much that he often took it home, and to other people’s homes as well, given the nature of his work.

“He basically just always had jobs because people would spread the word of what a good job he did on their remodels or builds,” she said. “He was the kind of person that would walk into your house and do an assessment for free because he couldn’t help looking at all the little areas of improvement on your house.”

Johannsen said the property’s standing was evident of the real love and knowledge he possessed of his craft, as well as the level of care he operated with. He maintained the 100-year-old property with specialized needs for use by a lot of extended family. The Johannsens are slowly learning to pick up where he left off.

“He was the main property caretaker that was keeping the place running, because of his knowledge and skill set,” Johannsen said. “He could just basically build anything, fix anything, and so after he died, we’re kind of figuring out how to manage the property.”

Contributed / Lauren Bishop / CDC Division of Vector-Borne Diseases Rickettsial Zoonoses Branch