Powassan and Eastern Equine Encephalitis Virus Seroprevalence in Endemic Areas, United States, 2019-2020

Abstract

Powassan virus (POWV) and Eastern equine encephalitis virus (EEEV) are regionally endemic arboviruses in the United States that can cause neuroinvasive disease and death. Recent identification of EEEV transmission through organ transplantation and POWV transmission through blood transfusion have increased concerns about infection risk. After historically high numbers of cases of both viruses were reported in 2019, we conducted a seroprevalence survey using blood donation samples from selected endemic counties. Specimens were screened for virus-specific neutralizing antibodies, and population seroprevalence was estimated using weights calibrated to county population census data. For POWV, median county seroprevalence in 4 states was 0.84%, ranging from 0% (95% CI 0%-2.28%) to 11.5% (95% CI 0.82%-40.9%). EEEV infection was identified in a single county (estimated seroprevalence 1.62% [95% CI 0.04%-8.75%]). Although seroprevalence estimates in sampled areas were generally low, additional investigation of higher-prevalence areas could inform risk for transmission from asymptomatic blood and organ donors.

Keywords: Eastern equine encephalitis virus; Powassan virus; United States; blood donor; blood safety; organ transplantation; seroprevalence; serosurvey; vector-borne infections; viruses.

Figure 1

Selected counties for Powassan virus sampling in in study of Powassan virus and Eastern equine encephalitis virus seroprevalence in endemic areas, United States, 2019–2020. A) Connecticut and Massachusetts; B) Minnesota and Wisconsin.

Figure 2

Selected counties for Eastern equine encephalitis virus sampling in study of Powassan virus and Eastern equine encephalitis virus seroprevalence in endemic areas, United States, 2019–2020. A) Connecticut and Massachusetts; B) Michigan.