Weeks after a tick bite, he couldn’t speak or move. A slew of tests finally gave him a diagnosis

John Reagan was enjoying the first few months of retirement when he pulled a tick off his skin in early May.

He didn’t think much about it. Reagan, 66, a retired pharmacist who lives in Concord, New Hampshire, loved being outdoors, often hunting, fishing or going on long walks with his son and daughter’s dogs – aka “the grand-dogs” – in tow.

Reagan fully appreciated the risks of tick bites. Lyme disease is a common infection in the area where he lives. Because it takes about 36 hours for an infected tick to transmit Lyme once it attaches to the skin, he pulled the tiny bloodsucker off almost immediately after returning home and thought he was safe.

A few weeks later, though, he started having flu-like symptoms that included a headache, body aches, a fever, nausea and diarrhea. He visited a local emergency room in mid-May, but doctors couldn’t zero in on a cause, so they sent him home after giving him fluids and anti-nausea medications. Still, he got worse.

His wife thought he might have been having a stroke. Back at the hospital, he lost his ability to speak, move or even open his eyes. Still, tests were negative. His family asked whether this could be related to Reagan’s tick bite a few weeks earlier. They were told no.

Reagan was transferred to Massachusetts General Hospital in Boston, where staff ran a slew of tests, including ones checking for tickborne illnesses. They sent a blood sample to a specialized lab at the Mayo Clinic.

On June 9, his family got a diagnosis: Powassan virus, a rare and serious infection that he almost certainly caught from the all-but-forgotten tick. Unlike Lyme, Powassan virus can pass from a tick to a person in about 15 minutes. Before that moment, they’d never heard of it.

Ticks and the diseases they carry are becoming more common in the United States. In the US, about 90% of all illnesses that are caused by a bite – including mosquitoes – are caused by ticks.

Lyme disease is on the rise but is already the most common tickborne disease, with nearly half a million cases each year, according to CDC estimates. Other growing tickborne threats include alpha-gal syndrome, an allergy to meat and other animal products that can be caused by the bite of lone star ticks.

Powassan virus disease is incredibly rare, with fewer than 100 cases diagnosed and reported in the United States each year, according to the CDC. But in recent years, this number too has been growing as the populations of ticks that carry it have increased.

“There are more ticks in more places,” said Dr. Stephen Rich, a microbiologist at the University of Massachusetts Amherst who runs TickReport, a tick-testing service the public can use to determine whether the tick that bit them is carrying something that could make a person sick. “Whenever you have more of something, more of the vectors, you’re inevitably going to have more of the pathogens.”

In 2025, 76 human cases of Powassan virus disease were reported in the US, an all-time high. Ten of these were fatal.

The virus was first identified by Canadian scientists in the 1950s. A child who had been hunting woodchucks with his father came down with a severe illness that resulted in brain swelling. The boy died, and the virus was ultimately isolated from his brain and named after the town in Ontario where the family lived.

Powassan virus is carried by blacklegged or deer ticks, the same species that carries Lyme disease. It’s an orthoflavivirus, part of the same family as West Nile and Zika.

About 1 in 10 cases are fatal. For those who survive, disability is common: About half of patients have long-term complications.

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After living through the past months of fear and uncertainty of not knowing whether they would ever get their dad back, Reagan’s family is eager to make people aware of how serious Powassan virus can be.

Because there’s no specific treatment, the only way to protect people is to urge them to be aware of the disease and take steps to prevent tick bites in the first place, said John’s son, Jeff Reagan.

“Advocate for yourself or your loved ones if they’ve been bitten by a tick recently,” he said. “Because not all medical professionals are familiar with Powassan.”

Early in John’s hospitalization, brain swelling caused him to stop breathing. Doctors inserted a breathing tube and feeding tube and put him on a ventilator, hoping that supporting his vital functions with machines could buy his body time to recover in the ICU.

The strategy worked. After nearly a month, he woke up and began to regain communication. He could follow some commands, but he’d been bedridden for so long that other problems had developed, including blood clots and pneumonia.

Doctors have managed those complications, and John is slowly regaining his ability to move. Since early July, he’s been at Spaulding Rehabilitation Hospital in Boston, where he’s been working on walking, talking and thinking properly again.

“He wants to walk, and he’s trying to get his coordination and balance and depth perception back,” Jeff Reagan said.

Although it’s been encouraging to see his dad’s progress, Jeff knows that he has months of recovery ahead.

“It’s been a roller coaster,” he said. “He has made some pretty good progress, especially with his cognition.”

As he was waking up, Jeff said, his dad was just listening and going with the flow. Now, the emotions are coming back.

“Now I think he realizes like, ‘oh, wow, I was essentially in a coma for almost a month, and I almost died,’ and he’s been pretty emotional about it, and that’s a good sign that the brain is healing properly,” Jeff said.

As with other kinds of diseases carried by insects, experts think that some people become infected but don’t get very sick because their immune systems are able to clear the virus.

“But in some appreciable fraction of cases, the virus is really able to replicate effectively in neurons and other cells in the brain, and that’s where you have this brain damage that can happen,” said Dr. Greg Ebel, a professor of microbiology, immunology and pathology at the Center for Vector-Borne Infectious Disease at Colorado State University.

Then, Ebel says, the immune system gets the message that something is going wrong in the brain and makes a slew of chemicals that aren’t supposed to be there to launch a counterattack.

“So there’s two problems: One is that the virus is killing neurons and other cells, and the other is that the immune system is kind of making things worse,” he said.

The result, as the Reagans have seen, can be devastating.

Powassan virus disease can be extremely serious, but because there are so few cases, there’s no commercial market to support the development of a vaccine or medicine to treat it. That makes government funding critical for research to develop tests, treatments and cures.

This year, both chambers of Congress passed the Kay Hagan Tick Reauthorization Act, named after the North Carolina senator who died of complications of Powassan in 2019. It is now awaiting votes on the final version. The act allocates $150 million over five years to researchers and local health departments as they work to address vector-borne diseases.

“America’s tick problem is growing and the size of the federal investment we make in combatting ticks needs to keep pace,” Sen. Jack Reed, a Democrat from Rhode Island and one of the bill’s co-sponsors, said in a statement. “The Kay Hagan Tick Act has already improved public health knowledge and prevention strategies, but we’ve got to do more.”

John Reagan has been off the breathing tube for a while but still gets most of his nutrition through a tube inserted into this abdomen.

Doctors had hoped he might be able to return home by the end of August, but new pain in his shoulder and back has scuttled that plan. For now, he’ll continue with rehab in the hospital.

Even with setbacks, there has been progress to celebrate. This week, doctors cleared John to eat ice cream, “which he was pretty happy about,” Jeff Reagan said . Coffee is one of his favorite flavors.

Jeff thinks his dad will still need the feeding tube after he comes home, at least for a while. They’ve also built a ramp in front of their house and installed grab bars to help him get around more easily.

But the Reagans know that John is one of the lucky ones: He’ll make it home.

约翰·里根退休后的头几个月过得很开心，五月初的时候，他从皮肤上拔出了一只蜱虫。

他没想太多。66岁的里根是一位退休药剂师，住在新罕布什尔州康科德，他热爱户外活动，经常打猎、钓鱼或带着儿子和女儿的狗——也就是“孙辈的狗”——去散步。

里根完全了解蜱虫叮咬的风险。莱姆病在他居住的地区很常见。由于携带病原体的蜱虫叮咬皮肤后大约需要36小时才能传播莱姆病，所以他回家后几乎立刻就把这只吸血的小虫子扯了下来，以为自己安全了。

然而，几周后，他开始出现类似流感的症状，包括头痛、全身酸痛、发烧、恶心和腹泻。五月中旬，他去了当地急诊室，但医生无法确定病因，只给他输液并开了止吐药就让他回家了。尽管如此，他的病情却持续恶化。

他的妻子怀疑他可能中风了。回到医院后，他失去了说话、行动甚至睁眼的能力。然而，检查结果呈阴性。他的家人询问这是否与几周前里根被蜱虫叮咬有关，得到的答复是否定的。

里根被转送到波士顿的麻省总医院，医护人员对他进行了一系列检查，包括蜱传疾病的筛查。他们将一份血液样本送往梅奥诊所的专门实验室进行检测。

6月9日，他的家人得知了他的诊断结果：波瓦桑病毒感染，这是一种罕见且严重的传染病，他几乎可以肯定是从那只几乎被人遗忘的蜱虫身上感染的。与莱姆病不同，波瓦桑病毒可以在大约15分钟内从蜱虫传播给人类。在此之前，他们从未听说过这种病毒。

蜱虫及其传播的疾病在美国越来越常见。在美国，约90%的叮咬疾病（包括蚊子叮咬）是由蜱虫引起的。

莱姆病的发病率正在上升，但据美国疾病控制与预防中心估计，它已经是目前最常见的蜱传疾病，每年病例近50万例。其他日益严重的蜱传疾病还包括α-半乳糖综合征，这是一种由孤星蜱叮咬引起的对肉类和其他动物产品的过敏反应。

波瓦桑病毒病极其罕见，据美国疾病控制与预防中心（CDC）统计，美国每年确诊和报告的病例不足100例。但近年来，随着携带该病毒的蜱虫数量增加，病例数也在不断上升。

“蜱虫的数量和分布范围都增加了，”马萨诸塞大学阿默斯特分校的微生物学家斯蒂芬·里奇博士说道。他运营着一家名为TickReport的蜱虫检测服务机构，公众可以通过该机构检测叮咬他们的蜱虫是否携带致病病原体。“当某种生物的数量增加，传播媒介增多时，病原体的数量也必然会增加。”

2025年，美国报告了76例人类感染波瓦桑病毒病的病例，创历史新高。其中10例死亡。

这种病毒最早由加拿大科学家在20世纪50年代发现。一个孩子和父亲一起猎杀土拨鼠后患上重病，导致脑肿胀。男孩不幸去世，最终科学家从他的脑组织中分离出这种病毒，并以他们一家居住的安大略省小镇的名字命名。

波瓦桑病毒由黑腿蜱或鹿蜱传播，与传播莱姆病的蜱虫属于同一种类。它是一种正黄病毒，与西尼罗河病毒和寨卡病毒属于同一科。

大约十分之一的病例会导致死亡。幸存者往往面临残疾问题：约一半患者会出现长期并发症。

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经历了过去几个月的恐惧和不确定，不知道是否还能找回他们的父亲之后，里根的家人迫切希望让人们意识到波瓦桑病毒的严重性。

约翰的儿子杰夫·里根说，由于没有特效药，保护人们的唯一方法是敦促他们了解这种疾病，并采取措施从一开始就防止蜱虫叮咬。

他说：“如果您或您的亲人最近被蜱虫叮咬，请务必寻求专业帮助。因为并非所有医务人员都了解波瓦桑病毒。”

约翰入院初期，脑水肿导致他呼吸停止。医生为他插入了呼吸管和喂食管，并接上了呼吸机，希望借助机器维持他的生命体征，为他在重症监护室的康复争取时间。

这个策略奏效了。将近一个月后，他醒了过来，开始恢复交流能力。他能听懂一些指令，但由于卧床太久，又出现了其他问题，包括血栓和肺炎。

医生们已经控制住了这些并发症，约翰的行动能力也在慢慢恢复。自七月初以来，他一直在波士顿的斯波尔丁康复医院接受治疗，在那里他正在努力恢复行走、说话和思考的能力。

“他想走路，他正在努力恢复协调性、平衡感和深度感知能力，”杰夫·里根说。

虽然看到父亲的康复进展令人鼓舞，但杰夫知道父亲还需要几个月的时间才能完全康复。

“这真是一段跌宕起伏的经历，”他说。“他取得了相当大的进步，尤其是在认知能力方面。”

杰夫说，他醒来的时候，他爸爸只是静静地听着，顺其自然。现在，那些情绪又回来了。

杰夫说：“现在我觉得他意识到，‘哇，我基本上昏迷了将近一个月，差点就死了’，他对此情绪非常激动，这是一个好兆头，表明他的大脑正在正常恢复。”

与其他昆虫传播的疾病一样，专家认为有些人感染了这种病毒，但并没有生病，因为他们的免疫系统能够清除病毒。

“但在相当一部分病例中，病毒确实能够在大脑中的神经元和其他细胞中有效复制，而这正是可能造成脑损伤的原因，”科罗拉多州立大学媒介传播传染病中心微生物学、免疫学和病理学教授格雷格·埃贝尔博士说。

埃贝尔说，然后免疫系统就会收到大脑出现问题的信号，并产生大量本不应该存在的化学物质来发起反击。

“所以现在有两个问题：一是病毒正在杀死神经元和其他细胞，二是免疫系统反而让情况变得更糟，”他说。

正如里根夫妇所见，其结果可能是毁灭性的。

波瓦桑病毒病可能非常严重，但由于病例极少，没有商业市场支持疫苗或治疗药物的研发。因此，政府资助对研发检测方法、治疗手段和治愈方法至关重要。

今年，国会两院通过了以北卡罗来纳州参议员凯·哈根（Kay Hagan）命名的《凯·哈根蜱虫防治再授权法案》。凯·哈根于2019年因波瓦桑病毒并发症去世。该法案目前正在等待最终版本的投票表决。该法案将在五年内拨款1.5亿美元，用于资助研究人员和地方卫生部门应对虫媒疾病。

“美国的蜱虫问题日益严重，联邦政府在防治蜱虫方面的投入也必须跟上步伐，”罗德岛州民主党参议员杰克·里德（Jack Reed）在一份声明中表示。里德是该法案的共同发起人之一。“《凯·哈根蜱虫防治法案》已经提高了公众的健康知识和预防策略，但我们必须做得更多。”

约翰·里根已经脱离呼吸机一段时间了，但他仍然通过插入腹部的导管获取大部分营养。

医生原本希望他能在八月底出院回家，但肩部和背部的新疼痛打乱了这一计划。目前，他将继续在医院进行康复治疗。

即便遭遇挫折，也取得了一些值得庆祝的进展。本周，医生允许约翰吃冰淇淋了，“他对此非常高兴，”杰夫·里根说道。咖啡是他最喜欢的口味之一。

杰夫认为他父亲回家后至少一段时间内还需要使用喂食管。他们还在房子前面建了一个坡道，并安装了扶手，以便他行动更方便。

但里根一家知道约翰是幸运儿之一：他一定会平安回家。