John Reagan, a 66-year-old retired pharmacist in Concord, New Hampshire, was diagnosed on June 9 with Powassan virus after a tick bite in early May left him unable to speak, move or even open his eyes. The bite came and went fast. The consequences didn’t.
Reagan had pulled a tick off his skin almost immediately after returning home and thought he was safe, but a few weeks later he developed flu-like symptoms that included a headache, body aches, a fever, nausea and diarrhea. He first went to a local emergency room in mid-May, where doctors gave him fluids and anti-nausea medications and sent him home after they could not identify the cause. His condition worsened, and his wife thought he might have been having a stroke.
Who Gets Left to Figure It Out
Back at the hospital, Reagan lost his ability to speak, move or even open his eyes, and tests were negative. His family asked whether the illness could be related to the tick bite, but 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, and sent a blood sample to a specialized lab at the Mayo Clinic. The diagnosis came on June 9: Powassan virus, a rare and serious infection he almost certainly caught from the tick. Unlike Lyme, Powassan virus can pass from a tick to a person in about 15 minutes.
That speed matters. So does the fact that the first round of care didn’t catch it. Reagan’s family said they want people to understand how serious Powassan virus can be. Jeff Reagan said there’s no specific treatment, so 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. "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."
A Rare Virus, A Growing Burden
Ticks and the diseases they carry are becoming more common in the United States. About 90% of all illnesses caused by a bite, including mosquitoes, are caused by ticks. Lyme disease is on the rise and 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. In 2025, 76 human cases were reported in the U.S., an all-time high, and 10 of those were fatal. The virus was first identified by Canadian scientists in the 1950s after 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, and about half of patients have long-term complications. That’s the kind of math ordinary people get handed when a tiny parasite meets a medical system that often doesn’t recognize the threat until the damage is already done.
Machines, Rehab and the Long Haul
Early in John Reagan’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. 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 since early July Reagan has been at Spaulding Rehabilitation Hospital in Boston, where he’s been working on walking, talking and thinking properly again. Jeff Reagan said, "He wants to walk, and he’s trying to get his coordination and balance and depth perception back." He also said, "It’s been a roller coaster. He has made some pretty good progress, especially with his cognition." As Reagan 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.
Dr. Greg Ebel, a professor of microbiology, immunology and pathology at the Center for Vector-Borne Infectious Disease at Colorado State University, said 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," he said. He added, "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."
What the State Funds, and What It Doesn’t
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.
Sen. Jack Reed, a Democrat from Rhode Island and one of the bill’s co-sponsors, said in a statement, "America’s tick problem is growing and the size of the federal investment we make in combatting ticks needs to keep pace." He added, "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 his 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. This week, doctors cleared John to eat ice cream, which Jeff Reagan said he was pretty happy about, and coffee is one of his favorite flavors. Jeff said he thinks his dad will still need the feeding tube after he comes home, at least for a while. The family has built a ramp in front of their house and installed grab bars to help him get around more easily. The Reagans know John is one of the lucky ones: He’ll make it home.