About Heartland Virus Disease
Heartland virus is a bandavirus, an RNA virus related to the severe fever with thrombocytopenia syndrome virus of East Asia. It was discovered when 2 Missouri farmers were hospitalized in 2009 with fever and low blood counts that did not respond to antibiotics. Since then it has been found in lone star ticks across much of the eastern half of the country, and antibodies have been found in deer, raccoons and other wildlife, which means the virus is far more widespread than the small number of recognized human cases.
The illness is hard to tell apart from ehrlichiosis, which is spread by the same tick: fever, fatigue, headache, muscle pain, low white cells, low platelets and raised liver enzymes. Doctors usually start doxycycline on that picture, which is correct, and Heartland virus becomes the question when the patient does not get better. The CDC's testing criteria are a fever with tick exposure in the previous 3 weeks plus a low white count or low platelets, or no response to doxycycline. Some patients need hospital care, and deaths have occurred in people with weakened immunity or several other illnesses.
There are no commercial tests. Blood samples go through the state health department to the CDC's Arbovirus Diagnostic Laboratory for PCR and antibody testing, and the CDC notes that some tests are not always available, so the state lab is the place to start. Treatment is supportive: fluids, fever control and hospital care when needed. Antibiotics do not treat viruses, and there is no vaccine.
Common Symptoms of Heartland Virus Disease
Recognizing the signs of Heartland Virus Disease early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Fever and fatigue, a few days to several weeks after a tick bite
- Headache, muscle and joint pain
- Loss of appetite, nausea and diarrhea
- Low white blood cells and low platelets on blood tests
- Raised liver enzymes
- Rarely, a severe overactive immune reaction (hemophagocytic lymphohistiocytosis) or death, mainly in people with other serious illnesses
Who Heartland Virus Disease Affects
Adults who live in, work in or visit areas where lone star ticks are common, particularly people who spend time outdoors for work or recreation. Almost all cases have been diagnosed between May and September. People with weakened immune systems or several other health conditions have had the most severe illness.
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Diagnosis and Testing
Tick-borne viral infection, diagnosed by PCR and antibody tests at the CDC; not genetic.
Trusted Heartland Virus Disease Resources
Reputable organizations and medical references for learning more about Heartland Virus Disease, including disease registries, foundation resources, and clinical guidelines.