What Do I Need to Know?
Heartland virus belongs to a family of viruses called Phleboviruses. Viruses in this family are found all over the world. Some of these viruses can cause people to get sick. Most of the phleboviruses that cause people to become ill are passed through the bite of a mosquito, tick, or sandfly.
It is not yet fully known how people become infected with Heartland virus. However, recent studies suggest that ticks, namely Lone Star ticks, may transmit the virus.
As of March 2014, eight cases of Heartland virus disease have been identified among residents of Missouri and Tennessee. It is unknown at this time if the virus may be found in other areas of the United States.
Since Heartland virus disease was first described in 2012 and there have only been a few cases, scientists are still learning about it. So far, all patients diagnosed with Heartland virus disease became sick during May-September. They all had a fever and felt very tired. Some also complained of headaches, muscle aches, diarrhea, losing their appetite, or feeling sick to their stomach. They all had low numbers of cells that fight infection and that help blood clot. Most patients required hospitalization for their illness. Most patients fully recovered, but one patient died.
People likely become infected with Heartland virus through a bite of a tick or other insect. Therefore, people who work or do activities outside, where they are exposed to ticks or insects, may be more likely to be infected.
There is no vaccine or drug to prevent or treat the disease. Preventing bites from ticks and mosquitoes may prevent this and other infections.
- Use insect repellents
- Wear long sleeves and pants
- Avoid bushy and wooded areas
- Perform thorough tick checks after spending time outdoors
Additional information on reducing exposure to ticks is available on the CDC Ticks website.
Currently, no tests are routinely available to tell if a person is infected with Heartland virus. Tests that will help a doctor diagnose Heartland virus infection are being developed. Consult your healthcare provider if you have any symptoms that concern you.
There is no specific treatment for Heartland virus disease. Antibiotics are not effective against viruses. Supportive therapy can treat some symptoms. Some patients may need to be hospitalized for intravenous fluids, and treatment for pain or fever.
Consult your healthcare provider for proper diagnosis if you have any symptoms that concern you.
It is not yet known what animals can get infected or become ill from Heartland virus. Studies are ongoing to look at this. Consult your veterinarian if your pet or livestock have any symptoms that concern you.
Heartland virus is a novel phlebovirus that was recently discovered in Missouri. It is an RNA virus in the same genus as Rift Valley fever, Sandfly fever, Toscana, and Severe fever with thrombocytopenia syndrome (SFTS) viruses.
All of the Heartland virus disease cases that have been identified were in males aged 50 years or older who had symptom onset during May-September. Most patients reported exposure to ticks before becoming unwell. Disease cases have been identified in Missouri and Tennessee.
Clinical Signs and Symptoms
Cases presented with fever, fatigue, anorexia, nausea, or diarrhea. They also had leukopenia, thrombocytopenia, and mildly to moderately elevated liver transaminases. Based on their clinical signs and symptoms cases were initially thought to have ehrlichiosis. They were given doxycycline but failed to improve clinically.
Treatment and Outcome
There are no available medications or therapies. With supportive care, most cases have fully recovered. However, one elderly patient with multiple comorbidities died.
There is no routine testing available for Heartland virus. However, protocols are in place for investigational diagnostic testing. Please contact your state health department if you have a patient with an acute illness that may be compatible with Heartland virus infection.
- Missouri Department of Health and Senior Services. Heartland virus -- What do I need to know? [PDF - 2 pages]
- McMullan LK, Folk SM, Kelly AJ. et al. A novel phlebovirus associated with severe febrile illness in Missouri. N Eng J Med 2012;367:834-41.
- Savage HM, Godsey MS, Lambert A, et al. First detection of Heartland virus (Bunyaviridae: Phlebovirus) from field collected arthropods. Am J Trop Med Hyg 2013;89:445-52.
- Pastula DM, Turabelidze G, Yates KF, et al. Heartland Virus Disease — United States, 2012–2013. MMWR 2014;63:270-71