For Healthcare Providers

Clinical Evaluation & Disease

Heartland virus is a Bandavirus first discovered as a cause of human illness in 2009 in Missouri. It is an RNA virus that is transmitted by the Lone Star tick (Amblyomma americanum). It is most similar to severe fever with thrombocytopenia syndrome (SFTS) virus, which has been identified in Asia and is transmitted by ticks.

Initial symptoms of Heartland virus disease are very similar to those of ehrlichiosis, which include fever, fatigue, anorexia, nausea and diarrhea. Cases have also had leukopenia, thrombocytopenia, and mild to moderate elevation of liver transaminases. Heartland virus disease should be considered in patients being treated for ehrlichiosis who do not readily respond to treatment with doxycycline.

Heartland virus disease cases have been identified in adults, most of whom had illness onset during May-September. Most patients reported exposure to ticks in the two weeks prior to illness onset. As of January 2021, more than 50 cases of Heartland virus disease have been identified in states in the Midwestern and Southern United States.

Diagnostic Testing

Molecular and serologic testing for Heartland virus infection can be performed at CDC. There are no commercially available tests for Heartland virus infection in the United States. Please contact your state health department if you have a patient with an acute illness that might be compatible with Heartland virus disease.

Treatment & Prevention

Treatment of Heartland virus disease is supportive. Many patients diagnosed with the disease have required hospitalization. With supportive care, most people have fully recovered; however, a few older individuals with medical comorbidities have died.

The best way to prevent Heartland virus infection is to avoid exposure to ticks. Protective actions people can take include avoiding wooded and bushy areas with high grass, using repellents, and finding and removing ticks before they attach. More information about reducing exposure to ticks is available on the CDC ticks website.