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Heartland Virus

Heartland virus is a newly identified phlebovirus that was first isolated from two northwestern Missouri farmers hospitalized with fever, leukopenia, and thrombocytopenia in 2009. Six cases were confirmed during 2012–2013. Five patients were Missouri residents and one was a Tennessee resident. Four of the patients were hospitalized and one died. Heartland virus is believed to be transmitted through infected ticks or other arthropods. (Pastula DM, etal. Notes from the Field: Heartland Virus Disease — United States, 2012–2013, MMWR Weekly, March 28, 2014 / 63(12);270-271).

In a recent study, 56,428 ticks were collected in northwest Missouri for analysis. Lone Star ticks (Amblyomma americanum) were the most common species identified and nymph stage Lone Star ticks were found to harbor the Heartland virus (Savage HM, Godsey MS Jr, Lambert A, et al. First detection of heartland virus (Bunyaviridae: Phlebovirus) from field collected arthropods. Am J Trop Med Hyg 2013;89:445–52).

Patients infected with Heartland virus typically present with fever, leukopenia and thrombocytopenia. Nonspecific findings include fatigue, anorexia, headache, nausea, myalgia, or arthralgia. These findings mimic the signs and symptoms of Ehrlichia and Anaplasma infection which need to be ruled out. Unlike these infections, patients with Heartland virus do not respond to doxycycline therapy. No vaccine or medication is available to prevent or treat Heartland virus disease.

Currently, testing for Heartland virus is only available through enrollment in a CDC clinical trial. Consultation with an infectious disease specialist is recommended, if Heartland virus infection is suspected.

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