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. The virus has been found in the Lone Star tick (Amblyomma americanum).

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.

Specific tests for recent infection with Heartland virus include detection of viral RNA by reverse transcriptase PCR in blood or tissue or a 4-fold or greater rise in antibody titers between acute and convalescent serum specimens by virus-specific plaque reduction neutralization.