The Heartland Virus, a Potentially Fatal Tickborne Illness, Has Been Discovered in Multiple States

Photo credit: Mironmax Studio - Getty Images
Photo credit: Mironmax Studio - Getty Images

A potentially deadly tickborne illness that’s usually found in the midwest is suddenly getting attention after it was detected in ticks in Georgia. Researchers studied ticks in the state for the virus after a Georgia resident reportedly died of the disease.

The study, which was published in Emerging Infectious Diseases, sampled 9,294 Amblyomma americanum ticks (aka lone star ticks) in 26 sites in Georgia between 2018 and 2019. The study’s researchers found the presence of Heartland virus in two different pools of ticks.

“Clinicians and public health professionals should be aware of this emerging tickborne pathogen,” the researchers concluded.

“This study confirms the presence of the virus in Georgia and, more importantly, that it is being transmitted by the most abundant tick species that bites humans in the state,” says study co-author Gonzalo M. Vazquez-Prokopec, Ph.D., an associate professor of environmental sciences at Emory University.

Vazquez-Prokopec points out that genomic sequences of the virus in the state’s tick collection sites and other states found that the Heartland virus sequences in Georgia “are quite distinct from other locations.” This, he says, “may indicate that the virus has been circulating in the state isolated from other locations.”

Heartland virus isn’t as well-known as other tickborne illnesses like Lyme disease but it can be serious. Here’s what you need to know about this virus.

What is Heartland virus, exactly?

Heartland virus is an illness that’s usually spread through the bite of an infected lone star tick. Most people who are infected with the virus develop the following symptoms, per the Centers for Disease Control and Prevention (CDC):

  • Fever

  • Fatigue

  • Decreased appetite

  • Headache

  • Nausea

  • Diarrhea

  • Muscle or joint pain

While it’s possible to have a more mild infection, many people with Heartland virus are hospitalized because of their symptoms, the CDC says.

Heartland virus can also cause people to develop lower-than-normal white blood counts (which blood cells help your body fight infections) and lower-than normal counts of platelets, which help your blood clot, per the CDC.

Where is Heartland virus usually found?

Heartland virus is a “recently defined virus,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. Meaning, it’s pretty new to doctors and researchers. In fact, it was first detected in two Missouri farmers in 2009.

As of January 2021, there have been more than 50 cases of Heartland virus diagnosed in the U.S. It’s specifically shown up in these states, per CDC data:

  • Arkansas

  • Georgia

  • Illinois

  • Indiana

  • Iowa

  • Kansas

  • Kentucky,

  • Missouri

  • North Carolina

  • Oklahoma

  • Tennessee

But, Dr. Schaffner says, it's possible the virus is even more widespread. “We’re now starting to do studies and discovering that it’s there,” he says.

How did Heartland virus spread to humans?

Heartland virus belongs to the viral genus Bandavirus, which includes other tickborne illnesses, the CDC says. While research has shown that it’s usually spread by the lone star tick, it’s not known at this point if other types of ticks can spread the virus or if people can be infected with Heartland virus in other ways.

Worth noting, per the CDC: Symptoms can take up to two weeks to appear after you’ve been bitten by an infected tick.

How is Heartland virus diagnosed?

It can be tricky to diagnose, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. “Heartland virus is really easily confused with all sorts of other health conditions,” he says. “It’s a really non-specific viral presentation in most individuals.” Meaning, doctors could easily confuse Heartland virus with anything from a stomach bug to other tickborne illnesses, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.

It’s also pretty much impossible for your doctor to diagnose you with Heartland virus just from examining you in their office. “This is not something that can be diagnosed clinically,” Dr. Adalja says.

Dr. Russo agrees. Heartland virus is “poorly recognized,” he says, adding, “if you don’t think about it, you won’t detect it.”

The diagnosis has to be made with specific tests that can be done by the CDC—and there are no commercially available tests for Heartland virus in the U.S., the CDC says. In fact, the agency directs doctors who suspect that their patient may have Heartland virus to contact their state health department about next steps.

One way that doctors may be able to tell symptoms of Heartland virus from an illness like the flu or a respiratory virus is that it doesn’t tend to happen in the winter, Dr. Schaffner says. “It’s usually a spring, summer, early fall kind of virus,” he points out.

How is Heartland virus treated?

That is also tricky. “There is no specific treatment,” says Richard Watkins, M.D., an infectious disease physician in Akron, Ohio, and a professor of internal medicine at the Northeast Ohio Medical University. Instead, Dr. Schaffner says, doctors try to give patients supportive care to help treat their symptoms.

The CDC points out that most people “have fully recovered” with supportive care, although a few older patients with underlying health conditions have died from the virus.

How concerned about this should people be?

Heartland virus can be serious, and experts say it’s important to at least be aware that it exists if you happen to live in an area where ticks are common. In fact, Vazquez-Prokopec notes that “most people found infected were hospitalized or died.”

However, he says, given that testing is hard to come by “the level of transmission to humans is unknown.”

“Lone star ticks are the most important tick species biting people in Georgia—and most of the southeast U.S.A.—and our findings contribute to the understanding of a pathogen that is poorly known and that could become a public health problem as people spend more time outdoors, either recreationally or occupationally,” Vazquez-Prokopec says.

How to protect yourself from Heartland virus

“The best way to protect yourself from Heartland virus is to try to protect yourself from tick bites,” Dr. Russo says. “Precautions against getting bitten by ticks is prudent for not only Heartland virus but also for a wide range of illnesses.”

To lower the risk you’ll be bitten by a tick, the CDC recommends doing the following:

  • Treat your clothes and gear with products containing 0.5% permethrin before going into tick-infested areas like grassy, brushy, or wooded areas.

  • Use EPA-registered tick repellents that contain DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone.

  • Try to avoid wooded and brushy areas with high grass and leaf litter.

  • Walk in the center of trails.

  • Check your clothes and your body for ticks after you come indoors.

  • Wash your clothes in hot water and tumble dry clothes in a dryer on high heat for 10 minutes after you come indoors, if possible.

  • Shower within two hours of coming inside after being outdoors.

“We want to make the public aware of the importance of protecting themselves against tick bites, particularly the lone star tick, given that there is an additional risk of infection with this novel virus,” Vazquez-Prokopec says. “As spring season progresses, ticks become more active and the risk of exposure increases.”

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