Heartland Virus Cases: What We Know from 10 Patients
Heartland virus cases are increasing, yet this potentially deadly tick-borne illness remains poorly understood.
Symptoms overlap with other tick-borne illnesses, including fever, headache, muscle and joint pain, fatigue, loss of appetite, and diarrhea.
Patients typically become ill about two weeks after a tick bite. There is currently no widely available diagnostic test, no vaccine, and no specific antiviral treatment.
Heartland Virus Cases Reviewed
Since 2012, more than 35 Heartland virus cases have been reported in the Midwest and southern United States.
A review by Brault and colleagues examined 10 reported cases.
Most infections occurred between April and September, with peak illness in June. The median patient age was 66 years.
“All ten patients presented with acute onset of fever,” the authors note. Rash was uncommon and typically limited to the tick bite site.
Clinical Presentation and Outcomes
Several patients developed confusion or altered mental status.
Of the 10 cases reviewed:
- 8 required hospitalization
- 7 recovered
- 3 died
Two of the three fatal cases involved patients with significant underlying medical conditions.
Laboratory Findings
All patients had thrombocytopenia, and most had leukopenia.
These findings overlap with ehrlichiosis, another tick-borne illness. However, ehrlichiosis responds to antibiotics, while Heartland virus does not.
A lack of response to antibiotics may help distinguish Heartland virus from treatable bacterial infections.
Many Questions Remain
More than a decade after its discovery, key aspects of Heartland virus remain unclear, including its full geographic spread and true disease burden.
As the authors conclude, the overall risk to human health is still not fully defined.
Frequently Asked Questions
How many Heartland virus cases have been reported?
More than 35 cases have been reported since 2012, primarily in the Midwest and southern United States.
What are the symptoms of Heartland virus?
Symptoms include fever, fatigue, headache, muscle and joint pain, loss of appetite, diarrhea, and sometimes confusion.
How is Heartland virus different from ehrlichiosis?
Both can cause low platelet and white blood cell counts. However, ehrlichiosis responds to antibiotics, while Heartland virus does not.
Who is most at risk for severe disease?
Older adults and those with underlying medical conditions appear to be at higher risk for severe outcomes.
Related Articles:
Heartland Virus: Fatal Case
Bourbon Virus
Powassan Virus
← Back to Co-infections Hub
References:
- Pastula DM, et al. Heartland Virus Disease — United States. MMWR. 2014.
- CDC. Heartland Virus Statistics.
- Brault AC, et al. Heartland Virus Epidemiology. Viruses. 2018.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
According to Dr. Daniel Cameron, MD, MPH, a nationally recognized expert on ticks, there are many tick-borne infections that pose a threat to humans and dogs. Below are some of the well known and recently surfaced tick-borne illnesses.
According to Dr. Daniel Cameron, MD, MPH, a nationally recognized expert on ticks, there are many tick-borne infections that pose a threat to humans and dogs. Below are some of the well known and recently surfaced tick-borne illnesses.
I had a severe case of Heartland tick Virus July 2017. I had horrible tremors, hemorrragic diarrhea, headache high fever, the worse nausea of my life. I had hallucinations and confusion from the Ativan they gave to try and decrease the nausea. Lab work horrible , very low platelets, wbc, and renal failure. Have bouts of exhaustion, and my memory has never been the same. In all the literature search I find nothing about long term effects. I have not regained my previous energy, a lot of days feel ill and my brain does not work as well.
I have also not read about long term effects. I typically look for treatable tick-borne infections if I have evidence of a tick-borne infection e.g. Poowassan virus.
My husband had a severe case of heartland virus last July and also developed HLH. His short term memory is non existent and he also says “my brain doesn’t work right” He has seen his regular doctor (after discharge from hospital) who referred us to neurologist when we mentioned the cognitive decline, but the neurologist ignored his complaints. We are at a loss on where to turn for help…it’s been almost a year now and he is not able to return to work do to the cognitive impacts from this virus. Have you had any luck with a physician that’s is knowledgeable on this virus?
I would advise my patients to revisit Lyme disease. A positive Heartland virus suggests a tick borne infection. The tests for these tick borne infections may not be positive. I would have had to consider antibody treatment even if the tests are negative.
According to Dr. Daniel Cameron, MD, MPH, a nationally recognized expert on ticks, there are many tick-borne infections that pose a threat to humans and dogs. Below are some of the well known and recently surfaced tick-borne illnesses.
According to Dr. Daniel Cameron, MD, MPH, a nationally recognized expert on ticks, there are many tick-borne infections that pose a threat to humans and dogs. Below are some of the well known and recently surfaced tick-borne illnesses
As of 12/7/22, the CDC lists the following disease at https://www.cdc.gov/ticks/diseases/index.html
Anaplasmosis Babesiosis Borrelia mayonii Borrelia miyamotoi Bourbon virus Colorado tick fever Ehrlichiosis Heartland virus Lyme disease Powassan disease Rocky Mountain spotted fever (RMSF) STARI (Southern tick-associated rash illness) Tick-borne relapsing fever (TBRF) Tularemia 364D rickettsiosis (Rickettsia phillipi, proposed)
According to Dr. Daniel Cameron, MD, MPH, a nationally recognized expert on ticks, there are many tick-borne infections that pose a threat to humans and dogs. Below are some of the well known and recently surfaced tick-borne illnesses.