Health officials report Heartland virus disease caused the death of a man in Virginia — a region not previously known to have the tickborne illness.
Cases of tickborne illnesses like Lyme disease have steadily increased in the United States. In fact, Lyme disease is currently the most commonly reported tickborne illness, with about 20,000 to 30,000 confirmed cases reported per year.
Now, the CDC has alerted to another possible concern related to Heartland virus (HRTV) — a new disease carried by ticks in the midwestern and southern regions of the U.S.
In an Emerging Infectious Diseases article published on February 23, the CDC reports that although HRTV has been reported in states across the midwestern and southern regions of the U.S., an investigation confirmed that an older adult in Virginia died as a result of HRTV infection from a tick bite.
Health officials say that the Maryland and Virginia region is already known to have lone star ticks (A. Americanum) — the tick species that carry the disease — but no previous cases of HRTV have been reported in the regions.
According to the study, a man in his late 60s with homes in Maryland and Virginia visited the emergency department in November 2021 for symptoms including fever, diarrhea, muscle aches, and fatigue. The individual had not been outside these regions in the previous three months but had spent time outdoors on his properties.
At the time, healthcare providers suspected a tickborne illness and treated the man with doxycycline. However, after a series of setbacks, the man’s condition deteriorated, and he died 13 days after the initial symptoms began.
To investigate, the Virginia Department of Health (VDH) sent serum samples to the CDC for testing. The test results confirmed that the man was positive for HRTV.
The VDH then performed tick drags at the man’s two properties, collecting 193 ticks in total. Although they all tested negative for the disease, study authors say this does not mean the region is HRTV-free.
"We suspect the Virginia property was the likely location of infection, based on the number of ticks VDH collected while sampling an area that the patient frequented 10–14 days before symptom onset and because fewer ticks were collected from the Maryland property," the study authors wrote.
The authors also note that because tick ranges are increasing overall, the incidence of previously regional tickborne infections, such as HRTV, will likely continue to rise.
What is the Heartland virus?
Spread by the lone star tick, the Heartland virus disease was first identified in 2009 in Missouri. Since then, the disease has been reported in Indiana, Illinois, Kansas, Oklahoma, Kentucky, Iowa, Arkansas, Tennessee, Georgia, Pennsylvania, New York, and North Carolina.
After a few days to two weeks after an infected tick bite, a person may experience symptoms including fever, fatigue, headache, nausea, joint and muscle pain, and reduced appetite. In addition, the illness can cause low white blood cell and platelet counts.
Although there are no medications to prevent or treat HRTV, rest, fluids, and over-the-counter pain medications can help relieve some of the symptoms.
Still, some people with HRTV may need hospitalization to receive intravenous (IV) fluids and supportive care.