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Meet the Heartland Virus

Clinician's Brief (Capsule)

Infectious Disease

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April 2014

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In 2009, 2 humans in Missouri were admitted to a regional hospital with ehrlichiosis-like symptoms. A pathogenic Phlebovirus was isolated from both patients during blood culture for Ehrlichia chaffeensis and named Heartland virus (HRTV). In 2012, 56,428 ticks representing 3 species were collected from 12 sites in Missouri, including both patients’ farms. Project goals included testing arthropods (ie, ticks, mosquitos) to determine if HRTV persisted at the 2 case patients’ residences, to describe its potential arthropod vectors, and to determine its geographic distribution and prevalence in potential vector species.

Amblyomma americanum (Lone Star tick) represented 97.5% of ticks collected. Dermacentor variabilis (American dog tick) was the second most commonly collected tick at 2.5% of ticks collected. Ten pools of deplete A americanum nymphs tested positive for HRTV; 8 pools yielded viable viruses. Sequence data indicated more than 97.6% sequence similarity between tick and human strains. A americanum likely feeds on viremic hosts during the larval stage, and transmission to humans occurs during the spring or early summer when nymphs are actively host seeking.

Commentary

The novel Phlebovirus HRTV is closely related to a sister Phlebovirus, severe fever with thrombocytopenia syndrome virus (SFTSV), and with a putative tick vector. Despite the geographic disparity and few identified clinical cases, this attests to the plasticity of ticks and tick species as disease vectors and the enormous adaptability of their viruses. It is likely that more HRTV and SFTSV cases are forthcoming and possible that affected individuals might harbor subclinical infection. Large-scale studies may better characterize the viral epidemiology of many of these novel emergent viruses.—Indu Mani, DVM, DSc, FNAP

Source

First detection of heartland virus (Bunyaviridae: Phlebovirus) from field collected arthropods. Savage HM, Godsey MS, Lambert A, et al. AM J TROP MED HYG 89:445-452, 2013.

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