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Heartland virus
Epidemiology:
- first identified in Missouri in 2009,
- cases reported in Midwestern & southern states
- transmitted bu Lone Star tick
- two cases in 2012, both occurring after exposure to ticks on farmland in Missouri
- Lone star ticks are common in Missouri, & in genera in the South & the Atlantic coast of the U.S.
- virus is circulating in lone star ticks in Georgia, 2021 [3]
Clinical manifestations:
- headache, myalgia, arthragia, fatigue, malaise, anorexia, fever
- nonbloody diarrhea
- clinically indistinguishable from Ehrlichiosis [2]
Laboratory:
- complete blood count; thrombocytopenia, leukopenia
- elevated serum AST & serum ALT
Differential diagnosis:
- Ehrlichiosis responds rapidly to doxycycline with fever defervescence [2]
Management:
- doxycycline not effective
General
phlebovirus
Properties
KINGDOM: virus
GENOME-TYPE: RNA
SINGLE-STRANDED
NEGATIVE-STRAND
CIRCULAR
GENOME-SIZE: 13-21 kB
ENVELOPE: PRESENT
CAPSID-SYMMETRY: HELICAL
References
- Physician's First Watch, Aug 30, 2012
Massachusetts Medical Society
http://www.jwatch.org
- McMullan LK et al
A New Phlebovirus Associated with Severe Febrile Illness
in Missouri
N Engl J Med 2012; 367:834-841August 30, 2012
http://www.nejm.org/doi/full/10.1056/NEJMoa1203378
- Medical Knowledge Self Assessment Program (MKSAP) 19.
American College of Physicians, Philadelphia 2021
- Crist C
Tick-Borne Heartland Virus Circulating in US, Researchers Say.
Medscape. March 24, 2022
https://www.medscape.com/viewarticle/970910
- Romer Y, Adcock K, Wei Z, et al.
Isolation of Heartland Virus from Lone Star Ticks, Georgia, USA, 2019.
Emerging Infectious Diseases. 2022;28(4):786-792.
https://wwwnc.cdc.gov/eid/article/28/4/21-1540_article