Investigation of Heartland Virus Disease Throughout the United States, 2013–2017

BackgroundHeartland virus (HRTV) was first described as a human pathogen in 2012. From 2013 to 2017, the Centers for Disease Control and Prevention (CDC) implemented a national protocol to evaluate patients for HRTV disease, better define its geographic distribution, epidemiology, and clinical chara...

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Veröffentlicht in:Open forum infectious diseases Jg. 7; H. 5; S. ofaa125
Hauptverfasser: Staples, J Erin, Pastula, Daniel M, Panella, Amanda J, Rabe, Ingrid B, Kosoy, Olga I, Walker, William L, Velez, Jason O, Lambert, Amy J, Fischer, Marc
Format: Journal Article
Sprache:Englisch
Veröffentlicht: US Oxford University Press 01.05.2020
Schlagworte:
Illnesses
Infections
Leukopenia
Major
Thrombocytopenia
Heartland virus
phlebovirus
tickborne diseases
ISSN:2328-8957, 2328-8957
Online-Zugang:Volltext
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Zusammenfassung:BackgroundHeartland virus (HRTV) was first described as a human pathogen in 2012. From 2013 to 2017, the Centers for Disease Control and Prevention (CDC) implemented a national protocol to evaluate patients for HRTV disease, better define its geographic distribution, epidemiology, and clinical characteristics, and develop diagnostic assays for this novel virus.MethodsIndividuals aged ≥12 years whose clinicians contacted state health departments or the CDC about testing for HRTV infections were screened for recent onset of fever with leukopenia and thrombocytopenia. A questionnaire was administered to collect data on demographics, risk factors, and signs and symptoms; blood samples were tested for the presence of HRTV RNA and neutralizing antibodies.ResultsOf 85 individuals enrolled and tested, 16 (19%) had evidence of acute HRTV infection, 1 (1%) had past infection, and 68 (80%) had no infection. Patients with acute HRTV disease were residents of 7 states, 12 (75%) were male, and the median age (range) was 71 (43–80) years. Illness onset occurred from April to September. The majority reported fatigue, anorexia, nausea, headache, confusion, arthralgia, or myalgia. Fourteen (88%) cases were hospitalized; 2 (13%) died. Fourteen (88%) participants reported finding a tick on themselves in the 2 weeks before illness onset. HRTV-infected individuals were significantly older (P < .001) and more likely to report an attached tick (P = .03) than uninfected individuals.ConclusionsHealth care providers should consider HRTV disease testing in patients with an acute febrile illness with either leukopenia or thrombocytopenia not explained by another condition or who were suspected to have a tickborne disease but did not improve following appropriate treatment.
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ISSN:2328-8957
2328-8957
DOI:10.1093/ofid/ofaa125