Heartland Virus Spreads East: Human Death in Mid-Atlantic
Emerging Infectious Diseases (Liu, S., et al.) 5.23, published “Fatal Case of Heartland Virus Disease Acquired in the Mid-Atlantic Region, United States.” The article describes a reported fatal case of Heartland virus (HRTV) in the Maryland and Virginia region, states that are generally not recognized as having human HRTV disease cases.
HRTV, a bandavirus, is spread by Amblyomma americanum (lone star) ticks in midwestern and southern regions of the U.S. Most cases involve severe illness or death− primarily men under 50 and with multiple comorbidities. Reporting indicates the majority of hospitalized patients recover; however, deaths associated with secondary hemophagocytic lymphohistiocytosis (HLH) have occurred.
According to CDC, since HRTV’s 2009 discovery in Missouri, human cases have been documented in Kansas, Oklahoma, Arkansas, Tennessee, Kentucky, Indiana, Illinois, Iowa, Georgia, Pennsylvania, New York, and North Carolina. Lone star distribution has been expanding, which may lead to HRTV spread.
Vertebrate animals with neutralizing antibodies to HRTV have been documented in Texas, Florida, South Carolina, southern Louisiana, Vermont, New Hampshire, and northeast Maine−none from Maryland or Virginia. The case fatality was caused by an initial infection that likely occurred in Maryland or Virginia.
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