Surveillance report tracks Heartland virus transmission across tick vectors and mammalian hosts, highlighting expanding geographic distribution into the northeastern United States.
H eartland virus (HRTV; Phenuviridae, Bandavirus) is an emerging human pathogen initially isolated from patients in Missouri, USA, during 2009 (1). Since then, >50 known human cases have been identifi ed in Arkansas, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Missouri, North Carolina, Oklahoma, and Tennessee (2-5). Amblyomma americanum, the lone star tick, has been implicated in HRTV transmission and maintenance (6-8). Small-sized and mediumsized mammals and ground dwelling birds, such as wild turkeys (Meleagris gallopavo), serve as hosts for immature ticks. Adult ticks feed primarily on large mammals, such as coyotes (Canis latrans) and whitetailed deer (Odocoileus virginianus). Ticks at all 3 active developmental stages will bite humans (9). Serologic evidence in mammal hosts, including white-tailed deer, indicates that HRTV is distributed primarily in the Midwest and southeast United States, as well as the northeastern Atlantic coast (10-12).
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