Heartland Virus

Also Known As SFTS or SFTSV

(Severe Fever with Thrombocytopenia Syndrome Virus)

Heartland virus (aka SFTS), thought to be caused by a bunyavirus, was named for the Heartland Regional Medical Center in St. Joseph, MO, where it was first discovered. The two Missouri men discovered to have contracted the virus were hospitalized for nearly two weeks and it took a couple of months for them to recover. One man says he still has problems with short-term memory, fatigue and headaches three years after the initial infection.

The virus is reported to cause a fever, lymph node swelling, multi-organ dysfunction, altered consciousness, diarrhea, leucocytopenia, and a condition known as thrombocytopenia (bleeding on skin surface or internally). Patients can present with red/purple spots on their skin (petechiae) or bruises (purpura or ecchymosis). There is reported to be a high fatality rate (12%- CDC).

The virus has been discovered in lone star and other ticks in the United States and China. It can be transmitted from human to human through a patients infected blood and mucous.

General information about thrombocytopenia can be found below. Excerpts from scientific articles on the Heartland virus are as follows:

"A small tick Haemaphysalis longicornis called 'Sochamjindeugi' in Korean has bitten a week before, and an onset is characterized by fever, lymph node swelling, diarrhea, thrombocytopenia, leucocytopenia, multiorgan dysfunction, altered consciousness, and occasionally to death in extreme cases (1, 2). This emerging febrile disease, severe fever with thrombocytopenia syndrome (SFTS), was reported in 2007 by the New England Journal of Medicine (3) and Clinical Infectious Diseases (4-6). The etiology of SFTS turned out to be the SFTS virus. Yet most physicians are not familiar with this disease, and initially it is difficult to differentiate from other febrile illnesses (7-9)."

CDC- "We conclude that subclinical SFTSV infections or a relatively mild form of SFTS illness may occur in humans; however, more research is needed."

CDC- "These findings demonstrate that natural infections of SFTSV occur in several domesticated animal hosts in disease-endemic areas and that the virus has a wide host range."

CDC- "The common signs and symptoms of SFTS include high fever, gastrointestinal symptoms, thrombocytopenia, leukocytopenia, and multiorgan dysfunction with an average case-fatality rate of 10%–16%, according to the information system for disease control and prevention, Chinese Center for Disease Control and Prevention (China CDC). In severe SFTS cases, neural symptoms, hemorrhages, disseminated intravascular coagulation, and multiorgan failure can occur and may result in death (2)."

CDC- "The role of domesticated animals in the circulation and transmission of SFTSV remains unclear."

CDC- "We sampled 472 sheep, 842 cattle, 359 dogs, 839 pigs, and 527 chickens in Laizhou and Penglai counties to assess the prevalence of SFTSV RNA and antibodies. Our results showed that 3.8% (18/472) of sheep, 4.2% (35/842) of cattle, 5.3% (19/359) of dogs, 2.6% (22/839) of pigs, and 1.7% (9/527) of chickens were viral RNA-positive."

CDC- "In conclusion, we have provided evidence to show that SFTSV is circulating among several species of domesticated animals and between animals and humans in disease-endemic areas of China."


What is thrombocytopenia?

Thrombocytopenia is a condition in which the body does not have a normal number of platelets in the blood.

Blood is made up of three major cell types: red blood cells, which carry oxygen throughout the body; white blood cells, which help fight infection; and platelets, which stick together at the site of a cut or wound to form a clot to stop the bleeding.

People who have thrombocytopenia don’t have enough platelets to form a blood clot, and so they may bleed excessively when they are cut.

How does thrombocytopenia occur?

Blood cells (including platelets) are made in the bone marrow, the spongy tissue inside of bones. Certain factors may interfere with the body’s ability to make platelets. Under other circumstances production is normal, but platelets are removed prematurely from the blood.

Causes of thrombocytopenia can include:

a bone marrow disease or treatment for disease. For instance, diseases such as leukemia (cancer of the bone marrow and bloodstream) and lymphoma (cancer of the lymph system) can cause dysfunction of the bone marrow.

aplastic anemia, a disease that prevents the bone marrow from making blood cells of all types

radiation and chemotherapy treatment for cancer can damage the blood stem cells that eventually become blood cells.

exposure to certain viruses, including Epstein-Barr, cytomegalovirus, hepatitis, and HIV

an autoimmune disease (the body’s immune system attacks the body), such as immune thrombocytopenic purpura or ITP)

an enlarged spleen (an organ that acts as a filter for the blood and helps the body fight infection). The enlarged spleen tends to trap platelets and prevent them from circulating in the bloodstream.

heredity (the condition is passed down from a parent)

exposure to toxic chemicals

taking certain medications, such as certain antibiotics, cardiovascular drugs, and seizure medications

drinking too much alcohol

What are the symptoms of thrombocytopenia?

The main symptom of thrombocytopenia is bleeding, either on the surface of the skin or inside the body. (In mild cases of thrombocytopenia, there may not be any symptoms.)

Symptoms of thrombocytopenia include the following:

bleeding on various parts of the skin. You may have small red or purple spots called petechiae on your lower legs, or bruising that is purple, red, or brown (known as purpura).

bleeding that doesn’t stop on its own, such as a nosebleed or bleeding from your gums when you brush your teeth

heavier bleeding during menstrual periods

internal bleeding, such as blood in the urine or stool or bleeding from the rectum

How is thrombocytopenia treated?

If your doctor feels that the thrombocytopenia is not a serious threat to your health, he or she may choose not to treat it.

Your doctor may decide to treat the thrombocytopenia by treating the disease or condition that is causing it. For instance, if you are taking a medication that is causing thrombocytopenia, your doctor may switch you to another medication. If the thrombocytopenia is caused by problems with your immune system, your doctor may prescribe steroids, immunoglobulin, or other medications.

A platelet transfusion may be needed if your platelet count is extremely low. In some cases, the patient may have his or her spleen removed in order to keep it from destroying platelets. Because the spleen helps the body fight infection, removing it may place the person at higher risk for certain types of infections. Several vaccinations are given before splenectomy to help prevent infection.






Last Updated- March 2019

Lucy Barnes