Seroprevalence of Heartland Virus Antibodies in Blood Donors

Northwestern Missouri, USA

Nicole P. Lindsey; Jay E. Menitove; Brad J. Biggerstaff; George Turabelidze; Pat Parton; Kim Peck; Alison J. Basile; Olga I. Kosoy; Marc Fischer; J. Erin Staples


Emerging Infectious Diseases. 2019;25(2):358-360. 

In This Article

Abstract and Introduction


We estimated the seroprevalence of Heartland virus antibodies to be 0.9% (95% CI 0.4%–4.2%) in a convenience sample of blood donors from northwestern Missouri, USA, where human cases and infected ticks have been identified. Although these findings suggest that some past human infections were undetected, the estimated prevalence is low.


In 2012, Heartland virus, a novel virus in the family Phenuiviridae, genus Phlebovirus, was identified in blood specimens obtained from 2 residents (men) of northwestern Missouri, USA.[1] Given the clinical manifestations of illness and history of tick bites of the patients, both men were initially believed to have ehrlichiosis but they failed to improve after being given doxycycline.

Before identification of Heartland virus in these 2 patients, to our knowledge, there were no known phleboviruses that caused human disease in the United States.[1,2] Subsequent field work identified Amblyomma americanum ticks, which are widely distributed across the eastern and central United States, as the likely vector for the virus.[3,4] Wild animals in Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Maine, Missouri, New Hampshire, North Carolina, Tennessee, Texas, and Vermont have been found to be seropositive for Heartland virus antibodies.[5] Investigations are underway to identify more disease cases, but little is known about the incidence of Heartland virus infection in humans. The objective of this study was to estimate the seroprevalence of antibodies against Heartland virus in a convenience sample of blood donors who reside in northwestern Missouri where human cases and infected ticks have been identified.[1,3,6]