The Joplin Globe, Joplin, MO

July 29, 2013

One more thing to worry about: Heartland virus latest addition to list of tick-borne diseases

By Roger McKinney
news@joplinglobe.com

JOPLIN, Mo. — Kevin Badgley said that in the spring he can sometimes see tick nymphs “questing.”

They climb to the tops of plants, weeds or blades of grass, attach their back legs to the plant, and reach out and flail their front legs, waiting to attach to any animal that passes by.

Sometimes, said Badgley, a naturalist and education outreach specialist with the Missouri Department of Conservation, the young ticks seem to line up.

When that animal is a biped that lives in Missouri, the eagerness that ticks demonstrate to attach to some host can become a problem.



Heartland virus

That ticks cause illnesses — Rocky Mountain spotted fever, tularemia, Q fever and Lyme disease — isn’t new, but what is new is being called the Heartland virus.

Two farmers in the St. Joseph area in 2009 were treated at Heartland Regional Medical Center there for fever and fatigue. Doctors initially suspected ehrlichiosis, a tick-borne illness common in Missouri, but the patients didn’t respond to antibiotics used to treat the disease. Doctors sent blood samples to experts at the Centers for Disease Control and Prevention.

CDC scientists then traveled to northwest Missouri, finding the new virus in ticks collected on the patients’ farms and in the Honey Creek Conservation Area. What has been dubbed the Heartland virus was detailed recently in a paper published in the American Journal of Tropical Medicine and Hygiene.

The author of the study, CDC research entomologist Harry Savage, was back in Andrew County near St. Joseph last week in the field, collecting more ticks.

Savage said by telephone that at this point, only the two human cases have been documented, but he’s sure there are others.

“Other Heartland cases out there probably have been misdiagnosed,” he said.

Savage said the lone star tick carries the virus. The female adult has a white spot.

The virus causes a fever, chills, body aches, nausea and diarrhea. The symptoms are similar to those associated with other tick-borne illnesses.

“This is just one more disease,” Savage said. “All we know now is it’s in northwest Missouri. There’s no reason to believe it’s not more widespread. Surveillance will be broadened to detect more human cases.”



‘Not feeling right’

Noppadol Paothong, a wildlife (and former Joplin Globe) photographer for the Missouri Department of Conservation, said he is always careful about taking preventive measures for ticks when on assignment. But it was after an assignment in Eureka that he found a lone star tick attached to his chest. He said he thought he had removed it within two hours, so he thought he would be OK.

“Two days later, I had a migraine headache, but it went away,” he said.

He posted on Facebook two weeks later, on June 16, that he had become severely dehydrated from over-exercise. He was having chest pains, chills and muscle cramps. “So I am checking myself in (to) ER. Great Father’s Day gift!”

“I came home and told Monica, ‘I’m not feeling right,’” he said, referring to his wife. “My chest was kind of numb.”

He said that when he got to the hospital, he told those treating him that it was either dehydration or a tick-borne disease, so they should test his blood. It was ehrlichiosis.

“I had headache and fever,” Paothong said. “It was awful.”

He said his heart was beating at 128 beats per minute for several hours, causing Paothong and his doctors concern, but he said the headache was the worst part.

“It was like somebody hit me in the head with a hammer constantly,” he said.

He was given antibiotics and was dismissed four or five hours later from the emergency room. Paothong said he continued on the course of antibiotics and fully recovered. He lost seven pounds during the ordeal.



Prevention

Badgley said he spends a lot of time in nature, and he’s careful to take measures to prevent tick bites. Those measures include spraying one’s clothes and exposed skin with DEET before going into areas where ticks are located. One also should wear long-sleeved shirts and long pants. It can also help to tuck pant legs into socks.

He said light-colored clothes make it easier to spot ticks if they get on a person.

In areas where there are trails, he recommends staying on the trails.

Badgley said it’s very important to check oneself for ticks from head to toe after having been in brushy areas.

If a tick has attached to the skin, remove it with tweezers, plucking it from as close to the skin as possible. Clean the area around the bite with rubbing alcohol or soap and water. He said it’s also good to wash one’s hands afterward.

“It takes 24 hours for a tick-borne illness to take hold,” Badgley said. He said if a person finds the tick quickly, there shouldn’t be problems with tick-borne illnesses.

People also should check pets for ticks if they have been in the wild, he said.

“Just a few precautions can allow you to continue to enjoy nature without fear,” Badgley said. “It shouldn’t keep you from enjoying the outdoors.”





We’re No. 1

DR. ERICKA HAYES, an infectious disease specialist at Washington University in St. Louis, said it’s not surprising that the Heartland virus was discovered in Missouri because Missouri leads the nation in tick-related diseases.