CDC

The Lone Star tick, or A. americanum, shown here, may be responsible for the spread of a never-before-seen virus that hospitalized two Missouri farmers.

When two Missouri farmers wound up hospitalized with fever, fatigue, low blood cell counts and elevated liver enzymes in 2009, doctors suspected ticks were to blame.

Both men recently had reported tick bites, including a 57-year-old whose wife plucked a single critter off his abdomen with tweezers and a 67-year-old man who figured he was bitten 20 times a day for two weeks while rebuilding fences on his 40-acre farm.

"I was getting worse and worse," recalled Robert Wonderly, now 60, of Sheridan, Mo., the victim with the single bite.

The men had all the symptoms of ehrlichiosis, a potentially dangerous bacterial infection spread by, yes, ticks. But when scientists cultured samples of the farmers’ blood, the bacteria were nowhere to be found.

“We placed it into the culture and then we didn’t get anything,” recalled Dr. William L. Nicholson, a research microbiologist who specializes in emerging and zoonotic infectious with the Centers for Disease Control and Prevention. “And that, to us, indicated that we had something else in there that we weren’t testing for.”

That something turned out to be an entirely new virus discovered only through sophisticated genetic analysis conducted by Nicholson’s colleagues at the CDC’s Viral Special Pathogens branch. The scientists reported their findings in this week's issue of the New England Journal of Medicine.

“This particular virus has never been detected before,” said Nicholson. “This is unique to the world.”

So far, the Missouri men are the only known victims of the new germ, which has been identified as a phlebovirus, part of the Bunyaviridae family of potentially serious bugs. Hantavirus, spread by deer mice, comes from that group. So does the deadly Crimean-Congo hemorrhagic fever.

But Nicholson, along with state and local health officials, has been scouring the region where the men were infected. They’re looking for additional signs of what has been dubbed “the Heartland virus,” after Heartland Regional Medical Center in St. Joseph, Mo., where the men were treated -- and because it was discovered in the nation’s heartland.

The new virus appears to be very rare. Although there are plenty of phleboviruses around -- more than 70 -- they are divided by the ways that they’re spread. Some are carried by sand flies, for instance. Others, like the Rift Valley fever virus, are spread by mosquitoes.

The only other tick-borne phlebovirus known to cause disease in humans is called SFTSV -- severe fever with thrombocytopenia syndrome virus -- which was recently identified in central and northeastern China.

“Even though the Chinese virus is similar, it is still quite distinct,” said Nicholson.

Researchers were able to identify the Heartland virus by using electron microscopes and next-generation genomic sequencing including total RNA analysis.

It’s not clear yet exactly how the new virus may be spread. Ticks appear to be the culprits. Nicholson and others suspect that A. americanum, the Lone Star tick found widely in northwestern Missouri and elsewhere, may be be a carrier. But other critters may be responsible as well. It’s also not clear what animals may serve as hosts, noted Dr. Scott M. Folk, the infectious disease expert at Heartland Regional who treated the two farmers.

Finding those answers will be imperative, because although the Heartland virus appears to be rare, it may not be.

“It could be responsible for more illness than we think,” Folk said.

In many ways, the new virus is just one more tick-borne problem to worry patients and doctors. The CDC lists 10 tick-borne diseases in the U.S.

The best-known is Lyme disease, which infected about 30,000 people in the U.S. in 2010. Other infections include anaplasmosis and ehrlichiosis, which affect about 1,000 people each a year, and babesiosis, which infected about 1,100 people in the U.S. last year, the CDC said. There's also Rocky Mountain Spotted Fever, an old disease that still strikes about 2,500 people a year.

Pat Smith, president of the Lyme Disease Association Inc., believes the new virus should help bolster growing awareness of the problem of tick-borne diseases and encourage people to realize that they can be serious.

“Maybe you don’t have Lyme. Maybe you have something else,” Smith said. “They can make you sick for a long time.”

The CDC encourages people to check for ticks after they’ve been outdoors, to use insecticides to kill ticks and to monitor dogs and other animals to prevent ticks from being brought indoors.

The two Missouri men were hospitalized for nearly two weeks and took a couple months to recover. Wonderly, who also works at the local Energizer Eveready Battery Co. in nearby Maryville, says he still has problems with short-term memory, fatigue and headaches three years after the infection.

The second victim, now 70, who agreed only to be identified by his first name, Larry, said he's fine now. Neither man seemed much impressed with being infected by a never-before-seen virus, though both are glad it didn't turn out to be worse. 

"I guess I never give it much thought," said Wonderly. "But I was glad they saved my life."

Related stories: 

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Patients suffering from Lyme disease often complain that the crushing fatigue, joint pain and neurological symptoms are not taken seriously.

Getty Images / Getty Images

A close-up of an adult female and nymph tick.

That could change with the bacterial infection’s link to the JPMorgan Chase’s multi-billion dollar financial meltdown.

Amid the finger-pointing for the bank’s trading loss, a recent New York Times story noted that senior banker Ina Drew, the executive most often blamed for the bank’s financial meltdown, had suffered Lyme disease since 2010.

Drew lost so many days at work after contracting Lyme that she didn’t realize her underlings were running amok and betting billions on bad investments, the newspaper reported.  

While any chronic illness might have had a similar effect, experts say that Lyme can indeed wreak havoc in an individual’s life, especially if it’s not caught and treated early. The problem is, many patients – and even doctors – don’t know Lyme’s early signs and symptoms. What's worse, the tick that carries the bug can often bite you without your ever noticing it.

“If you catch it early and give the appropriate antibiotics, then there’s a relatively quick recovery,” said Dr. Andrew Nowalk, an assistant professor of pediatrics at the Children’s Hospital of Pittsburgh at the University of Pittsburgh. “If the disease progresses, then it becomes more serious.”

The longer Lyme lingers in your system, the worse the outcome, Nowalk explained. As months go by, the bug can inflame joints and even cause mental disorders, if not treated. 

Many experts now think that people who continue to have symptoms after long courses of antibiotics aren’t suffering from an ongoing infection, but rather, are dealing with the damage wrought by the bug before it was stopped.

The third stage of Lyme is very much like an autoimmune disease, with the body’s immune system attacking joints, brain and nerves, said Dr. Otto Yang, professor of infectious diseases, David Geffen School of Medicine at the University of California, Los Angeles.

“This type of damage is often irreversible,” Yang said. “These stages are very similar to those of syphilis, which is caused by a cousin of the bacteria causing Lyme disease.”

Which is why nobody should be surprised that people with long undiagnosed Lyme end up with lingering problems.

“Just like syphilis, you can have it for years,” Nowalk said. “You give an antibiotic and you get a cure 100 percent of the time. But nobody is surprised if you end up with symptoms from syphilis for the rest of your life because it damages so many organs so dramatically. It’s the same concept with Lyme.”

The main protection against Lyme infection is to know the symptoms.

While it would be nice if you could count on spotting the deer ticks that carry the disease, that’s unlikely, said Nowalk. “The tick is well designed to avoid your notice,” he explained. “It is extraordinarily small -- smaller than the point of a pen -- when it’s not engorged. And it has a little anesthetic in its bite so you don’t feel it.”

James Gathany / AP

In this CDC photo, the Lyme infection rash is seen in the bulls-eye pattern, which appeared at the site of a tick bite.

Nowalk suggests dousing yourself -- and your kids -- with insect repellant before going for a walk in woods and fields frequented by deer. 

The blacklegged ticks need to be attached at least 36 hours before they can transmit the disease, which is why it’s so important to check for them promptly after being outside.

If you or your kids develop a bulls-eye rash – which may gradually expand over several days -- that’s a clear sign of Lyme infection, Nowalk said. But many people either don’t get a rash or don’t see it.  So you need to be tuned in to other early symptoms, like muscle stiffness and fatigue.

“Unfortunately a lot of the symptoms of Lyme sound like a really bad case of the flu,” Nowalk said. “You feel really tired, you’ve got swollen glands, headaches, a low-grade fever. You might also have muscle weakness and big swollen joints.”

As we enter high Lyme season -- a warm, wet spring could make it worse than usual, experts suggest -- the disease seems to be on the rise in some parts of the country.

“Our own hospital has seen a 10-fold increase in cases from 2008 to 2011,” Nowalk said of western Pennsylvania. “It worries me a little when we start seeing this many cases ... I hope it’s not making its merry way to other parts of the country.”

Just because you’ve had Lyme once doesn’t mean you can’t get it again, Nowalk warns. If you live in an area where there are lots of deer – and hence lots of deer ticks -- you need to be alert for the symptoms and realize that not every doctor will be as educated about the disease as you might like. Some may even not know you can get it more than once.  

“You know, the American dream is often about a big house in a nice suburban area with a deck from which you can watch the deer idyllically trotting around,” Nowalk said. “To me, that’s become a nightmare scenario: all those deer carrying ticks that are jumping off the deer and making their way to you.”

For more on Lyme disease, visit the CDC 

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