Heartland virus disease was first diagnosed in 2009 in Missouri. It is rare. Patients report flu-like symptoms that are similar to those of other tickborne illnesses, such as ehrlichiosis or anaplasmosis. There is no vaccine to prevent and no treatments to cure it, so taking personal protection measures to prevent tick bites is crucial. Always use repellents with EPA-registered active ingredients, following label directions. Heartland cases occur May through September but June is the most active month.

Lone Star Tick
Lone Star Tick

Ticks that carry it

Recent studies have shown that the Lone Star tick transmits the Heartland virus to humans. Lone Star ticks are aggressive human biters.

Where Heartland virus has been found

This virus is found primarily in the Midwest and southeastern U.S. The diagonal lines on this map show where Heartland virus has been reported. The goldenrod area indicates the range of Lone Star ticks in 2009. The red area shows their range as of 2020. In 2020, 50 cases have been reported in humans.

Distribution of Heartland virus and Lone Star Ticks 2009–2020
Distribution of Heartland virus and Lone Star Ticks 2009–2020
Centers for Disease Control and Prevention



The incubation period (time from tick bite to feeling sick) is not known, but most patients reported a tick bite in the 2 weeks before feeling Ill.

Most patients have

  • Fever (severe)
  • Fatigue (feeling tired)
  • Decreased appetite
  • Headache
  • Nausea
  • Diarrhea
  • Muscle or joint pain

Who is most at risk?

People who spend time outdoors where Lone Star ticks are found may have exposure to Heartland virus. Results of a recently reported (2020) study showed that, of the 85 individuals tested, 16 showed evidence of acute Heartland virus infection. One had had heartland infection in the past. Among those diagnosed with acute Heartland virus disease, 12 were men. Their median age was 71 years. These individuals lived in Arkansas, Indiana, Kansas, Kentucky, Missouri, North Carolina and Oklahoma. Most were hospitalized. Two who were included in this study died from the illness. Patients in other reported cases were men over age 60 who had multiple underlying medical conditions.