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Missouri Tick-borne Disease

Heartland virus

The Heartland virus (HRTV) was first discovered in northwest Missouri. In 2009, Dr. Scott Folk of Heartland Regional Medical Center in St. Joseph found the virus infecting two farmers. Both farmers had similar symptoms, including fever, fatigue, diarrhea, decreased appetite, headache, joint pain, low blood platelet count, and low white blood cell count. The lone star tick transmits HRTV. As of 2020, doctors have only identified 50 human HRTV infections in the Midwest and the South (Arkansas, Indiana, Missouri, Oklahoma, and Tennessee.) Most HRTV patients reported a tick bite in the two weeks before they felt sick. Almost all patients suffering from HRTV need to be hospitalized. Antibiotics are not effective against viruses, including HRTV. Right now, there is no vaccine and no known cure for HRTV.


Ehrlichiosis is a bacterial infection spread by the lone star tick. Three species Ehrlichiosis chaffeensis, E. ewingii, and E. muris are responsible for most infections. Missouri, along with Oklahoma and Arkansas, accounts for 35% of all E. chaffeensis infections. All Ehrlichiosis patients present with similar symptoms, including fever, chills, headache, malaise, muscle pain, nausea, vomiting, diarrhea, altered mental status, weight loss, and rash. The time from tick bite to first symptoms is anywhere from five to 14 days. The Mayo Clinic reports antibiotics are an effective treatment for Ehrlichiosis.

Rocky Mountain Spotted Fever

The American dog tick spreads Rocky Mountain Spotted Fever (RMSF) in Missouri. RMSF can be deadly if not treated by a doctor with antibiotics within five days of the first symptoms. Five states, including Missouri, North Carolina, Oklahoma, Arkansas, and Tennessee, are responsible for over 60% of RMSF cases.


Brown Dog Ticks are known vectors of Lyme disease in the U.S..

Emerging research is identifying more cases of Anaplasmosis. Anaplasmosis is caused by the bacteria Anaplasma phagocytophilum. The tick-borne infection can be severe and life-threatening if patients do not seek medical help. Anaplasmosis is found in Missouri as well as the Upper Midwest and the Northeastern United States. Lyme Disease (B. burgdorferi, B. microti) is a common coinfection of Anaplasmosis because many ticks may be vectors for both infections. The typical incubation for Anaplasmosis is five to 14 days. Symptoms include fever, chills, headache, malaise, muscle pain, nausea, vomiting, diarrhea, weight loss, and sometimes a rash.

Lyme Disease

Red ring rash (Erythema migrans) commonly associated with Lyme disease.

Lyme Disease was first reported in Connecticut and has spread from coast to coast. In Missouri, the bacteria that causes Lyme Disease (Borrelia burgdorferi) has not been isolated. However, several patients have presented with Lyme Disease symptoms. The incubation period for Lyme Disease is typically three to 30 days. Patients with Lyme Disease usually notice a red, ring-like rash (Erythema migrans) and typically experience symptoms like, malaise, headache, fever, muscle pain, and joint discomfort. If Lyme Disease is identified early, doctors can usually cure it with antibiotics.


Tularemia is uncommon in the United States, but 40% of all Tularemia cases are reported in Missouri, Oklahoma, and Arkansas. Dog ticks and wood ticks can carry the bacteria Francisella tularensis. The Missouri Department of Health and Senior Services identified 190 cases of Tularemia from 2000 to 2007. The Mayo Clinic reports the incubation time for Tularemia is generally three to 14 days. There are several types of Tularemia, and symptoms can vary depending on where the bacteria enter your body.

Ulceroglandular Tularemia

  • Skin ulcer at the infection site
  • Swollen lymph nodes
  • Fever
  • Chills
  • Headache
  • Exhaustion

Oculoglandular Tularemia

  • Eye pain
  • Redness of the eye
  • Swelling and/or discharge form the eye
  • Ulcer inside the eye lid
  • Sensitivity to light

Oropharayngeal Tularemia

  • Fever
  • Throat discomfort or pain
  • Mouth ulcers
  • Vomiting
  • Diarrhea
  • Inflamed tonsils
  • Swollen lymph nodes

Pneumonic Tularemia

  • Dry cough
  • Chest pain
  • Trouble breathing
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