In a follow-up to a report of a Kansas man dying from a novel virus, called Bourbon virus over the summer, the Centers for Disease Control and Prevention (CDC) reported today in the journal, Emerging Infectious Diseases, it is a novel member of the genus Thogotovirus.
This is the first time a virus in this group has been shown to cause human illness in the United States and only the eighth known case of thogotoviruses causing symptoms in people.
Since viruses in this group (thogotoviruses) have been linked to ticks or mosquitoes in parts of Europe, Asia, and Africa, Bourbon virus might also be spread through tick or other insect bites. The Kansas man had received multiple tick bites in the days before becoming ill.
After test results for many infectious diseases came back negative, a sample of the patient’s blood was sent to CDC for additional testing. Initial CDC testing showed evidence of an unidentified virus in the sample. CDC researchers then used Advanced Molecular Detection (AMD) and determined that it was a new virus.
According to the study, the patient was a previously healthy man >50 years of age from Bourbon County, Kansas, USA. While working outdoors on his property in late spring 2014, the patient had several tick bites and found an engorged tick on his shoulder several days before he became ill with nausea, weakness, and diarrhea. The following day, a fever, anorexia, chills, headache, myalgia, and arthralgia developed. On the third day of illness, the patient went to his primary care physician, who empirically prescribed doxycycline for a presumed tickborne illness because of his history of tick bites, symptoms, and no reported travel outside the immediate area. The following morning, the patient’s wife found him obtunded (experiencing reduced consciousness) but arousable. He was taken by ambulance to a local hospital.
The patient had a papular rash on his trunk, but otherwise results of his physical examination were unremarkable. Initial laboratory findings showed leukopenia, lymphopenia, and thrombocytopenia.
The patient showed no serologic evidence of Rocky Mountain spotted fever, Lyme disease, or ehrlichiosis.
He was treated initially with doxycycline and later with broad-spectrum antibiotics.
After deterioration of renal function, acute respiratory distress syndrome and a multitude a several other problems , he passed away on day 11.
CDC is collaborating with Kansas Department of Health and the University of Kansas Medical Center to identify additional cases of Bourbon virus disease, determine who gets sick and with what symptoms, and how people are getting infected. CDC experts will also be working in the lab to better understand the virus itself, how it makes people sick, and what animals (if any) may play a role in its spread.This information will help determine the best ways to potentially prevent and control Bourbon virus.
The discovery of Bourbon virus, as well as the recent discoveries of Heartland virus in Missouri and severe fever with thrombocytopenia syndrome viruses in China, leads CDC researchers to believe that other undiscovered viruses are likely causing people to get sick. Use of AMD methods in laboratories across the world is an important tool for discovering and addressing new pathogens.