From bite to burden: unraveling the clinical epidemiology, host response, and molecular determinants of heartland and bourbon virus infection - tick-borne viruses (tbvs), including heartland (hrtv)…

The National Institute of Allergy and Infectious Diseases awarded Hennepin Healthcare Research Institute $198,600 on August 17, 2026, under the Allergy and Infectious Diseases Research program (CFDA 93.855) to support research on the clinical epidemiology, host response, and molecular determinants of Heartland and Bourbon virus infection—emerging tick-borne viruses capable of causing severe illness and death.

The award funds a K23 career development grant supporting a physician-scientist's training and research to advance understanding of tick-borne viral epidemiology. The research addresses gaps in clinical knowledge of Heartland and Bourbon virus disease, which are suspected to be more prevalent than currently recognized but remain understudied due to scarcity of clinical specimens, lack of commercially available diagnostic tests, and poor clinician awareness. The project will capture fuller clinical symptomatology across mild to moderate presentations, evaluate factors mediating invasive disease, and leverage clinical specimens for therapeutic development and phylogenetic analysis. The awardee will receive additional training and mentorship in viral dynamics and laboratory diagnostics, viral immunopathogenesis, and sequencing and phylogenomics to support the long-term career goal of becoming an independent physician-scientist drawing on expertise in applied epidemiology, laboratory science, and viral immunology.

Performance takes place in Minneapolis, Minnesota, with a period of performance from August 17, 2026, through July 31, 2031.

From bite to burden: unraveling the clinical epidemiology, host response, and molecular determinants of heartland and bourbon virus infection - tick-borne viruses (tbvs), including heartland (hrtv) and bourbon virus (brbv), are emerging viruses capable of causing severe illness and death. Yet, despite significant rises in tick-borne disease incidence, little is known about clinical hrtv and brbv disease. Existing data is primarily derived from small case series, often biased towards those with severe presentations. The lack of commercially available tests, poor clinician awareness, and a suspected spectrum of disease that mimics more commonly recognized bacterial pathogens (e.g., ehrlichia), has led to inadequate testing and inaccurate disease estimates. The scarcity of clinical specimens has also resulted in few published sequences, further hindering our understanding of in vivo TBV pathogenicity and phylogenetics. Through preliminary studies, i have demonstrated the feasibility of detecting viremia in real-time, have shown that these viruses are likely more common than previously recognized, and how we can leverage these clinical specimens for therapeutic development. However, larger studies are needed to capture the full clinical symptomatology, particularly in those with mild to moderate illness, and to evaluate factors that mediate invasive disease. My long-term career goal is to become an independent physician-scientist that draws upon expertise in applied epidemiology, laboratory science and viral immunology to define those at risk for vector-borne viral infections and factors driving morbidity. However, to achieve these goals, i need additional training and mentorship in: (i) viral dynamics including laboratory diagnostics (II) viral immunopathogenesis and (III) sequencing and phylogenomics. I will draw upon this instruction and leverage the resources of my mentors to achieve my scientific objective, which is to advance our understanding of TBV epidemiology through systematic case detection and to generate a biobank of clinical specimens that can be utilized to characterize the pathogenesis of and host response to hrtv and brbv infections. I hypothesize that in addition to being more prevalent than currently recognized, severe hrtv and brbv cases may represent a distinct subset of individuals who are exposed to phylogenetically unique strains or have immunological deficiencies. I will test this hypothesis by pursuing two specific research aims: (1) determine the incidence of hrtv and brbv infection from a prospective cohort of patients suspected to have acute tickborne illness; and (2) define viral and host factors associated with severe hrtv and brbv disease. I am well positioned to achieve these aims given the vast institutional resources available to me through the hennepin healthcare research institute, the university of north carolina, emory university, and the university of minnesota, along with an internationally renowned team of mentors, including DRS. Ross boyce, anne piantadosi, jacco boon, melissa miller, and jason baker. The proposed research is innovative and significant, as the results will challenge the dogma that these viruses are rare, will justify the need and use for commercially available diagnostic tests, and will provide the specimens needed for future therapeutic design.