Residents in Illinois are being warned after ticks collected in the state tested positive for the Heartland virus, a rare illness that nearly always requires patients to be hospitalized. The results come a year after a Kankakee County resident tested positive for the virus, marking the first case reported in Illinois.

Health officials at the time collected ticks from the area and sent them to the Centers for Disease Control and Prevention (CDC) for testing, which yielded positive results in the Lone Star tick species. According to the Illinois Department of Public Health, the virus was first discovered in 2009 when two Missouri farmers landed in the hospital after being bitten.

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The CDC reports that the virus can be transmitted through the bite of an infected tick, mosquito or sandfly. It is not yet known if tick species other than the Lone Star can transmit the disease.

Symptoms of the virus can mimic those of other tick-borne diseases, including fever, headache, fatigue, muscle aches and diarrhea, but most report becoming sick about two weeks after being bitten. There is no treatment or vaccine, and while most patients fully recover after being hospitalized, there have been several fatalities.

“It is important to take precautions and protect yourself from tick bites by using insect repellent and checking regularly for ticks when in wooded areas or high grass.” — Dr. Nick Ezike, director of the Illinois Department of Public Health

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Such was the case of a 68-year-old man in Tennessee who died in 2015. He was initially treated with doxycycline, which is often used in patients suspected to have a tick-related ailment, but his symptoms continued to worsen. Despite aggressive care, the man died. Following the man’s death, doctors found signs of the Heartland virus in nearly every tissue in his body.

“Bites from ticks can result in multiple types of infections, which can cause serious illness in some people,” Dr. Nick Ezike, IDPH director, said in a news release. “It is important to take precautions and protect yourself from tick bites by using insect repellent and checking regularly for ticks when in wooded areas or high grass.”

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The health department noted that Lone Star ticks can be found throughout the state, and that health care providers should consider the Heartland virus in patients who exhibit symptoms but are not responding to typical treatment for tick-borne illnesses.