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Dr. Folk and the Heartland Virus

Recently, KCUR Health Reporter Elana Gordon featured Dr. Folk and the discovery of the Heartland Virus in a radio segment. Listen here.

How I discovered the Heartland Virus

“I was born and raised in Reading, Pa. If you have ever played Monopoly, you’ll remember ‘Take a ride on the Reading Railroad’, that’s it,” says Infectious Disease Specialist Scott Folk, MD. Dr. Folk’s parents owned a coin-operated laundry mat and his father was an office manager at the local state police barracks in Reading. His parents taught him the value of hard work — they sent both Dr. Folk and his younger brother through college and medical school.

“I stayed in Reading to earn my Bachelor of Science degree in Biochemistry from Albright College. I then went to the Temple University School of Medicine for my medical degree. That’s the same university that Bill Cosby went to — that was our claim to fame!” After completing medical school, it was time to decide where to complete his residency and his list was short — Geisinger Medical Center in Danville, Pa. or the famous Mayo Clinic in Rochester, Minn. “I decided to go to Geisinger to complete my residency in internal medicine. It is the largest rural medical center in the country, but small enough that I knew I would receive a LOT of hands-on experience. Geisinger is very much modeled after Mayo, so it was the best of both worlds for me.”

Me and Mayo

After completing his residency, Dr. Folk and a few of his colleagues moved to Lewistown, Pa., to begin their career at a Geisinger clinic. That is when he became interested in Infectious Diseases (ID). “There were no ID physicians in Lewistown. I attended annual continuing education courses in Boston and that’s when I began thinking about a fellowship in ID. I knew exactly where I wanted to go — Mayo,” says Dr. Folk. Out of a large pool of applicants, Dr. Folk was only one of two physicians accepted for an ID fellowship at Mayo. “The other physician completed his residency at Mayo. I was thrilled to get the opportunity. While I was there, I taught at Mayo’s medical school. It was the best three years of my professional life.”

Mayo was just the platform to fuel Dr. Folk’s interest in research and education. “It is ironic looking back on it now. I deliberately chose topics that were more obscure to teach, because I thought I would need to know the information to be able to help my patients and to get ready for boards. For me, the best way to learn is by teaching. I was especially attracted to tick-borne infections such as Ehrlichiosis [infectious disease transmitted by tick bites]. I had no idea that it would become something that would change my life.”

I heart Florida

“After I left Mayo, I took a job in Erie, Pa. — I just wasn’t wild about Erie. I knew that I didn’t want to stay there. I moved to Tallahassee, Fla. — I was the only Infectious Disease Specialist in Tallahassee. It was there that I started to learn a lot about HIV and AIDS. I spent many Saturday afternoons going to see and care for women with HIV and AIDS in prison.

I also started to see patients bitten by ticks — they had a high fever, chills, headaches, low white blood cell count and low platelet counts. I thought they had Ehrlichiosis, but the question in my mind was how to prove the diagnosis. I called CDC [Centers for Disease Control and Prevention] in Atlanta and sent them samples that came back positive. I have continued sending them samples every spring. I screen the patients very carefully, because I know how valuable the CDC’s time is, so I try very hard not to send them unless I’m convinced that’s what they have.”

The joy of my life

Dr. Folk has a special place in his heart for Tallahassee not only for his profession but also for his personal life. “I met my wife in Tallahassee,” says Dr. Folk with a smile. “She was a nurse in the Intensive Care Unit. We got married on my 40th birthday. We did that so that when I got old, I couldn’t forget our anniversary.”

Ready for a change and to enjoy the four seasons, Dr. Folk and his wife decided it was time to leave Florida. “We moved to St. Joe in 1998, and one of the first things we did when we got here was find an OB/GYN to talk about fertility issues. They gave us a very low chance of having children. They offered us invitro and other fertility options, and we said no, ‘If God wants us to have children we will’. It wasn’t long after that my wife became pregnant, and we had our little guy Stefan. Stefan is German for Scott. His middle name is Caldwell, which is my wife’s maiden name. He will own a little piece of both of us. He is now in 6th grade at St. Joe Christian and is a real joy in our lives. My personal emphasis has always been faith, family and career. I’m blessed to be Stefan’s dad.”

The Heartland Virus

Dr. Folk continued to send samples to the CDC when it warranted further research. “There have been several cases over the past few years that I would bet the house that they would have Ehrlichiosis, but the testing would come back negative. That would always leave me scratching my head,” says Dr. Folk.

“In 2002, Missouri Western State University (MWSU) Professor Dr. David Ashley was my patient and I diagnosed him with Ehrlichiosis. We built a relationship and he asked me if I would like to present to his parasitology course to talk about parasites. It’s a good refresher for me to be able to talk about things that I normally don’t think about on a daily basis. It’s fun for me; I enjoy it.” Dr. Folk’s collaboration with Dr. Ashley eventually led to a very important piece of the Heartland Virus puzzle. 

In 2009, Dr. Folk treated two patients, about two weeks apart, who both had been bitten by ticks and shared similar symptoms — chills, fever and headaches. “I thought they had Ehrlichiosis. After I sent the samples, I started them on doxycycline [antibiotic] but they were just not getting any better. That’s when the CDC noticed a difference in cell cultures, never seen before.” The combined efforts resulted in a new-found phlebovirus, the Heartland Virus, named after Heartland Regional Medical Center where it was discovered.

After the discovery of the Heartland Virus, members of the CDC, including Director of Disease Ecology Laboratory William L. Nicholson, Ph.D., made several trips to Northwest Missouri to “tick hunt.” Dr. Folk knew that this would be a great opportunity for Dr. Ashley and his students at MWSU, so he brought them along on the journey. “Scott offered us an opportunity of a lifetime to be a part of this,” says Dr. Ashley. “The assistance my students and I offered helped paint a better picture of how the virus is transmitted to humans.”

It’s not often that this type of discovery is made outside of large research hospitals. Because of his relationship with the CDC, Dr. Nicholson knew not to take Dr. Folk’s concerns lightly. “Whenever Dr. Folk sends us samples, we pay attention because we’re likely to find something,” says Dr. Nicholson.

Dr. Folk and the Heartland Virus have received national and international attention. It has been published in the 200th anniversary edition of the New England Journal of Medicine and featured in thousands of online sources, publications, newscasts, newspapers and magazines including the L.A. Times, the New York Times and the Chicago Tribune.