Clinical findings are nonspecific and include fever (96%), headache (72%), myalgia (68%), and malaise (77%). Nausea, vomiting, diarrhea, cough, rash, and confusion may be noted.

• The median incubation period is 8 days.
• Disease can be severe: up to 49% of pts are hospitalized and ~2% die. Complications include a toxic shock-like syndrome, respiratory distress, cardiac failure, hepatitis, meningoencephalitis, fulminant infection, and hemorrhage.
• Leukopenia (61%), thrombocytopenia (73%), and elevated serum aminotransferase levels (84%) are common.