Scientists detected Bourbon virus in a lone star tick in New York, suggesting the infection may be underdiagnosed in the Northeast. Symptoms — fever, extreme fatigue, vomiting, rash and body aches — overlap with other tick-borne illnesses, complicating diagnosis. There are no vaccines or specific treatments and diagnostic testing is limited; researchers call for expanded surveillance, better clinical tests and increased clinician awareness.
Bourbon Virus Found in New York Lone Star Tick — Researchers Warn Cases May Be Underdiagnosed
Researchers just found a tick carrying rare and deadly Bourbon virus. They say more infections could be coming
Researchers have identified Bourbon virus in a lone star tick collected in New York, raising concern that the rare but potentially serious infection may be underrecognized in the Northeast as tick ranges expand.
The lone star tick (Amblyomma americanum) — common across the region — tested positive for Bourbon virus, an RNA virus first identified in Bourbon County, Kansas, in 2014. Infection can cause fever, profound fatigue, vomiting, rash and muscle or body aches, symptoms that overlap with many other tick-borne conditions.
Lone Star Tick (Amblyomma americanum) on human skin. The tick can carry Bourbon virus, which was recently detected in New York (Getty/iStock)
Experts at Stony Brook Medicine say cases are likely being missed because symptoms mimic other infections and diagnostic testing is limited. In one recent patient, severe illness led to hospitalization after an initial misdiagnosis of Lyme disease; the patient did not improve with standard Lyme therapy, and subsequent testing identified Bourbon virus.
"There are a lot of lone star ticks in New York and in the Northeast, and when someone is infected with Bourbon virus the symptoms are similar to other tick-borne infections," said Dr. Luis Marcos, director of the Tick-borne Disease Clinic at Stony Brook Medicine. "For these reasons, the Bourbon virus is likely more prevalent than we think in our region and other cases are likely not being diagnosed."
There are currently no vaccines or approved antiviral treatments for Bourbon virus, and clinical testing is scarce. Since its discovery in 2014, the virus has been associated with three reported deaths (the original 2014 case, a 2017 death, and a death reported this year). Documented fatalities have occurred in Kansas and Missouri, and Bourbon virus has also been detected in Oklahoma. The U.S. Centers for Disease Control and Prevention says its full geographic range remains uncertain.
Bourbon virus is a RNA virus that was discovered in Bourbon County, Kansas, in 2014 (CDC)
Researchers emphasize that warming temperatures and changing habitats are enabling ticks to expand northward, increasing the potential for exposure in new areas. They call for expanded surveillance, development of reliable clinical tests, and greater clinician awareness to better detect and manage infections.
What physicians and the public should know: Be aware of lone star ticks in the region, consider Bourbon virus when patients present with nonspecific febrile illness after a tick bite, and support efforts for improved testing and surveillance.
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