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A rarely diagnosed tick-borne virus with no vaccine or specific treatment has been confirmed in New York for the first time, prompting researchers to warn that additional infections may be going undiagnosed.
The Bourbon virus, “transmitted through the common lone star tick, could soon begin to complicate diagnoses if it becomes more prevalent this summer and in coming years,” Stony Brook Medicine warned in a news release reporting on a study of the virus.
Only six human cases have been reported since Bourbon virus was first identified in Bourbon County, Kansas, where the first known patient was diagnosed in 2014. That patient later died.
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The virus has been associated with at least two deaths, including the original 2014 case and another reported in 2026. Researchers believe, however, that additional infections have likely gone undiagnosed.
Symptoms of Bourbon virus include fever, fatigue, rash, headache, body aches and nausea. Because there is no commercially available diagnostic test, doctors have a difficult time identifying it.
Many healthcare providers are also unfamiliar with the virus, “thus increasing the possibility of misdiagnosis,” the release said.
A team of researchers led by Stony Brook Medicine confirmed the first case of Bourbon virus in New York in a patient from Long Island who developed very severe symptoms and an eight-fold rise in antibody titers of the Bourbon virus. The patient was hospitalized.
“There are a lot of lone star ticks in New York and in the Northeast, we have dense populations, and when someone is infected with Bourbon virus symptoms they are similar to other tick-borne infections,” Luis Marcos, MD, Stony Brook Medicine professor and director of the Tick-borne Disease Clinic, said in the news release.
“For these reasons, the Bourbon virus is likely more prevalent than we think in our region and other cases are likely not being diagnosed.”
Marcos and his co-authors said their findings show the need for expanded surveillance and better testing to improve diagnosis and track the spread of Bourbon virus.
“Without identifying the cause of an infection, the chances of developing accurate diagnostic tests or effective treatments are minimal,” he said. “That is why it is so important to first understand the true impact of the virus in high-risk areas.”
According to the Centers for Disease Control (CDC), “The lone star tick is widely distributed in the Northeast, South and Midwest United States.”
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The tiny, blood-feeding, parasitic arachnid has established populations in Arkansas, Connecticut, Delaware, Georgia, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia and West Virginia, per the CDC.
Lone star ticks are an “aggressive tick,” according to the agency.
“The adult female is distinguished by a white dot or ‘lone star’ on her back. The nymph and adult females most frequently bite humans and spread disease,” the CDC reports.
Despite the Bourbon virus’ severity, “only a select few [ticks] bite and transmit bacteria, viruses and parasites (pathogens) that cause diseases in people,” according to the CDC.
To avoid tick bites, people should wear protective clothing, such as pants they can tuck into boots and long-sleeve shirts.
Experts also recommend applying insect repellent, such as permethrin, to clothing and outdoor gear – not directly on the skin.
Stay out of tall grass and on well-beaten trails whenever possible, as ticks thrive in overgrown and heavily wooded areas.
Check for ticks after spending time outdoors and remove them as soon as you find them. Seek medical attention if you develop fever, rash, fatigue or other flu-like symptoms in the days or weeks following a tick bite.
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