Bourbon Virus: Another Reason to Avoid the Lone Star Tick

“[A] recently confirmed case of Borbon virus in Suffolk County has raised questions about another tick-borne illness that many people have never heard of.”

Luis A. Marcos, MD, MPH, Stony Brook Medicine, August 5, 2026

“[I]’ve a feeling we’re not [just] in Kansas anymore.”

Dorothy to Toto, The Wizard of Oz

Ixodes scapularis (the deer tick) and Amblyomma americanum (the Lone Star tick) are two tick species responsible for carrying large numbers of pathogens. Most people are aware that the deer tick carries the bacterium that causes Lyme disease, by far the most common vector-borne disease in this country. And some people are aware that the Lone Star tick has been linked to ehrlichiosis, tularemia and alpha-gal syndrome. But, the Lone Star tick is also the vector for transmitting another viral threat—the Bourbon virus.

Even though it was first identified a little over a decade ago, Bourbon virus is likely an emerging infection pathogen that you have never heard of. It recently received renewed attention after researchers at Stony Brook Medicine confirmed the first case in New York state, suggesting that the virus’s range may be expanding well beyond its original Midwestern foothold. My goal in writing this week’s post is to familiarize you with this potentially fatal tick-borne infection.

What is the Bourbon virus? Bourbon virus is a rare tick-borne virus that can cause serious illness in humans. The virus belongs to the Thogotovirus genus within the Orthomyxoviridae family—the same broad viral family that includes influenza.

Bourbon virus was first identified in 2014 after the death of a man in Bourbon County, Kansas—thus, the name. Since then, evidence of its presence has been found in the Midwestern and Southern U.S., primarily in Kansas, Missouri, Oklahoma, Arkansas, Georgia, North Carolina and Virginia. Recently, the first confirmed Bourbon virus case was reported in Suffolk County, New York, raising concern that this rare tick-borne infection may be significantly underdiagnosed across the region. (Bateman, V.A., et al., “Evidence of Heartland and Bourbon Viruses Transmitted by Ticks in Suffolk County, New York,” American Journal of Tropical Medicine and Hygiene, May 12, 2026).

How is it spread? The Bourbon virus is transmitted by the bite of infected Lone Star ticks. A. americanum is an aggressive, generalist tick species native to the central and eastern U.S.  These ticks are known for their broad host range, feeding readily on a wide variety of mammals and birds, which may explain their effectiveness as a viral vector.

In addition to Bourbon virus, the Lone Star tick is the vector of a variety of infectious agents, including another virus that causes Heartland virus disease, bacteria that cause tularemia and ehrlichiosis, Southern tick-associated rash illness that resembles Lyme disease, and alpha-gal syndrome or “red meat allergy”—an increasingly common allergy.

What are the symptoms of Bourbon virus illness? Symptoms of Bourbon virus infection usually begin within days after a tick bite and can include fever, fatigue, headache, muscle and joint pains, nausea and vomiting. These symptoms resemble those of many other tick-borne diseases which complicates diagnosis.

While Bourbon virus infection remains rare, it is not always mild. Some infections can become severe, especially in older people with underlying health problems. An exact percentage fatality rate is not officially established because so few human cases have been identified. (The recent case reported in Suffolk County, NY was a 67-year-old man who survived after a prolonged illness.)

Is there a treatment for Bourbon virus? There is no specific antiviral treatment or vaccine for Bourbon virus. Treatment is thus supportive, that is, managing fever and maintaining hydration. Compounding the problem, no commercial diagnostic test currently exists for Bourbon virus.

Because the symptoms of Bourbon virus infection overlap so closely with Lyme disease, patients are frequently misdiagnosed and treated with antibiotics; a treatment that is ineffective against the virus. In the recently documented Suffolk County case, the patient was initially diagnosed with Lyme disease and received standard antibiotic treatment but showed no improvement with fatigue and severe headache persisting until further antibody testing revealed the true cause of the illness.

Avoiding tick bites is key. As with other tick-borne diseases, prevention remains the primary defense against Bourbon virus. The best way to prevent Bourbon virus disease is to avoid tick bites by:

• Using insect repellents containing DEET or picardin;

• Wearing long sleeve pants and shirts when in tick habitats;

• Treating clothing and gear with permethrin;

• Checking your body for ticks after spending time outdoors; and

• Removing ticks promptly.

  
  

If you find a tick, visit the University of Rhode Island’s outstanding website (URI TickEncounter) for advice about tick removal and identification of the tick species. If you find a Lone Star tick, don’t panic but do seek medical advice.

 It’s not just in Kansas anymore. Climate change is widely thought to be lengthening tick season and pushing tick populations into new territories. The Centers for Disease Control and Prevention reported that emergency room visits for tick bites in 2026 reached their highest levels since 2017 in nearly every region of the country. The emergence of Bourbon virus in New York fits into this larger pattern of expanding tick-borne disease risk.

At present, Bourbon virus remains a rare disease. But, its recent confirmation in New York, far from its original Kansas identification, signals that the geographic range of the Lone Star tick and the pathogens it carries may be shifting. As the researchers at Stony Brook emphasized, continued surveillance will be essential to understanding how widespread the Bourbon virus truly is and to developing tools for detecting and managing it as tick populations continue to expand into new regions.