Rare Tick-Borne Bourbon Virus Surfaces in New York

A patient in New York revealed a diagnostic challenge involving the rare tick-borne Bourbon virus. Initially treated for Lyme disease, the patient was actually infected with this virus, which lacks a vaccine and cure. This case marks the first known Bourbon virus infection in New York, specifically on Long Island, as documented in research published in the American Journal of Tropical Medicine and Hygiene.

Tick-Borne Disease Expansion

Dr. Suraj Saggar, the chief of Infectious Disease at Holy Name Medical Center in Teaneck, New Jersey, informed Newsweek about the growing spread of tick-borne diseases. Climate changes allow ticks to thrive in previously inhospitable areas. As winters shorten and precipitation patterns shift, ticks extend their reach into new territories.

Misdiagnosis Due to Similarity

The study highlighted that the patient initially received a Lyme disease diagnosis and was treated with doxycycline. However, symptoms like severe fatigue and headaches persisted. Dr. Luis Marcos, the study’s lead author and a professor at the Renaissance School of Medicine at Stony Brook University, noted an eightfold increase in antibody titers, confirming a Bourbon virus infection.

Early symptoms of Bourbon virus closely mimic Lyme disease, leading to potential misdiagnosis. Without a commercial test for Bourbon virus, samples must be sent to the state health department for specialized testing.

Case Discovery and Implications

This incident arose from a broader study of 107 individuals in Suffolk County, New York, who developed fever and other symptoms post-tick bite between 2019 and 2024. Blood samples from this group were screened for Powassan, Heartland, and Bourbon viruses. Two individuals showed antibodies for Bourbon virus, and one for Heartland virus. None tested positive for Powassan virus. A fourfold antibody increase in two patients indicated a recent or active infection, highlighting the need for broader testing.

Bourbon Virus Background

Discovered in 2014, the Bourbon virus is named after Bourbon County, Kansas. It primarily exists in the central U.S., although this case hints at a broader range. Symptoms include fever, fatigue, rash, headache, body aches, and nausea. The virus is spread by the lone star tick, which also raises concerns due to its link to meat allergies.

Preventing Tick Bites

Dr. Saggar emphasized that tick-borne illnesses are most common in the Mid-Atlantic, Northeast, New England, and parts of the Midwest and West. The expansion of tick habitats has doubled or tripled Lyme disease cases over two decades.

For protection, he suggests wearing light-colored clothing, long sleeves, and pants tucked into socks during hikes. Using insect repellents with DEET and permethrin-treated clothes also helps.

After outdoor activities, he advises thorough tick checks, focusing on areas like behind the knees, groin, underarms, and along the scalp, and promptly removing any attached ticks. Some healthcare providers might prescribe doxycycline as a precaution if a tick remains attached for 48 to 72 hours.

Reference: Bateman, V. A., et al. (2026). Evidence of Heartland and Bourbon Viruses Transmitted by Ticks in Suffolk County, New York, The American Journal of Tropical Medicine and Hygiene. https://doi.org/10.4269/ajtmh.26-0012.

Contact Newsweek editors on this story: Kara Dolman and Sam Wilson.