The lone star tick, shown on this plant leaf, can transmit the Bourbon virus.
Photo Credit: Ilia Rochlin, Stony Brook University.
Scientific Frontline: Extended "At a Glance" Summary: Bourbon Virus and the Lone Star Tick
The Core Concept: The Bourbon virus is an emerging, rare viral pathogen transmitted by the lone star tick (Amblyomma americanum) that causes severe, influenza-like illness in humans.
Key Distinction/Mechanism: Unlike common bacterial tick-borne illnesses, such as Lyme disease or ehrlichiosis, the Bourbon virus is viral and does not respond to standard antibiotic treatments like doxycycline. Furthermore, the absence of commercial testing makes acute diagnosis highly difficult, requiring specialized antibody titer analysis.
Major Frameworks/Components:
- Transmission Vector: The lone star tick, which also acts as a vector for ehrlichiosis, tularemia, and alpha-gal syndrome.
- Symptom Profile: Initial symptoms closely mimic other tick-borne infections, presenting as fever, fatigue, rash, severe headaches, body aches, and nausea.
- Laboratory Diagnostics: Due to the lack of exact commercial tests, disease confirmation requires sending blood samples to state health departments to detect neutralizing antibodies; a four-fold or greater rise in antibody titers indicates an acute or recent infection.
- Epidemiological Risk: Research examining 107 individuals with tick-borne illness symptoms revealed two cases with Bourbon virus antibodies, suggesting the pathogen is likely more prevalent in regions with dense tick populations than previously diagnosed.
Branch of Science: Epidemiology, Infectious Diseases, Virology, Entomology, and Immunology.
Future Application: These findings highlight the immediate need for the development of accessible commercial diagnostic assays, expanded viral surveillance networks, and enhanced vector management strategies.
Why It Matters: As the lone star tick population thrives in the Northeast United States, the risk of Bourbon virus infections rises. Clinical unfamiliarity and diagnostic bottlenecks increase the likelihood of misdiagnosis, which can delay proper supportive care and potentially lead to fatal outcomes.
Tick-borne diseases are common throughout the United States, and most cases are treated effectively. A rarely diagnosed tick-borne infection, the Bourbon virus, transmitted through the common lone star tick (Amblyomma americanum), could soon begin to complicate diagnoses if it becomes more prevalent this summer and in coming years.
This finding was reported by a team of researchers led by Stony Brook Medicine. They confirmed the first Bourbon virus case in New York State, on Long Island, in a paper published in the American Journal of Tropical Medicine and Hygiene.
The lone star tick, shown on this plant leaf, can transmit the Bourbon virus. Photo credit: Ilia Rochlin, Stony Brook University.
The Bourbon virus was discovered in 2014 and named for Bourbon County, Kansas, the area where the virus was first identified. There are no vaccines to prevent or medicines to treat the illness, which remains rare and is found mostly in regions in the central United States. Symptoms of the virus include fever, fatigue, rash, headache, body aches, and nausea.
The lone star tick acts as a vector for several bacterial and viral illnesses, including ehrlichiosis, tularemia, and alpha-gal syndrome, a condition that causes the immune system to produce allergic antibodies leading to a meat allergy. When a patient presents with symptoms common to these conditions and has been bitten by a lone star tick, a diagnosis typically results. However, if someone has a rare infection transmitted by the lone star tick, such as the Bourbon virus, diagnosis and treatment are more difficult because there is currently no precise commercial test to confirm the viral infection.
“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 are similar to other tick-borne infections,” said Luis Marcos, MD, lead author, professor in the Departments of Medicine and Microbiology and Immunology at the Renaissance School of Medicine (RSOM) at Stony Brook University, and director of the Tick-Borne Disease Clinic. “For these reasons, the Bourbon virus is likely more prevalent than we think in our region, and other cases are likely not being diagnosed.”
The Bourbon virus remains a rare infection, and because of this, many clinicians may be unfamiliar with it, thus increasing the possibility of misdiagnosis. Because there is no commercial test for the virus, any samples in New York are sent to the New York State Department of Health for analysis.
Marcos and colleagues identified the first tick-borne Bourbon virus case in April 2026. The finding was based on a published study of 107 individuals presenting with fever and other tick-borne illness symptoms between 2019 and 2024. Blood samples were collected from patients and sent to the New York State Department of Health. Two cases had neutralizing antibodies for the Bourbon virus. One of these patients had a fourfold rise in antibody titers for the Bourbon virus, which, according to the researchers, indicates an acute or recent infection of this virus.
“This one case certainly was the Bourbon virus, and over a one-month period, antibody titers increased eightfold. The patient showed some very severe symptoms and was hospitalized,” Marcos said.
He added that early symptoms can be very similar to Lyme disease. This patient was initially diagnosed with Lyme disease and received standard doxycycline but showed no improvement in symptoms, which included fatigue and severe headaches.
A 2014 case of the Bourbon virus in Kansas caused by a tick bite resulted in a patient's death. In 2026, the virus caused another fatal case.
Marcos and his coauthors stress that, for clinicians, the results of their study “highlight the need for expanded viral surveillance, clinical testing, and assay development to improve clinical decision-making and inform tick-borne disease epidemiology and vector management.”
He added, “Without identifying the cause of an infection, the chances of developing accurate diagnostic tests or effective treatments are minimal. That is why it is so important to first understand the true impact of the virus in high-risk areas.”
Published in journal: American Journal of Tropical Medicine and Hygiene
Title: Evidence of Heartland and Bourbon Viruses Transmitted by Ticks in Suffolk County, New York
Authors: Victoria A. Bateman, Rudline G. Zamor, Brigitte Maczaj, Angelina Blyufer, and Charles Kyria
Source/Credit: Stony Brook University
Edited by: Scientific Frontline
Reference Number: epi072126_01
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