Tick-Borne Bourbon Virus Discovered in New York: A Growing Concern

A recent study has unveiled a diagnostic issue stemming from a tick bite in New York, highlighting an instance of misdiagnosis between Lyme disease and Bourbon virus infection. The research, published in the American Journal of Tropical Medicine and Hygiene, confirms the first recorded case of Bourbon virus in New York State, precisely on Long Island.

The Spread of Tick-Borne Diseases

Dr. Suraj Saggar, chief of Infectious Disease at Holy Name Medical Center in Teaneck, New Jersey, shared insights with Newsweek regarding the increasing spread of tick-borne diseases due to climate changes. He noted that regions previously characterized by colder winters are becoming more accommodating to ticks as temperatures rise and precipitation patterns shift, allowing ticks to inhabit new environments.

Misdiagnosed Case and Research Findings

The initial misdiagnosis in the patient identified in the study stemmed from similarities in symptoms between Lyme disease and Bourbon virus. After being treated with the antibiotic doxycycline for Lyme disease, the patient continued to experience fatigue and severe headaches. According to Luis Marcos, lead author of the study and professor at the Renaissance School of Medicine at Stony Brook University, the patient’s symptoms worsened over a month as antibody levels rose eightfold, necessitating hospitalization.

Bourbon virus symptoms mimic Lyme disease, leading to diagnostic confusion. Due to the absence of commercial testing options for Bourbon virus, samples from suspected cases must be submitted to the state health department for specialized testing.

Discovery and Implications

The emergence of this case came from a broader investigation involving 107 individuals from Suffolk County, New York, between 2019 and 2024. These individuals had developed fever and other symptoms following tick bites. Blood samples were analyzed for three tick-borne viruses: Powassan, Heartland, and Bourbon.

Two patients showed evidence of Bourbon virus antibodies, and one for Heartland virus. None tested positive for Powassan virus. The findings emphasized the importance of broader testing and vigilant monitoring of these less recognized viruses.

Bourbon virus, identified in 2014 in Bourbon County, Kansas, is mainly found in the central U.S. Symptoms include fever, fatigue, rash, headache, body aches, and nausea. It is spread by the lone star tick, notorious for inducing meat allergies through its bite.

Precautions Against Tick Bites

Tick-borne diseases are prevalent in regions such as the Mid-Atlantic, Northeast, New England, and parts of the Midwest and West, including Michigan’s Upper Peninsula. Lyme disease cases have significantly increased as tick habitats expand.

Precautionary measures include wearing light-colored clothing, long sleeves, and pants tucked into socks during hikes. Insect repellent with DEET and permethrin-treated clothing offer additional protection.

Dr. Saggar recommends checking the body thoroughly for ticks, focusing on areas such as behind the knees, the groin, underarms, and the scalp after outdoor activities. Prompt removal of attached ticks is crucial. He mentioned that doxycycline might be prescribed as a post-exposure measure 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. doi:10.4269/ajtmh.26-0012.