A patient in New York received treatment for Lyme disease, only to find out later that they were infected with the Bourbon virus. This rare tick-borne illness, lacking a vaccine and treatment, marks the first known case in New York State, specifically on Long Island. The study detailing this case appears in the American Journal of Tropical Medicine and Hygiene.
Tick-Borne Diseases on the Rise
Dr. Suraj Saggar, Head of Infectious Disease at Holy Name Medical Center in New Jersey, commented on the increased spread of tick-borne diseases, attributing it to climate change. His explanation: regions with historically cold, long winters are becoming more suitable habitats for ticks. As temperatures rise and precipitation shifts, ticks spread into new areas and establish themselves.
The Misdiagnosis
The study authors reported that the patient initially received a Lyme disease diagnosis and treatment with doxycycline. Despite this, symptoms like fatigue and severe headaches persisted. Luis Marcos, lead author and professor at Stony Brook University’s Renaissance School of Medicine, noted an eightfold increase in antibody titers over a month, confirming the presence of Bourbon virus.
Misdiagnosis occurred because early symptoms of the Bourbon virus mimic those of Lyme disease. Without a commercial test to confirm Bourbon virus infections, health departments require special testing for suspected cases.
The Study Findings
The diagnosis stemmed from a broader study involving 107 individuals from Suffolk County, New York. These participants experienced fever and other symptoms after tick bites between 2019 and 2024. Their blood samples were checked for Powassan, Heartland, and Bourbon viruses. The results showed two patients with antibodies for Bourbon virus and one for Heartland virus, highlighting the need for increased testing and awareness of these rare viruses.
First identified in 2014, Bourbon virus is named after Bourbon County, Kansas. Previously rare and mostly found in the central U.S., this case suggests its geographic range might be expanding. Symptoms include fever, fatigue, rash, headache, body aches, and nausea. The common lone star tick spreads the virus and has gained attention due to its association with meat allergies.
Prevention Tips
Saggar pointed out tick-borne diseases are prevalent in the Mid-Atlantic, Northeast, New England, parts of the Midwest, and West, including Michigan’s Upper Peninsula. Lyme disease sees a two to threefold increase in cases over two decades as tick habitats widen.
Saggar advises wearing light-colored clothing, long sleeves, and pants tucked into socks while hiking, as ticks are attracted to darker shades. Using DEET-based insect repellents and permethrin-treated clothes also offers protection.
A thorough post-outdoor check for ticks on the body, behind the knees, in the groin, underarms, and along the scalp, is crucial. If a tick attaches for 48 to 72 hours, healthcare providers might prescribe doxycycline as a preventive measure.
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