New York Confirms First Bourbon Virus Case: No Vaccine, No Cure, No Standard Test

The Case

A 67-year-old Suffolk County landscaper named Michael Larkin was bitten by two lone star ticks while working outdoors in 2021, according to Hudson Valley Post. He got sick. Doctors initially treated him for a more common tick-borne illness because the symptoms lined up with Lyme disease, according to NDTV.

He got worse. Eventually doctors identified Bourbon virus as the cause. Larkin was hospitalized and made a full recovery, according to both NDTV and Hudson Valley Post.

His blood sample sat unexamined for years. Researchers at Stony Brook Medicine only confirmed the Bourbon virus diagnosis recently, as part of a study analyzing blood from 107 patients with suspected tick-borne illness collected between 2019 and 2024, according to SciTechDaily. The findings were published in the American Journal of Tropical Medicine and Hygiene.

What Bourbon Virus Actually Is

Bourbon virus was first identified in 2014 in Bourbon County, Kansas, after a man died from an unexplained illness following multiple tick bites, according to NDTV. That original patient's death remains one of at least two fatalities linked to the virus, according to Fox News.

It's a thogotovirus, a family related to influenza but spread by ticks instead of person-to-person contact, according to NDTV. Only six human cases had been reported nationwide before this New York confirmation, according to Fox News.

Symptoms include fever, fatigue, rash, headache, body aches and nausea, per Fox News and SciTechDaily. In severe cases, patients can develop low white blood cell and platelet counts, liver abnormalities, and breathing difficulties requiring hospital care, according to NDTV.

There is no vaccine. There is no specific antiviral treatment. There is no commercially available diagnostic test. All four outlets agree on that basic set of facts. Treatment is supportive care only: IV fluids, fever and pain management, oxygen if needed, and monitoring, according to NDTV.

Why It's Hard to Catch

Standard antibiotics like doxycycline, the go-to for Lyme disease, do nothing against Bourbon virus because it's viral, not bacterial, according to Hudson Valley Post. Suspected samples have to be sent directly to the New York State Department of Health or the CDC for confirmation. That's a slow process, and cases can sit undetected for years, which is exactly what happened with Larkin's 2021 exposure.

"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 they are similar to other tick-borne infections," said Dr. Luis Marcos, a Stony Brook Medicine professor and director of the Tick-borne Disease Clinic, in comments carried by both Fox News and SciTechDaily. "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 study Marcos led found two patients out of 107 tested had neutralizing antibodies against Bourbon virus. One showed a fourfold rise in antibody levels, evidence of a recent or acute infection, according to SciTechDaily.

The Bigger Picture on Ticks

The lone star tick, identifiable by a white dot on the backs of adult females, is already known for spreading ehrlichiosis and tularemia, and it's linked to Alpha-Gal Syndrome, the red-meat allergy triggered by tick bites, according to SciTechDaily. Milder winters and expanding wildlife populations have let the tick spread aggressively across the Northeast in recent years, according to Hudson Valley Post.

Fox News tied this story to a broader tick-season warning, citing Dr. Marc Siegel's comments on record-high Powassan virus cases, 15 reported so far this year following a record 76 in 2025. Powassan and Bourbon are different viruses, but Fox's framing groups them together as evidence of a growing tick-borne disease problem in the Northeast that outpaces the medical system's ability to test for it.

The concern isn't hype. When a disease has no commercial test and confirmation requires shipping samples to a state or federal lab, genuine underdiagnosis is a real possibility, not a scare tactic. Marcos himself, the researcher who led the study, is making that exact argument.

What's not established is how many people are actually infected. Two out of 107 tested patients showing antibody evidence isn't a basis for claiming an epidemic. It's a basis for saying more surveillance is needed, which is what Marcos and his co-authors are explicitly calling for.

What Comes Next

There's no indication any additional Bourbon virus cases have been confirmed in New York beyond Larkin's. The Stony Brook team's stated goal is expanded surveillance and better testing, according to Fox News. Until a commercial diagnostic test exists, patients bitten by lone star ticks who develop Lyme-like symptoms that don't respond to antibiotics remain the main way additional cases will surface, one hospitalization at a time.