A Long Island man became New York's first confirmed Bourbon virus case this year, contracting the rare, sometimes-fatal tick-borne disease from ticks he found on his leg while doing yard work.
The case matters beyond one patient. The lone star tick responsible for spreading Bourbon virus has pushed north for two decades, from a once-southern insect into an established presence across more than 30 states, and it now turns up in brush and tall grass well outside its historic range, not just in the South.
Doctors at Stony Brook Medicine confirmed the case in April 2026 in a 67-year-old patient named Michael Larkin. He'd spotted two lone star ticks on his leg while landscaping; a month later, blood tests showed his antibody levels had climbed eightfold. "This one case certainly was the Bourbon virus, and over a one-month period antibody titers increased eight-fold," said Dr. Luis Marcos, director of Stony Brook's Tick-borne Disease Clinic. Larkin was hospitalized with severe symptoms and recovered.
Marcos doesn't think Larkin's case was unusual, just unusually caught. "The Bourbon virus is likely more prevalent than we think in our region and other cases are likely not being diagnosed," he said. No standard clinical lab in the US currently tests for Bourbon virus, so a case only surfaces when a doctor specifically thinks to look for it. The disease has killed three people since researchers first identified it in 2014: a Kansas farmer that year, a Missouri man in 2017, and a 63-year-old Kansas man in 2026 who developed organ failure and needed ECMO support after removing three ticks from his body five days earlier.
Bourbon virus itself is rare, with roughly a handful of confirmed cases since 2014. The tick behind it is not. Amblyomma americanum, the lone star tick, was a southern species twenty years ago; current surveillance now puts established populations in more than 30 states, with new activity showing up in Minnesota, Michigan, Iowa, and coastal New England, and overwintering populations as far north as coastal Maine. Warmer winters let eggs and overwintering nymphs survive at latitudes that used to be a hard stop, and migratory birds carry larval and nymphal ticks hundreds of miles in a single flight.
That combination widens the ground where ticks and backcountry travel overlap. A multi-day route through brush, tall grass, or an overgrown two-track puts a person, a dog, and a rig's interior all in contact with exactly the habitat this tick has been colonizing. It's also a wider stretch of the calendar than most people plan around. Lone star ticks are active from early spring through fall across most of their range, and adult females in particular will climb onto anything that brushes past, vehicle bumpers and gear bags included, not just bare skin.
The states carrying the heaviest documented lone star tick pressure today, Missouri, Arkansas, Oklahoma, and the broader Mid-Atlantic and Southeast, overlap directly with some of the busiest overland routes east of the Rockies: the Ozark backroads, Appalachian forest routes through Virginia and West Virginia, and coastal-plain trail networks from the Carolinas down through Georgia. None of that means avoiding those regions. It means treating a tick check as a routine part of camp setup there, the same way a trip through open desert calls for checking radiator screens for brush.
Permethrin-treated clothing is the tool the CDC, EPA, Department of Defense, and World Health Organization all recommend, but the lab data behind it is more specific than "it works." A CDC study led by entomologist Lars Eisen found permethrin-treated fabric disabled ticks unevenly by species and life stage: after an hour of exposure, every blacklegged tick nymph and 86 percent of lone star tick nymphs had lost normal movement, but only 2 percent of adult lone star ticks and 18 percent of adult American dog ticks had. Treat clothing and gear, never skin, and don't assume it's a complete shield against the adult ticks most likely to be biting on a summer trip.
The more reliable habit is the low-tech one: check people, pets, and gear for ticks at the end of every day outside, especially around the waistband, hairline, and behind the ears. That check extends to the rig itself. Ticks ride in on gear bags, tent stuff sacks, and pant legs tossed in the back seat, and a folded tent pitched again a week later without a look-over is a good way to carry one from a Missouri campsite to the next stop three states away. Pick a campsite with the grass already knocked down or gravel underfoot when there's a choice, rather than pitching straight into brush.
Remove any tick promptly with fine-tipped tweezers, pulling straight out without twisting, and note the date. If fever, fatigue, or a rash follows in the days after a trip, tell a doctor specifically that a tick was involved, since Bourbon virus won't show up on a standard test panel unless someone asks for it by name.
Frequently asked questions
How common is Bourbon virus?
Rare. Roughly a handful of cases have been confirmed since researchers identified it in 2014, and three have been fatal, most recently a Kansas man in 2026.
How is Bourbon virus different from Lyme disease?
Both spread through tick bites, but different ticks and different pathogens cause them. Lyme comes from blacklegged ticks and responds to antibiotics; Bourbon virus is spread by the lone star tick and has no vaccine or treatment, since antibiotics don't work on viruses.
Can pets get Bourbon virus?
No confirmed animal cases have been documented, but pets can carry infected ticks into a vehicle or a campsite, so the same tick checks that apply to people apply to dogs after time in brush or tall grass.
What do I do if I find a tick on myself after a trip?
Remove it with fine-tipped tweezers, pulling straight out. Watch for fever, fatigue, rash, headache, body aches, or nausea in the days after, and tell a doctor a tick was involved if symptoms appear, since Bourbon virus requires a specific test rather than a standard panel.
How we reported this
This article draws on the following sources:
- Fox Weather — First case of rare, potentially fatal tickborne virus confirmed in New York state, Jul. 31, 2026 — the Stony Brook Medicine case and Dr. Luis Marcos's quotes.
- Fox 5 New York — What is Bourbon virus? — patient identification and exposure detail.
- Tech Times — Bourbon Virus Reaches New York: Doctors Have No Standard Test to Find It, Jul. 30, 2026 — the diagnostic-testing gap.
- Case Reports in Infectious Diseases (Wiley) — Lethal Case of Bourbon Virus Leading to Shock and ECMO Utilization, Mitchell et al., 2026 — the fatal Kansas case.
- CDC — About Bourbon Virus — disease basics, transmission, and symptoms.
- CIDRAP, University of Minnesota — Study: Treated clothes stop ticks in their tracks — the CDC permethrin lab study.
- Entomology Today — New CDC Tick Study Adds to Promise of Permethrin-Treated Clothing — corroborating detail on the same study.
- New England Journal of Medicine (Perspective) — Bracing for the Worst: Range Expansion of the Lone Star Tick in the Northeastern United States — the range-expansion mechanism.