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Tick-borne condition • Viral

Bourbon virus disease

Bourbon virus disease is a rare viral illness that, in the United States, is believed to spread through the bite of an infected Lone Star tick. Reported cases have typically caused a flu-like illness with fever, fatigue, and body aches, and only a small number of cases have ever been documented since the virus was identified in 2014. There is no specific antiviral medicine or vaccine, so care is supportive, and only a licensed clinician can diagnose it. Preventing tick bites is the most effective protection.

Last reviewed: 2026-07-20 · Educational only — not medical advice.

Carried by the Lone Star tick. Spread by: Lone Star tick.

What is bourbon virus disease?

Bourbon virus is a virus first identified in 2014, after a resident of Bourbon County, Kansas, became ill following tick exposure — the source of its name. In the United States, CDC says it is believed to spread to people mainly through bites of infected ticks, likely Lone Star ticks (Amblyomma americanum). It remains rare, and researchers are still studying exactly how often it occurs, its full range, and how it is transmitted.

Symptoms

  • Fever
  • Fatigue (tiredness)
  • Headache and body aches
  • Rash
  • Nausea and vomiting
  • Abnormally low white blood cell and platelet counts (found on lab tests)

How soon do symptoms appear?

Not firmly established by CDC. In the small number of reported cases, symptoms have generally begun within days to a couple of weeks of a tick bite (broadly described as days to weeks). CDC has not published a precise incubation period for Bourbon virus.

Diagnosis

There is no routine at-home or standard office test for Bourbon virus. A clinician who suspects it — for example, in a tick-exposed patient with fever plus low white blood cell and platelet counts that do not improve with antibiotics — can arrange specialized laboratory testing through state health departments and CDC. It cannot be self-diagnosed.

Treatment

There is no antiviral drug or vaccine for Bourbon virus. Because it is a virus, antibiotics do not work against it. Care is supportive: rest, fluids, and over-the-counter medicines for fever and aches in milder illness. People who become severely ill may need hospital care with IV fluids and monitoring. A licensed clinician should guide any treatment.

Prevention

The best protection is avoiding tick bites. Use an EPA-registered repellent (such as DEET or picaridin), treat clothing and gear with 0.5% permethrin, stay on cleared trails away from tall grass and leaf litter, and do a full-body tick check and shower within about two hours of coming indoors. Prompt, correct tick removal further lowers risk. No vaccine or preventive medicine is available.

Where it occurs

Bourbon virus cases have been reported from the Midwest, East Coast, and Southern United States, matching the general range of the Lone Star tick. It was named for Bourbon County, Kansas, where the first case was identified in 2014. Because so few cases have been reported, its full geographic footprint is still being mapped.
When to seek care: Contact a clinician if you develop fever, fatigue, body aches, or a rash within a few weeks of a tick bite or time in tick habitat — especially in areas where Lone Star ticks are common — and be sure to mention the tick exposure. Seek urgent care for severe symptoms such as a very high fever, confusion, or signs of serious illness. This page is educational and is not a substitute for professional medical advice. For emergencies such as trouble breathing or anaphylaxis, call emergency services. Educational information only — not medical advice. See our sources and disclaimer.

Bourbon virus disease — frequently asked questions

Which tick spreads Bourbon virus?+

CDC reports that Bourbon virus is believed to spread through bites of infected ticks, likely the Lone Star tick (Amblyomma americanum), the same tick linked to Heartland virus, ehrlichiosis, STARI, tularemia, and alpha-gal syndrome. Transmission is described as 'believed'/'likely,' and research is ongoing.

How soon after a tick bite would Bourbon virus symptoms appear?+

CDC has not published a specific incubation period. In the few reported cases, illness has generally started within days to a couple of weeks of a tick bite. If you feel ill after a bite, contact a clinician rather than waiting for an exact timeline.

Is there a cure, medicine, or vaccine for Bourbon virus?+

No. There is no antiviral drug and no vaccine. Antibiotics do not work because it is a virus. Treatment is supportive — rest, fluids, and symptom relief — with hospital care for severe illness.

Does the Lone Star tick spread Lyme disease or Rocky Mountain spotted fever?+

No. Despite being an aggressive biter, the Lone Star tick does not transmit Lyme disease (spread by blacklegged/deer ticks) and is not a primary vector of Rocky Mountain spotted fever (spread mainly by American dog, Rocky Mountain wood, and brown dog ticks). This is a common point of confusion for Lone Star tick areas.

How common is Bourbon virus?+

It is very rare. Only a limited number of human cases have been reported since the virus was identified in 2014, and some have been severe. Because reporting and testing are still developing, the true number of infections is not precisely known.

Sources used

  • Bourbon Virus

    Rare tickborne virus first identified in the U.S. in 2014; supportive care only.

    CDC
  • Heartland Virus

    Rare virus associated with Lone Star tick bites; no specific antiviral treatment.

    CDC
  • Where Ticks Live

    The Lone Star tick is widely distributed in the Northeast, South, and Midwest U.S.

    CDC
  • CDC
  • Tick Removal

    Step-by-step guidance for removing an attached tick.

    CDC
  • Lyme Disease

    Spread by blacklegged (deer) ticks — NOT the Lone Star tick. Early sign is often an expanding erythema migrans rash.

    CDC

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Bourbon virus disease

Bourbon virus is a rare illness believed to spread through Lone Star tick bites in the US. Learn the symptoms, the days-to-weeks onset window, testing, supportive care, and how to prevent tick bites. Educational, not medical advice.

Educational • not medical advice
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Lone Star tickHeartland virus diseaseEhrlichiosisSouthern Tick-Associated Rash Illness (STARI)TularemiaAlpha-gal syndrome
All tick-borne diseases →After a tick bite →Prevention →