What Is Bourbon Virus? Symptoms, Treatment, and Tick-Borne Risks
Bourbon virus remains poorly understood
Symptoms may resemble other tick-borne illnesses
Treatment options remain limited
Bourbon virus is a rare tick-borne infection that can cause fever, fatigue, rash, muscle aches, nausea, and weakness. Because the disease is uncommon and symptoms overlap with other infections, diagnosis can be challenging.
Patients frequently ask what Bourbon virus is, whether it can be treated, and how dangerous the infection may be. Unfortunately, there are currently no approved treatments or vaccines.
Researchers have explored whether antiviral medications used for influenza might offer future treatment options, but current evidence remains limited.
In 2017, a 58-year-old woman from Missouri developed generalized weakness, myalgia, nausea, and rash approximately one week after tick exposure. Despite hospitalization, she died after 23 days. Similar fatal cases have been reported in the United States, although Bourbon virus remains rare.
What Are Bourbon Virus Symptoms?
Bourbon virus symptoms overlap with several other tick-borne diseases, which may complicate diagnosis.
- Fever
- Fatigue
- Rash
- Headache
- Body aches
- Nausea
- Vomiting
- Weakness
- Myalgia
- Arthralgia
Because symptoms overlap with other infections, clinicians may need to consider broader diagnostic possibilities, especially following tick exposure.
Why Bourbon Virus Can Be Difficult to Diagnose
The virus remains relatively new, and there are currently no widely available diagnostic tests, approved antiviral therapies, or vaccines.
Diagnostic uncertainty may delay recognition, particularly when symptoms resemble other illnesses after a tick bite.
Learn more about delayed diagnosis after tick exposure.
How Is Bourbon Virus Spread?
Current evidence suggests the Lone Star tick (Amblyomma americanum) is the primary vector for Bourbon virus transmission in the United States.
Researchers have also raised concerns that the geographic expansion of Lone Star ticks could increase future exposure risk in areas where these ticks were previously uncommon.
Because Lone Star ticks continue expanding geographically, clinicians may increasingly encounter patients concerned about emerging tick-borne infections.
Could Antiviral Drugs Treat Bourbon Virus?
Researchers at Washington University School of Medicine explored whether the antiviral medication favipiravir might help treat Bourbon virus infection.
Using a mouse model, investigators found that favipiravir protected mice from lethal infection.
“Without the flu drug, 100% of the infected mice died, and with the treatment, 100% survived.”
The researchers treated mice daily for 8 days using oral favipiravir beginning immediately after infection.
To evaluate delayed treatment, researchers started therapy after symptoms developed and after viral replication had already been detected throughout the body.
One day after treatment began, mice stopped losing weight and gradually recovered.
The authors concluded:
“Prophylactic and therapeutic treatment with favipiravir resulted in complete protection from a lethal BRBV infection.”
Although promising, these findings come from animal studies and should not be assumed to translate directly to humans.
What Is the Bourbon Virus Mortality Risk?
The true mortality rate remains uncertain because relatively few cases have been identified. However, multiple deaths have been reported, suggesting severe disease can occur in some patients.
Severe disease appears more likely when diagnosis is delayed or supportive care is limited, although predictors remain poorly understood.
Other emerging infections can present similar diagnostic challenges. Learn more about tick-borne coinfections.
Does Bourbon Virus Go Away?
Many patients ask whether Bourbon virus simply goes away on its own. Because cases remain uncommon, the natural history is not fully understood.
Some patients recover with supportive care, while others have developed severe disease requiring hospitalization. Researchers are still working to understand who is most likely to recover and who may be at higher risk for complications.
Frequently Asked Questions
What is Bourbon virus?
Bourbon virus is a rare tick-borne viral infection associated with fever, fatigue, rash, and systemic illness.
What are Bourbon virus symptoms?
Symptoms may include fever, weakness, nausea, rash, body aches, fatigue, headache, vomiting, and muscle pain.
Is there treatment for Bourbon virus?
There are currently no approved treatments, though antiviral drugs are being studied.
How dangerous is Bourbon virus?
Severe disease and fatalities have been reported, though the true mortality risk remains uncertain.
Does Bourbon virus go away?
Some patients recover, but severe disease and fatalities have been reported. Long-term outcomes remain poorly defined because cases remain rare.
Clinical Takeaway
Bourbon virus remains poorly understood because cases remain uncommon and diagnostic tools are limited.
Emerging tick-borne viral illnesses highlight the importance of recognizing unusual symptoms after tick exposure and understanding that treatment options may still be evolving.
Related Articles
These related articles explore emerging infections, viral illnesses, and diagnostic challenges following tick exposure.
10 cases of Heartland virus reviewed
Chikungunya virus can mimic Lyme disease
Tick bite prevention strategies
Tick-borne symptom guide
Persistent symptoms after tick-borne illness
References
- Bricker TL, Shafiuddin M, Gounder AP, Janowski AB, Zhao G, Williams GD, et al. Therapeutic efficacy of Favipiravir against Bourbon virus in mice. PLoS Pathog. 2019;15(6):e1007790.
- Hao S, Ning K, Küz CA, McFarlin S, Cheng F, Qiu J. Eight years’ advances on Bourbon virus, a tick-born Thogotovirus of the Orthomyxovirus family. Zoonoses. 2022;2(1):18.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
