A Long Island father of three spent five days in the hospital and waited five years for a diagnosis after contracting a rare tick-borne virus that has no treatment, no commercial test, and has already killed two Americans.
Michael Larkin, 67, of Suffolk County, New York, became the state's first confirmed case of Bourbon virus after researchers at Stony Brook University identified the infection in April 2026, roughly five years after two lone star ticks bit him while he worked in his own yard. The diagnosis came only after a year-long antibody trial, and it raises a question public health officials should have been asking sooner: how many other cases across the Northeast are going undetected?
Bourbon virus was first identified in 2014 in Bourbon County, Kansas. In the decade-plus since, only a handful of cases have surfaced nationally, roughly one American per year, with prior detections limited to Missouri, Kansas, and Oklahoma. Two patients diagnosed with the virus have died, in cases health authorities place in 2014 and 2026. No vaccine exists. No antiviral treatment exists. And no commercial diagnostic test is available anywhere in the country. Samples in New York must be sent to the state Department of Health for analysis.
Larkin's ordeal began in 2021. Days after removing the two ticks, he developed a fever and a headache severe enough to send him to a local clinic. He told the staff about the bites. They tested him for Lyme disease. The test came back negative. Doctors prescribed antibiotics anyway.
He did not improve. As Larkin told CBS News:
"I was not feeling well. I went to a local clinic, I told them about the tick bites. They tested for Lyme, but it did not show up."
What followed was a rapid decline. Larkin developed a rash, night sweats, and what he described as an excruciating headache. His condition swung wildly, functional one moment, flat on the couch the next.
"Three or four hours later, I would hit rock bottom and can't get off the couch. I demanded my wife take me to the hospital because that's how bad it was. I couldn't stand it anymore."
He spent five days hospitalized. Doctors released him without a confirmed diagnosis. For years, the cause of his illness remained a mystery.
Larkin's case was eventually picked up by Dr. Luis Marcos, director of the Tick-borne Disease Clinic at Stony Brook University, who had been running a broader antibody study. Between 2019 and 2024, Marcos and his team enrolled 107 people who had presented with fever and other symptoms consistent with tick-borne illness. Blood samples were collected and sent to the New York State Department of Health for analysis.
Larkin's blood was checked every three months. Over a one-month window, his antibody levels, known as titers, increased eight-fold, a spike significant enough to confirm Bourbon virus as the culprit. Dr. Marcos was unequivocal about the finding.
"This one case certainly was the Bourbon virus, and over a one-month period antibody titers increased eight-fold."
The results were published in the American Journal of Tropical Medicine and Hygiene. The study's co-authors called for "expanded viral surveillance, clinical testing and assay development to improve clinical decision-making and inform tick-borne disease epidemiology and vector management."
In plain English: the medical establishment does not have the tools to find this virus, and the researchers who finally did find it are warning that the problem is almost certainly bigger than anyone realizes.
Dr. Marcos pointed to a basic diagnostic problem. Bourbon virus symptoms, fever, fatigue, headache, rash, overlap heavily with Lyme disease and other common tick-borne infections. Clinicians who see those symptoms in the Northeast default to testing for Lyme. When the Lyme test comes back negative, as it did for Larkin, patients can fall through the cracks.
The lone star tick, which carries Bourbon virus, is not rare in the region. Marcos was direct about the implications:
"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."
"For these reasons, the Bourbon virus is likely more prevalent than we think in our region and other cases are likely not being diagnosed."
He also framed the stakes in terms of what happens when public health agencies fail to identify the scope of a threat early.
"Without identifying the cause of an infection, the chances of developing accurate diagnostic tests or effective treatments are minimal. That is why it is so important to first understand the true impact of the virus in high-risk areas."
That statement deserves attention. Twelve years after Bourbon virus was first identified, there is still no commercial test and no treatment. The federal public health apparatus, which spent billions on pandemic preparedness infrastructure, has produced neither for a virus that has killed patients on American soil. Researchers at a single university clinic on Long Island had to run a five-year study on their own to confirm a case their state health department could not catch through routine surveillance.
Larkin recovered from his 2021 hospitalization and now takes precautions outdoors, wearing clothing treated with permethrin, a tick repellent, when he works in his yard. He is alive. Two other Americans diagnosed with Bourbon virus were not as fortunate. Health authorities believe fatal cases occurred in 2014 and 2026, though the identities of those patients and the specific circumstances of their deaths have not been publicly detailed.
Whether the 2026 fatality is connected to the broader Stony Brook study or occurred independently remains unclear. What is clear is that a virus capable of killing Americans has been circulating for more than a decade with minimal public awareness, no diagnostic infrastructure available to frontline clinicians, and no path to treatment.
The lone star tick's range has expanded steadily northward and eastward in recent years. New York's dense suburban population, millions of residents with yards, gardens, and wooded property lines, sits squarely in the tick's habitat. If Marcos is right that Bourbon virus is more prevalent than current case counts suggest, the gap between the threat and the public health response is not shrinking. It is growing.
When a father of three has to wait five years for a diagnosis that a state health department could not produce on its own, the system is not working. And telling Americans there is no test, no treatment, and no cure is not a plan, it is an admission of failure.
