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St. Louis County resident bit by tick likely had Bourbon virus


The rare Bourbon virus could be in the St. Louis region, state health officials say.

A patient with symptoms matching the virus was bitten by a tick recently in the southwest part of St. Louis County, but has recovered.

The announcement from the Missouri Department of Health and Senior Services indicates the sometimes-deadly virus could be spreading through the state, experts said.

The virus was first reported in Missouri last year. In June 2017, a state park worker died after contracting the virus, likely spread by ticks. A resident of southwest Missouri and another in the east central part of the state have developed the virus and recovered, according to the department.

The St. Louis County resident who developed the virus was a nature lover and an “excellent historian,” Missouri State Health Director Randall Williams said. That likely helped the person pinpoint when and where the tick bite that potentially caused the virus occurred. The patient exhibited the symptoms of Bourbon virus — fever, headache and joint pain — after the bite.

During the summer, people should be vigilant in trying to prevent tick bites. They and their health care providers should watch for symptoms, which also include nausea, vomiting and loss of appetite, Williams said.

The Centers for Disease Control and Prevention “feels like in the United States this year, it’s going to be an especially bad year for ticks, so the overall message is to have a high index of suspicion,” Williams said, adding the St. Louis County patient initially tested negative for the virus but underwent new tests after health workers recognized the symptoms.

Few people have been diagnosed withthe Bourbon virussince it was first found in 2014 in a man from Bouble County, Kansas.  The symptoms are similar to several other tick-borne diseases such its fellow newcomer, the Heartland virus, which was discovered in 2009.

“We would think Bourbon and Heartland will continue to emerge," Williams said. “We don’t know for sure, but we are operating under the assumption we’ll see more cases.”

Because the virus is new, the state doesn’t have the abilities to test for it, Williams said. The state sent this patient’s test results to a lab at the CDC that can confirm the presence of the virus in two or three weeks.

County health officials are looking out for the potential for disease, said Fred Echols, communicable disease director at the St. Louis County Health Department. Prevention requires the same strategy as other more established vector-borne illnesses: DEET bug spray and daily checks after going outside, he said.

“The best way to prevent tick-spread diseases is by preventing tick bites,” he said. “The fundamentals of public health don’t change based on one incident, so our core messaging will remain the same.”

Echols said the county has several initiatives to address tick-borne illnesses, which the CDC has said have increased threefold in the past decade. Those include identifying all the ticks endemic to the St. Louis County area and the developing the abilities to test them for different diseases.

There are several hundred cases of tick-spread viruses reported every year in Missouri, but because the state can counts only the reported cases, the actual number is likely much higher,  Saint Louis University infectious disease professor Sarah George said.

“Honestly, for all we know … there may have been infections for decades if not hundreds of years. It depends on how hard you’re looking for them and what kind of tests you’re using,” George said. Testing technology has become much more sophisticated in the past two decades and it’s possible researchers only discovered the disease in recent years.

Many aspects of the Bourbon virus remain a mystery. It’s unclear why the virus is causes death in some people and not others, and if people who have contracted the disease have created antibodies to keep them safe in the future, George said.

George joined Williams and Echols in preaching prevention:

“I know it’s no fun, but ideally, you ought to wear long sleeves and pants,” George said. “And if you’re out in the woods, or even in your yard, when you come inside, take off all your clothes and check all over for ticks.”

Follow Sarah on Twitter: @petit_smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.