After working for a decade in Meramec State Park in Missouri, Tamela Wilson knew how to protect herself from ticks — when she went into the woods she wore long sleeves and jeans and sprayed herself with insect repellent.

On Mother’s Day, Wilson, who enjoyed camping and being outdoors, asked her daughter Andrea Cabanas to inspect her for ticks. Cabanas spotted two and removed them.

As an assistant superintendent of a state park, Tamela Wilson understood how to protect herself from ticks yet she still contracted a tick-borne illness. Courtesy Amie May

A few days later Wilson, 58, who also had non-Hodgkin’s lymphoma, felt ill so she visited her primary care physician. The doctor diagnosed her with a urinary tract infection and sent her home with antibiotics. But Wilson didn’t improve. She returned to the doctor, who ran blood tests and noticed her white blood cell count was low. The doctor sent her to Barnes-Jewish Hospital in St. Louis for treatment.

“She told the doctors she had a tick bite,” May said. “She looked like she had a flu. She didn’t look herself, but she was fine otherwise.”

Then Wilson developed a rash. Because she worked in a park, doctors suspected she might have Rocky Mountain Spotted Fever, a bacterial disease, or Heartland virus, two tick-borne illnesses that occur in the lower Midwest.

After tests came back negative for Rocky Mountain Spotted Fever and Heartland virus, doctors sent Wilson’s blood to the Centers for Disease Control and Prevention (CDC) for more testing. Wilson received shocking news — she had the Bourbon virus.

“No one had ever heard of it,” May said.

Tamela Wilson enjoyed the outdoors frequently and always made sure to protect herself from ticks. Courtesy Amie May

Similar to other tick-borne illnesses

That’s because Wilson was only the fifth confirmed case of Bourbon virus, which was first discovered in 2014, when a man from Bourbon County, Kansas caught it and subsequently died. There's so little known about the Bourbon infection, it's unclear how long a tick needs to be attached for the virus to be transmitted. For instance, with Lyme disease, a tick needs to be attached for at least 24 hours.

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“It presents with an illness similar to other tick-borne illnesses,” said Dr. Steven Lawrence, a Washington University infectious disease specialist at Barnes-Jewish Hospital, who did not treat Wilson.

People with Bourbon virus experience fatigue, fever, headache, body aches, nausea, vomiting, and a rash. There’s no treatment for it but doctors can manage the symptoms.

“It is a potentially serious infection and raised some concern. But not to the point that everyone should have a daily concern they are going to get the Bourbon virus,” Lawrence said.

People in the lower Midwest are much more likely to contract Rocky Mountain Spotted Fever and ehrlichiosis than Bourbon virus, he said. While these tick-borne illnesses can be serious, there are treatments for both of them.

“The Bourbon and this Heartland virus … have captured a lot of attention because there is not an antiviral treatment for them,” Lawrence said. Heartland virus was first identified in 2011 when two Missouri men got sick and later recovered.

That’s why prevention remains important. Lawrence said people should follow four guidelines to try to avoid tick-borne illness.

Avoid tick heavy areas

Be careful in wooded areas, high grasses, and leaf litter.

Use insect repellent with 20 percent DEET

This prevents ticks bites best, according to the CDC.

Remain covered

Wear long sleeves and long pants and tuck pants into boots.

Do regular tick checks

Removing ticks as soon as possible reduces the chance of illness.

While Wilson followed the guidelines, she still was exposed to a tick carrying the virus. At the same time, she battled the Bourbon virus, Wilson also developed pneumonia and hemophagocytic lymphohistiocytosis (HLH), which doctors treated with a round of chemo.

Amie May hopes that her mom's death from complications of the Bourbon virus reminds people to protect themselves from ticks. Courtesy Amie May

“They were at a loss of what to do for her,” May said. “It was very frustrating. To see her every day and she would just be a little worse than the last time.”

On June 23 Wilson passed away from complications related to the Bourbon virus. May hopes that people hear her mother’s story and realize the importance of protecting themselves from ticks.

“If you are outside in the woods, just check for ticks and know the symptoms," she said.