Maybe you’ve heard about the mysterious red meat allergy some people are suddenly developing. Or maybe you’re just worried in general about tick bites and tickborne illnesses. Put those together, and you may now find yourself concerned about the lone star tick and its ability to make you sick with alpha-gal syndrome (AGS).
“Alpha-gal syndrome was first noticed in the South, but rates are rising in other parts of the country, including the Midwest,” says Amy A. Eapen, M.D., a pediatric allergist-immunologist and allergy researcher at Henry Ford Health.
Here, Dr. Eapen details how to spot the signs of AGS, live with the symptoms and, ideally, prevent tick bites in the first place.
Where Did Alpha-Gal Syndrome Come From?
The discovery and journey of alpha-gal syndrome began in the Southeastern United States. In the early 2000s, doctors began noticing that some patients receiving infusions of a specific cancer medication (cetuximab) were having odd allergic reactions.
“Researchers looking into these reactions identified the alpha-gal carbohydrate, which is in the medication, as the source of the reaction,” explains Dr. Eapen. “They found that the patients who had allergic reactions to the medication already had antibodies to alpha-gal (likely from a previous tick bite), which could explain allergic reactions to the drug on the first dose.”
Separately, some people in the same region were waking up in the middle of the night with severe diarrhea or allergic reactions after eating a dinner that included red meat. Researchers eventually put the two together and identified that red meat also contains alpha-gal.
The Connection Between the Lone Star Tick and Red Meat Allergy
“The saliva of the lone star tick contains alpha-gal,” says Dr. Eapen. “This is likely the result of the tick previously biting a deer or other mammal.”
Then, if you get bitten by that tick, alpha-gal makes its way under your skin and into your bloodstream. Your immune system reacts to this foreign substance by producing antibodies against it.
Alpha-Gal Syndrome Symptoms
This mysterious illness is often referred to as a red meat allergy. People with AGS sometimes develop a strong allergic reaction to non-primate mammal products, most commonly red meat including beef, pork, lamb or venison.
Stomach issues are the most frequent symptoms. “Classically, someone will wake up in the middle of the night, four to eight hours after eating a meal that contains red meat, with vomiting or diarrhea,” says Dr. Eapen. “It’s often mistaken for food poisoning until you start to see a pattern of it happening repeatedly.”
Some people with AGS also experience more classic allergy-type symptoms including:
- Difficulty breathing
- Hives
- Swelling
In rare (but very dangerous) cases, people experience anaphylaxis, a life-threatening allergic reaction. This is a medical emergency that requires calling 911 and using an Epipen immediately.
How to Treat Alpha-Gal Syndrome
“For now, the standard treatment is avoidance,” says Dr. Eapen. Not everyone who tests positive for AGS experiences a reaction after consuming non-primate mammal products. If you do have symptoms after consuming meat, you should see a provider to determine if you have AGS.
Red meat is the most common culprit, but some people also get a reaction from (and need to avoid) dairy products or gelatin. “Gelatin is a common food additive that’s also found in some medications,” says Dr. Eapen. “For some patients with AGS, these additives need to be avoided, and so reading labels is very important.”
Research is ongoing into treatment for AGS. “Some people are using oral immunotherapy to slowly help the body readapt to eating red meat,” says Dr. Eapen. “And researchers are looking into the possibility of using an already FDA-approved food allergy drug, omalizumab, to treat AGS.”
Staying Safer From Ticks
The best way to deal with alpha-gal syndrome is, of course, to not get it in the first place. That means practicing smart protection strategies anytime you’re outdoors in areas that have ticks.
You can be exposed to ticks in the woods, walking the dog through a park, gardening or even playing in your own backyard. Protective strategies include:
- Avoiding walking or playing in areas of tall grass
- Using insect repellents that are effective against ticks, including DEET, picaridin or oil of lemon eucalyptus
- Wearing long sleeves, long pants, tall socks and closed-toed shoes
“The majority of people who are bitten do not get alpha-gal syndrome,” says Dr. Eapen. “But if you get bitten and start having symptoms of AGS, it’s important to see your doctor for evaluation and testing.”
Reviewed by Amy A. Eapen, M.D., a senior staff allergist who sees pediatric and adult allergy patients at Henry Ford Hospital in Detroit, Henry Ford Medical Center – Columbus, Henry Ford Medical Center – Fairlane and Henry Ford Medical Center – Sterling Heights.
