Introduction to Alpha-Gal Syndrome
A 47-year-old airline pilot from New Jersey is the first person known to have died from alpha-gal syndrome, a red meat allergy caused by a tick bite. Researchers at the University of Virginia School of Medicine publicly reported the cause of death after months of investigation. Their findings were published in the Journal of Allergy and Clinical Immunology: In Practice.
The Incident and Investigation
The man’s death had previously been seen as a mystery, since medical examinations showed no evidence of a heart attack or other life-threatening issues. According to the researchers, the man started feeling sick four hours after consuming a hamburger at a barbecue in September 2024. When he returned home, he was well enough to mow the lawn and read the paper. But shortly after 7:30 p.m. that day, the man’s son found him unconscious on the bathroom floor with vomit around him. An autopsy ruled that his death was sudden and unexplained.
Previous Illness and Diagnosis
Two weeks earlier, the man had become ill after eating a steak dinner on a camping trip with his wife and children. The researchers said he woke up at 2 a.m. with severe diarrhea, vomiting and stomach pain, and later told one of his sons that he thought he was going to die. However, he and his wife were uncertain of what had happened, so they decided not to consult a doctor. “The tragedy is that they didn’t think of that episode as anaphylaxis, and therefore didn’t connect it to the beef at the time,” said Dr. Thomas Platts-Mills, an allergist at the University of Virginia School of Medicine who discovered alpha-gal syndrome and diagnosed the New Jersey man’s case.
Connection to Tick Bites
It’s large, it’s invasive and it spreads disease to people and animals. Here’s what you need to know about the Asian longhorned tick. Once he was connected with the man’s wife, Platts-Mills arranged for blood testing. A blood sample in April indicated that the man had experienced an allergic reaction, which didn’t show up on his autopsy. “The level he had is basically only seen in fatal cases of anaphylaxis,” Platts-Mills said. “His level was 2,000. The highest level I’ve seen in practice of a person who survived is 100.” Blood testing also revealed antibodies to a sugar called alpha-gal — a telltale sign of a tickborne meat allergy. Alpha-gal is found in the blood of cows, deer, goats and pigs. When ticks feed on these mammals, the sugar gets into their saliva and can be transmitted to humans through bites.
Symptoms and Risk Factors
People who have been bitten may go on to develop alpha-gal syndrome, a sensitivity to alpha-gal that causes allergic reactions when they eat red meat. Symptoms include nausea, stomach cramps, diarrhea, hives or trouble breathing. Most cases in the United States are linked to a particular tick species — the lone star tick — which is found in the Northeast, the South and the Midwest. Dr. Scott Commins, an allergy immunology specialist at the University of North Carolina Department of Medicine in Chapel Hill, said the biggest risk factors for severe reactions are exercise and alcohol, which can increase the absorption of food allergens. The New Jersey pilot exercised and consumed a beer on the day of his death, according to the researchers.
Increasing Threat and Migration Patterns
The timing of a tick bite may matter, as well: Commins said a recent bite could freshly boost alpha-gal allergies. The pilot’s wife told researchers that he had been bitten by chiggers — tiny mite larvae — around his ankles last summer. However, the researchers now suspect that the bites instead came from the larvae of lone star ticks. In the paper, the researchers wrote that alpha-gal syndrome has become a mounting threat as the lone star tick and its primary host — white-tailed deer — have migrated to new locations. “A large and increasing population of the United States is being exposed to the Lone Star tick, both because the tick is moving north and because there are now large populations of deer in many states,” they wrote.
Climate Change and Exposures
Warmer winters due to climate change may be responsible for these migration patterns, leading to exposures in places where the ticks were previously uncommon, such as Washington and Maine. The number of suspected cases of alpha-gal syndrome has increased substantially in the U.S. since 2010, according to a 2023 report from the Centers for Disease Control and Prevention. “Unfortunately, more people are at risk these days,” Commins said.
Diagnosis and Prevention
The allergy can affect anyone with an outdoor lifestyle where tick exposures are likely, including children, Commins said. But people who have been bitten by a tick don’t necessarily need to get tested for antibodies to alpha-gal unless they have symptoms, he said. “When someone has a tick bite, we just ask them to be mindful about stomach upset or itching or hives that might occur three to six hours after eating either red meat or maybe some high-fat dairy like ice cream or milkshakes,” Commins said.
Challenges in Diagnosis
One challenge with getting people diagnosed, he said, is that many doctors aren’t knowledgeable about the illness. In another 2023 report from the CDC, 42% of doctors surveyed said they had never heard of alpha-gal syndrome. And 35% said they were not confident in their ability to detect or treat the illness.
Reversibility of the Allergy
Even if someone develops alpha-gal syndrome, the allergy might not necessarily be permanent, Commins said. “It’s possible, through tick bite avoidance, that after three to four, maybe five years, it’ll fade,” he said.
Conclusion
The death of the 47-year-old airline pilot from New Jersey highlights the importance of awareness and diagnosis of alpha-gal syndrome. As the lone star tick and its primary host continue to migrate to new locations, the risk of exposure to this tickborne meat allergy increases. It is crucial for individuals, especially those with an outdoor lifestyle, to be mindful of the symptoms and risk factors associated with alpha-gal syndrome.
FAQs
- What is alpha-gal syndrome?
Alpha-gal syndrome is a red meat allergy caused by a tick bite, specifically the lone star tick. - What are the symptoms of alpha-gal syndrome?
Symptoms include nausea, stomach cramps, diarrhea, hives, or trouble breathing. - How is alpha-gal syndrome diagnosed?
Diagnosis is typically made through blood testing, which reveals antibodies to a sugar called alpha-gal. - Can alpha-gal syndrome be treated?
There is no specific treatment for alpha-gal syndrome, but avoiding red meat and high-fat dairy products can help prevent allergic reactions. - Is alpha-gal syndrome permanent?
The allergy might not necessarily be permanent, and it is possible for it to fade after three to four years through tick bite avoidance.
