Tick season is in full effect and it’s always good to know what to worry about after a tick bite. Ticks can transmit various diseases, but did you know that they can also cause someone to develop a new allergy to red meat? Alpha Gal syndrome is a rare food allergy that can develop after a bite from the Lone Star tick. Let’s discuss when to worry, when NOT to worry, and when to see an allergist.
What Is Alpha Gal Syndrome?
Most people bitten by Lone Star ticks will either never know they were bitten or will not suffer any long-term consequences. However, some people may later develop a rare, delayed form of food allergy called Alpha Gal syndrome. This happens when the tick bite transfers a sugar molecule called galactose-α-1,3-galactose (alpha gal) directly into the blood stream. This can then cause the immune system to develop allergy antibodies against this molecule.
Alpha gal is a sugar found in mammalian meat, not poultry or seafood. If someone develops allergy antibodies towards alpha gal, then they may have a reaction after eating red meat such as steaks or burgers. Most food allergies (peanut, milk, etc.) happen very quickly after eating a food, whereas reactions to alpha gal typically occur 3-6 hours later. This can make it difficult to diagnose as symptoms can appear seemingly out of nowhere.
Symptoms of Alpha Gal Syndrome
Symptoms from alpha gal allergy range from stomach pain and nausea to hives, swelling or anaphylaxis (a rapidly progressive systemic allergic reaction involving more than one body system). Diagnosis relies on a history of reactions associated with eating red meat followed by blood testing for alpha gal allergy antibodies. Management entails avoiding red meat and having epinephrine available in case of severe reaction. Some people may also need to avoid dairy products, cosmetics or medications that may come from mammalian sources.
Alpha Gal syndrome can go away over time so it’s important to follow with an allergist not only for accurate diagnosis but also long-term management.
Things to Remember
Here are a few very important things to keep in mind:
Most people bitten by a tick will NOT develop alpha gal syndrome. This remains a rare condition.
Allergy testing for alpha gal antibodies should only be done IF someone has a clinical history suggesting delayed allergic reactions to red meat. Unfortunately, false positive results and misdiagnosis are extremely common.
As with everything, there is a LOT of misinformation surrounding Alpha Gal syndrome online. If you have concerns that you or your child have this condition, please see a board-certified allergist for evaluation.
Be Prepared
We’re having an above average year for ticks so it’s important to take precautions for you and your children. Tick bites don’t occur just from hikes in the woods; this can happen in your own yard. It’s important to check for ticks after spending time outdoors and capture them before they attach. If you do see a tick already attached, use clean tweezers to tightly grasp the tick as close to the insertion as possible and pull upwards to remove. Do not use fire, petroleum jelly, twisting, or nail polish to remove ticks.
David Stukus, MD, is an associate professor of pediatrics in the Section of Allergy and Immunology at Nationwide Children’s Hospital. Dr. Dave, as his patients call him, is passionate about increasing awareness for allergies and asthma.
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