Understanding Alpha-Gal Syndrome: A Closer Look at the Lesser-Known Food Allergy in Illinois

While most outdoor enthusiasts and nature lovers understand that tick bites can result in various infectious diseases, they may not be aware that some of these bites can also induce a dangerous meat allergy, particularly to red meat. Alpha-gal syndrome (AGS) is a relatively unknown food allergy linked to the bite of the Lone Star tick, and it’s made its way to Illinois.

According to a study published in the Annals of Allergy, Asthma & Immunology, Illinois ranks among the top 13 states with a rising incidence of AGS. The cases are expected to increase, yet there’s little public and medical awareness about the signs, symptoms and diagnosis of AGS. Currently, the available treatment options are limited to managing allergic symptoms, but a few key points may be valuable for recognizing and addressing this condition.

What is Alpha-Gal Syndrome?

Alpha-gal, scientifically known as galactose-α-1,3-galactose, is a sugar molecule prevalent in most mammals, except humans and primates such as monkeys and apes. Typically, alpha-gal is harmless, but some people can develop AGS, an allergic immune response to the molecule primarily found in red meat, including beef, pork, venison and lamb. Some people may notice a mild allergic reaction, while others can experience life-threatening anaphylaxis.

The Lone Star Tick Connection

AGS is believed to be triggered by the bite of the Lone Star tick. Other types of ticks need to be attached to a host for a certain amount of time to transmit diseases, but that’s not the case with Lone Star ticks. They carry alpha-gal in their saliva, so they can initiate an immune response in the humans they feed on almost immediately.

Lone Star ticks can be identified by a few key markings: The females have a distinctive white dot on the center of the body, and the males display white spots or streaks along the body’s outer edge.

Symptoms of Alpha-Gal Syndrome

AGS symptoms typically manifest 3 to 6 hours after consuming red meat, according to a medical review in Expert Review of Clinical Immunology. The delayed onset helps to distinguish AGS from other food allergies with a more immediate onset, as does the presence of a new reaction in people who previously tolerated red meat.

• Symptoms can vary in intensity and include a combination of the following:
• Hives
• Itching
• Facial and body swelling
• Respiratory issues, including wheezing, coughing, shortness of breath, or asthma attacks
• Abdominal discomfort, such as cramping, bloating, vomiting, and diarrhea
• Rapid heart rate
• Low blood pressure
• Feeling dizzy or faint
• Anaphylaxis, a serious allergic reaction requiring prompt medical care

Diagnosing Alpha-Gal Syndrome

Despite increasing cases of AGS in Illinois and throughout the United States, a recent survey of 1,500 healthcare providers showed that 42 percent of those who responded hadn’t heard of the condition. Additionally, 35 percent of respondents indicated they were “not too confident” in diagnosing and managing those with AGS.

Across the state, there’s an increasing need for medical providers to learn more about AGS, however, testing for the condition is relatively simple. A healthcare provider, often an allergist, can order a blood test to detect the presence of IgE antibodies specific to alpha-gal. Testing is available at many of the larger commercial labs most people are familiar with, as well as some academic institutions. Additionally, skin prick tests may help identify specific allergies to various meat and mammalian products.

Treatment Options

As of now, there is no known cure for AGS, but decreasing the consumption of red meat and other mammalian products can reduce the risk of experiencing reactions. Alpha-gal isn’t always obvious, so individuals with AGS should carefully inspect their food and product labels for potentially problematic ingredients. Some people may experience severe reactions, so their healthcare provider may recommend carrying prescription epinephrine or antihistamines, and emergency room treatment may be required in critical cases.

Preventive Measures and Tick Removal

To minimize the chances of contracting AGS and other tick-borne diseases, be proactive and take preventative measures to avoid tick bites. If a tick has latched onto you, remove it carefully by using the following steps:

To minimize the chances of contracting AGS and other tick-borne diseases, be proactive and take preventative measures to avoid tick bites. If a tick has latched onto you, remove it carefully by using the following steps:

1. With fine-tipped tweezers, grasp the tick as close to the skin as possible.
2. Pull upward with firm, even pressure.
3. If the mouthparts remain in the skin, see if you can remove them gently. Don’t dig or rip the skin.
4. Clean the bite area with soap and water or alcohol.
5. Place the tick in a sealable bag to send to a tick testing site. Do not crush it.
6. Share questions, concerns, or symptoms with your healthcare provider.

Illinois residents can receive free tick identification through the INHS Medical Entomology Lab at the University of Illinois Urbana-Champaign. For information on the pathogens your tick may carry, you can send it to TickReport (results are for educational purposes only).

While AGS may not be widely recognized, its prevalence in Illinois and other states underscores the importance of understanding and managing this unique food allergy, especially for those at risk due to their potential exposure and proximity to ticks.

For a printable version of this information, download an Alpha-Gal Syndrome Factsheet from the Illinois Lyme Association.

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Jenny Lelwica Buttaccio, OTR/L, is a Chicago-based health journalist and licensed occupational therapist. She lives with her husband and rescue dogs Emmi and Opal. When not writing, she can be found buried in a book, working out, or out in nature. Her work has been featured in HuffPo, Prevention, Men’s Health, Healthline and many other publication.

References

Alpha-Gal Syndrome. Centers for Disease Control and Prevention.

Binder AM, Commins SP, Altrich ML, et al. Diagnostic testing for galactose-alpha-1,3-galactose, United States, 2010 to 2018. Ann Allergy Asthma Immunol. 2021 Apr;126(4):411-416.e1.

Commins SP. Diagnosis & management of alpha-gal syndrome: lessons from 2,500 patients. Expert Rev Clin Immunol. 2020 Jul;16(7):667-677.

Health Care Provider Knowledge Regarding Alpha-gal Syndrome — United States, March–May 2022. Centers for Disease Control and Prevention.