An allergy is emerging that may be still under the radar for many health care professionals and the public. It is caused by the saliva of a small parasitic arachnid that has been associated with the southern states but has found its way to the northeast. We are talking about the red meat allergy (Alpha-gal syndrome) or AGS which is transmitted by the lone star tick.
Ticks
Ticks, as we have discussed in my post Ticks- Spring’s Parasitic Terrors of the Trail, are parasitic arachnids. They vary by species, habitat, appearance, and pathogens carried. Most people are familiar with the black-legged tick or deer tick (Ixodes scapularis) which is most associated with spreading Lyme Disease. But many may not know about another disease spreading tick which has extended its range in recent years and is associated with an emerging disease known as AGS or red meat allergy.
The Lone Star Tick
The lone star tick (Amblyomma americanum) can be found in the eastern United States, especially in the south. They are known to be active from April to September. According to research, lone star ticks are active seekers as they are attracted to the CO2 and movement of potential hosts such as humans. They have rounded bodies and are usually reddish brown or tan in color. Females have a characteristic whitish spot on their backs. Besides the red meat allergy, lone star ticks have been known to spread other diseases such as southern tick associated rash illness (STARI), Rocky Mountain spotted fever, ehrlichiosis, tularemia, Heartland virus, and Bourbon virus.
Red Meat Allergy
According to scholarly articles, the red meat allergy or AGS was first noted in Australia in 2009 and was suggested to be associated with ticks at that time as well. A meat allergy appeared in the southern United States by 2011. Afterwards, researchers found evidence suggesting that contact with the lone star tick was associated with the red meat allergy (AGS).
Transmission of Red Meat Allergy
The transmission of the red meat allergy is unique. The main difference between the Red Meat Allergy and the other diseases spread by the lone star tick is that the allergy is not caused by a bacteria or virus, rather it is the saliva of the tick which is the cause of the illness. The lone star tick’s saliva carries an antigen which is injected into the host. Afterwards, the person affected develops an allergy to the carbohydrate galactose-alpha-1,3-galactose (alpha-gal).
Reaction to Red Meat Allergy (AGS)
Reaction to the red meat allergy or AGS is difficult to generalize because the symptoms vary from patient to patient. But, for the most part, patients can experience itchy skin, swelling, and anaphylaxis. The onset of symptoms can also vary due to the amount of alpha gal ingested. Symptoms can be delayed for hours after consuming alpha gal containing products such as red meat or they can happen within minutes of receiving a pharmaceutical injection containing the carbohydrate alpha gal.
Management of the Red Meat Allergy
Management of the red meat allergy (AGS) typically involves avoidance. The patient is instructed to avoid products of and containing mammalian meats, this includes gelatin which can be found in some pharmaceutical products as well. Additionally, the use of an epinephrine auto injector is also needed in some cases.
It’s Just an Allergy. What’s the Big Deal?
The red meat allergy (AGS) may seem like an annoyance in comparison to the pathogens the lone star tick and other ticks can spread to humans, but that is only looking at it on face value. According to research, AGS has been known to affect people who have had bovine or porcine valve replacements. In the south, AGS was discovered when cancer patients had anaphylaxis after receiving certain therapies. It was determined they were reacting negatively to the treatments because they had AGS. Additionally, many drugs contain gelatin, which if ingested by someone with AGS can present a reaction as well.
In short, the possibility of anaphylaxis, the negative reaction to certain cancer treatments, and the need to be certain that the pharmaceutical therapies and/ or prescriptions do not contain alpha-gal all make it difficult and potentially life threatening to a person who has contracted the red meat allergy (AGS) from the lone star tick.
Prevention of Lone Star Tick Bites
Preventing exposure to ticks is the best defense against contracting any tick-borne disease including red meat allergy (AGS). To prevent tick bites its best to avoid their habitats which for the lone star tick is expanding northward and westward due to climate change, land use change, and prey dispersal. The lone star tick is generally found in forests, especially new growth forests. If avoidance of forests is not practical, then the use of personal protections should be considered.
Personal Protections
Personal protections against ticks include the use of products containing DEET for the skin and Permethrin for clothing. With the use of these products it is important to closely follow their instructions. Also, removal of leaf litter should be done as this is often the habitat for lone star ticks to overwinter in.
Conclusion
As of now, there is now evidence of certainty that people outgrow the red meat allergy, but some studies suggest avoidance of tick bites is the best bet for reducing side effects. The range of lone star ticks is expanding. With it, the occurrence of tick-borne pathogens such as the red meat allergy will also expand. It is important to safeguard yourself against potential tick bites by using products containing DEET and Permethrin. It is also important to not underestimate the long-term effects of contracting a tick-borne disease.