Alpha-Gal Syndrome: The Mean Girl of Tick Bites
Tick bites can cause a variety of conditions and are of concern for hikers, campers, and anyone spending time outdoors. In recent years, a condition has emerged – alpha-gal syndrome (AGS). It is commonly caused by a bite from the lone star tick which is most prevalent in south, east, and south-central states of the US. Bites from other types of ticks may also cause AGS. Nearly one-half of a million people have been affected by alpha-gal syndrome.
What happens after a tick bite?
While ticks often carry infectious diseases, the lone star tick can carry a substance in their saliva that can cause a human’s natural defense system to have an immune response. The substance in the tick’s saliva is alpha-gal, a sugar molecule found in some mammals, but not in humans. This immune response can later trigger an allergic reaction in people when exposed again to food or products containing alpha-gal.
Not everyone bitten by the lone star tick (or other ticks) may have an immune response leading to alpha-gal syndrome. Some other risk factors for the syndrome include coronary artery disease and sensitivity to allergens; more cases are reported in adults. If you have experienced a recent tick bite, see your doctor for further evaluation and testing.
What triggers an alpha-gal reaction?
Foods containing alpha-gal from mammals (e.g., red meat, some dairy products) may cause a reaction in some people, usually about 1 to 4 months after the tick bite. Reactions usually occur within 2 to 6 hours after eating a triggering substance.
Some medication and medical products may contain alpha-gal. It is important to tell all your healthcare providers about your condition before treatment.
How bad is the allergic reaction?
It is reported that people have varying degrees of reaction to alpha-gal. Gastrointestinal symptoms are most common and include nausea, heartburn, vomiting, diarrhea, and abdominal pain. Less commonly, some people may have rashes, hives, difficulty breathing, or swelling of the lips, tongue or eyes. The type and degree of reaction can also be affected by other medications or medical conditions.
What to do if you are diagnosed with alpha-gal syndrome?
Unlike other tick-borne diseases, this one cannot be treated with antibiotics.
The only way to avoid allergic reactions is to avoid substances containing alpha-gal that may trigger the reaction. Avoid red meats from mammals such as beef, pork, lamb, venison, oysters, and rabbit. Alpha-gal may also be found in gravy, broth, or in fats used for cooking such as suet, lard, or tallow. Be aware when dining out that contamination with alpha-gal may occur from frying bacon or contact with other meats in the kitchen. Other products such as gelatin, marshmallows, gummy bears, and other desserts may not be tolerated. In some people, dairy products may cause reactions. Be sure to carefully follow your doctor’s advice for your diet.
Additionally, you may need to avoid medication products that contain alpha-gal, so it is important that you tell your doctor and pharmacist of your allergic condition due to alpha-gal syndrome. They will need to screen your medications, vaccines, and medical products carefully to see if they contain gelatin, lactose, or magnesium stearate. Certain animal-derived medical products, such as heart valves from pigs or cows, monoclonal antibodies, heparin, and certain antivenoms may contain alpha-gal. Ask your pharmacist for advice and to review your current medications for other options.
If you have serious allergic reactions to alpha-gal, your doctor may prescribe epinephrine in an injectable pen or nasal spray for emergency management of your symptoms.
What can I do to prevent getting alpha-gal?
The best way to avoid alpha-gal syndrome is to avoid tick bites. Prevention of repeat tick bites is also very important to lessen the chance of worsening your reactions to alpha-gal. Prevention tips include use of an EPA-registered insect repellent to skin, clothing, and shoes, doing total body checks for ticks after being outdoors, and showering after outdoor activity. Remove any ticks as soon as possible.
Summary
Alpha-gal is a potentially serious allergic condition that is becoming more common in the US. Prevention of tick bites is key to avoiding this condition. If you have had a recent tick bite, be sure to check with your doctor and report any symptoms of alpha-gal syndrome.