Alpha-gal is Horrible Way to Vegetarianism

The Alpha-gal syndrome is a very serious, and life-threatening, allergic reaction mammals can get after a specific tick bite. CDC reports ~450k people in the USA might already have the syndrome, and just have not reported it. You, in fact may have it if your body, all of a sudden, seems to have become allergic to meat.

I am not a medical person in any way, just a cook who gets interested in topics and researches them to find out more information. Everything listed below has been researched, and comes from the many sources I have read on this topic. If you think you have been bitten by a tick and have a rash or other symptoms, please seek medical advice immediately.

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Tick Related Illnesses

I am not going to discuss all the illnesses ticks can transmit, just two which serve as a good comparison to the main disease I am interested in, Alpha-gal Syndrome (AGS). But here is a good source if you want to see ticks and what harm they can do, and below is just a partial list of tick borne illnesses.

• Deer ticks spread babesiosis and Lyme disease
• American dog ticks + brown dog ticks can give you Rocky Mountain spotted fever
• Lone star ticks spread ehrlichiosis, tularemia, Heartland virus, and cause AGS.

Minimally, what this post should do is serve as a notice that when going out in the woods remember to prepare for ticks. One of the impacts of climate change is the extension of warm months which also extends tick season, and thus increases tick numbers, and gives them more opportunities to bite us.

Lyme Disease

Between 1992 and 1998, studies report that Lyme disease was the number one tick-related disease in the USA. It is transmitted to humans by infected Ixodes scapularis and I. pacificus ticks. During this time period, ~88,967 cases of Lyme disease were reported to the CDC. Those reporting represented 49 states and the District of Columbia and trends indicate a growth in the number of cases yearly. The CDC noted that 92% of the reported cases were from 8 northeastern and mid-Atlantic states, and two north-central states.

Then another study looked at 2008 through 2015 and found its coverage area increased a bit so that the majority of Lyme disease cases occurred in the broader Northeast, mid-Atlantic, and upper Midwest regions. This time period had ~298,834 cases of Lyme disease reported to the CDC with an additional 66,755 probable cases.

STARI Illness

So, imagine you go out in the woods for a Japanese Forest Bath (aka shinrin-yoku), a therapeutic practice that involves spending quality time in nature, to reconnect with it through our senses. But after awhile, you are not feeling so well. A rash may appear, looking similar to the rash of Lyme disease, but you are in an area not known for Lyme disease, and the rash is not like a bullseye. Meanwhile, you have feelings of fatigue, fever, headache, muscle, and perhaps joint pains. What you may be experiencing is the “Southern tick-associated rash illness”, aka STARI. This is an illness that comes from bites of the Lone Star tick. While we do not how this works, we know that it is not Lyme disease.

Lone star ticks can be commonly found in the southeastern and south-central parts of the USA, but it is showing up along the Atlantic coast as far north as Maine. Unlike the transmission of Lyme disease from ticks, Lone star ticks saliva actually have been shown to kill Borrelia burgdorferi, the bacteria that causes Lyme disease (Ledin et al., 2005, Zeidner et al., 2009).

STARI seems to disappear after a few weeks and as of yet it is unclear if there is long lasting negative impact. It is also unclear what treatments help, although commonly doctors will treat with antibiotics.

Alpha-gal Syndrome (AGS)

Months after going for that lovely walk, and after suffering a rash and other flu-like symptoms that go away, you finally sit down for that juicy smash meat burger you have wanted. After eating it, 3-6 hours later (1), you are getting ready for bed and uncomfortableness settles in, and hives (or other similar skin reactions) start to occur, or perhaps you have gastrointestinal issues (heartburn or diarrhea), or maybe you are feeling cardiac symptoms severe enough to warrant a trip to the ER (2). Although the likelihood of misdiagnosing this disease is high, you are eventually found to have AGS.

• According to Prevention, conservative estimates 50,000 residents of the Southeast and the Midwest United States are most at risk, with the greatest number of cases in Missouri, Arkansas, Virginia, and North Carolina.
• The CDC sites that during 2010–2018, more than 34,000 suspected cases of AGS were identified in the USA. Later, 2017–2022, a total of 90,018 tested positive for AGS. These cases predominantly occurred in counties within the southern, midwestern, and mid-Atlantic U.S. Census Bureau regions.
• However, due to climate change these, and other animals, are on the move. In this case moving north into Canada.

This tick is interesting, it does not wait for you to walk by before pouncing. They are very active hunters, and will seek you out. They can sense our emitted carbon dioxide and will find us. Active all year round, they love deer, but we are also high on the list. Plus, in all phases of development, if the ticks are male or female, they will connect and suck your blood. Amazingly, the young larval ticks hunt in packs, colloquially called “tick bombs” according to the WaPo. Some call these ticks the most aggressive out all ~800 species of hard and soft bodied ticks in the USA.

What makes this interesting to me is that AGS is essentially an allergy (or unusual immune response) to an Alpha-gal sugar that is part of a normal tick’s saliva (3). This sugar has been found in all mammals, except for humans and some primates. So it is foreign to our bodies, and for some of us, our body will over-respond to AGS’ initial introduction. This means some of us then become over-sensitized to the Alpha-gal sugar, and respond with allergic symptoms next time that sugar is introduced. But the catch is Alpha-gal is in many things, and eating meat is not required for the onset of symptoms, for even smelling the sugar can bring on the symptoms.

Some people with AGS need to avoid meat (like beef, pork, and lamb), milk and dairy products (4), gelatin, medications or products (like heparin, anti-venom shots, and vaccines), personal care products (like lotion, perfume, and make-up), products containing carrageenan (5), meat broth (like beef or pork), and many other items. It is even claimed that the meat and products derived from bison, buffalo, rabbit, horse, and goat should be avoided. So people with AGS are then limited to fowl, mollusks, crustaceans, and fish should they want to eat meats. But one caution, flounder roe (eggs) and the eggs of some other bony fish do seem to have Alpha-Gel (6).

• It is unclear if pet dander is also a trigger or not.
• >20k medications have mammalian by products.

There is no treatment for AGS, yet. Some people take a daily antihistamine to deal with small exposures and minor symptoms, some carry an emergency dose of epinephrine, but all stay away from the triggers. Importantly, it is imperative that additional tick bites be avoided, as studies indicate it can increase the severity of the AGS.

The same study showed that some people (12% of patients followed for 5 years had remission), were able to reintroduce pork or even beef back into their diet. Some patients could tolerate some meat, but not others, or could eat meat on some occasions but not all. The vast majority might need to avoid meat for their lifetime.

Lots of studies are being undertaken, one that implies having blood type B may make one more susceptible to AGS (6). Other studies indicate this is a growing global situation, and are tracking where cases have been reported:

• Australia
• Europe (France, Spain, Germany, Switzerland, Sweden, United Kingdom, Italy + Norway)
• Asia (Korea and Japan)
• North America (USA)
• Central America (Panama)
• South America (Brazil)
• Africa (South Africa and Ivory Coast)

Tick Protections

I have read many suggestions on how to prevent tick bites to begin with, and so far most fall into the same lists I mention below. No matter where you live in the USA, consider following these suggestions when enjoying the great wooded outdoors:

• Understand where ticks hang out (tall grass, wooded areas) and avoid them. Or consider walking in the center of trails.
• In case you say, “fine I will stay out of the forests!” Note that the Brown Dog tick actually lives in the desert, and they often feed on people, dogs, and cats.
• Use appropriate insect repellent (containing 0.5% permethrin) to spray the outside of your clothes and boots.
• You can spray your skin with EPA approved chemicals or Oil of Lemon Eucalyptus (OLE). Look here to find the right chemicals for you: EPA Repellents Search Tool
• Wear light-colored clothing so they are easy to spot, and tuck pants into boots or high socks.
• Use a lint roller on your clothes when you get home and you could be amazed how many you can just “roll up”.
• Check your skin, especially armpits, groin, breasts, and folds.
• Shower immediately and watch for rashes, which can show up within a month or so of being bitten.

Remove any ticks as soon as you see them. Or, if you find one feasting, follow these suggestions:

• First, carefully clean the site with rubbing alcohol.
• Second, use tweezers to pull the tick’s head up carefully from the skin, use a steady pressure.
• Third, once removed CDC suggests disposing of the tick by flushing it down the toilet. If you would like to bring the tick to your healthcare provider or vet for identification, put it in rubbing alcohol or place it in a sealed bag/container.
• Fourth, clean your hands, and the site one more time.

Regarding our pets, currently there are three vaccines available formulated to prevent Lyme disease in dogs. Cats are especially suseptible to chemicals, so in all cases of tick bites on animals do not medicate them without discussing with your vet.

Conclusion

Climate change is introducing all sorts of plants and animals (including insects) into new areas where people do not have years of experience with them. Do not underestimate life’s strong survival instincts to move into your neighborhood, if that is what is needed for survival.

Before I sign off, I should mention a few loose ends.

• Some studies suggest chiggers may also transmit the alpha-gel allergy in humans.
• Globally, different ticks in each country may be responsible for the spread of this allergy. Check the local equivalent of the CDC to find out which tick is of concern in your area.

Good luck out there, Patty

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