May 10, 2016: What allergy is related to tick bites and has a delayed reaction?

With the full-blown tick bite season about to make an appearance, another concern seems to be increasing in scope.

 In an article by Tavia Smith, Vanderbilt’s Asthma, Sinus and Allergy Program has seen an increase in the number of patients treated for alpha-gal syndrome.

Alpha-gal is a carbohydrate molecule found in meats such as beef, pork and lamb. The syndrome is an allergy linked to tick bites.

The patient can experience hives, swelling of the lips/tongue/throat, vomiting, diarrhea, and other symptoms of allergic reaction.  The symptoms, however, can be delayed three to six hours after exposure to the offending meat.

The first reports of delayed reaction from eating red meat were written about in 2009.  By 2012, thousands of cases across the southern and eastern U.S. were reported.

The lone star tick is the commonly associated tick with this syndrome.

Alpha-gal syndrome does not have a cure, but there is treatment.  (e.g., epinephrine, antihistamines, steroids)

Some patients, depending on the severity of their allergy, might also need to avoid organ meats such as kidney or liver, gelatins, and even milk in some cases.

I was speaking with a neighbor of mine the other week – he suffers from the alpha gal syndrome.  When going out to eat, he has to be mindful of keeping his meal restricted to ‘white meat’.  He carries an epi-pen with him in case he mistakenly partakes of a trouble-causing meat.

Another consideration would be regarding a child with alpha-gal.  Potential in-school settings can be variable regarding dietary habits and possible food sharing. Staff would need to be alerted by the child’s family in case symptoms develop from an inadvertent exposure.


Reference: VUMC Reporter, Tavia Smith; March 2016.                                                                            Website: American College of Allergy, Asthma & Immunology.


This question prepared by:  Scott Muir, RN, CSPI  (Certified Specialist in Poison Information)  Tennessee Poison Center


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