Red-Meat Allergy Spread By Chiggers And Ticks: Awareness Could Save A Life
Alpha-gal syndrome needs to be in the forefront of every hunter’s mind.
Odds are that it won’t happen to you. However, the reality of odds is that it can happen, no matter how unlikely it may be. So it is with alpha-gal syndrome, and knowledge of it could just save your life.
Jamie Stewart is just another outdoorsman, a normal guy who likes to hunt and fish. On Nov. 10, 2022, Jamie was hunting at Chattahoochee Fall Line WMA, when his life changed.
“That first day of the hunt, Thursday, we had a lot of rain,” Jamie began. “Jackie, my ‘bonus dad’ as I call him, made a big pot of beef chili for supper, and I ate a stomach full. I went to bed in the camper feeling good, then woke up around 11 p.m. with severe cramps, diarrhea, sweating, disorientation, hives, itchiness and low blood pressure.”
After taking a Benadryl and getting Jackie to call 911, Jamie passed out. The next few hours were hazy for him: the ambulance ride, the IV fluids, the epinephrine injections, the hospital room in Columbus. Then, as quickly as his symptoms began, they were retreating.
“The second shift doctor that night came in, introduced himself, and told me that he was also a hunter. He informed me that he had recently read an article in an outdoor magazine about alpha-gal syndrome and that he suspected I had it,” Jamie said. “Evidently, many medical professionals have never diagnosed this disease or know very little about it since it is uncommon. Good thing my doctor was a hunter!”
The doctor continued to explain the disease process through which an individual, after being bitten by certain ticks (and chiggers), can become allergic to specific meats and even milk.
“Then, I thought back to the spring when I had similar, less severe symptoms after eating venison burgers. I had a pretty bad reaction but thought it was caused by something in my yard since I had done yard work that day,” Jamie said. “I went to the ER, and my doctor there didn’t think too much about it. He just treated me for an allergic reaction and sent me on my way. After that, for the next several months, I had intermittent bouts of diarrhea, but never bad enough to go to the ER. In retrospect, I bet it was always after I ate red meat.”
By 8 a.m. the next morning, Friday, Nov. 11, Jamie felt great with complete resolution of his allergic symptoms. The doctor sent Jamie out the door with an EpiPen, advised him to schedule an appointment with an allergist, and instructed him to avoid red meats.
“Since the rain was clearing out that day and I felt good leaving the hospital, I decided to get back in the woods. I went to my spot around 1 p.m. overlooking some scrapes and figured that a buck would be by to freshen them up,” Jamie explained.
This hunt was Jamie’s seventh time at Chattahoochee Fall Line WMA since 2015, and he had killed nice 8-point bucks the previous six times, all in the same area. At 4 p.m., he saw a buck working his way to one of the scrapes.
“I confirmed that he had at least 4 points on one side, making him a legal buck, and decided to shoot him. Normally, I would have let a buck like this pass, but with everything that had happened the night before, I realized that I was lucky just to be alive. That 8-point was a very special buck for me.”
After leaving the WMA and traveling back to his home in Patterson, Jamie made an appointment with an allergist in Brunswick like his doctor in Columbus had instructed him to do. Tests confirmed that he did indeed have alpha-gal syndrome.
“I’m so glad my ER doctor in Columbus got my diagnosis right,” Jamie said. “I could have eaten more chili that following day after my reaction if I had not known to avoid it. I probably would have had a worse reaction then.”
Again, thank goodness that doctor was a hunter.
What exactly is this strange condition? Alpha-gal syndrome is an uncommon meat allergy that can develop following certain tick bites and even chigger bites. The lone star tick (Amblyomma americanum) seems to be the main culprit in the southeastern U.S. Alpha-gal (galactose-alpha-1,3-galactose) is a carbohydrate found in all mammals except primates. Alpha-gal is also present in the saliva of certain ticks and chiggers. Therefore, after bite exposure, some humans may become sensitized to alpha-gal, and when these individuals ingest mammal meat, they are susceptible to an allergic reaction because their immune system recognizes this carbohydrate as enemy material and attacks it. Milk also contains alpha-gal, but not all patients react to it. Jamie reported no ill-effects to drinking milk.
Dr. Justin Lancaster, family practitioner and sports medicine specialist in Statesboro, said, “One unusual feature of this type of reaction is the delayed onset of three to six hours after ingestion of meat. As a result, a person might develop symptoms in the middle of the night, like in Jamie’s case. The delayed symptoms may be related to alpha-gal allergens binding to lipids (fats) which are absorbed by the body more slowly and in a different way compared to proteins.”
In addition to reacting to foods, people with alpha-gal syndrome may react to vaccine components or agents derived from animal products, like snake antivenom.
Brandy Abbott faced this antivenom challenge with her now 13-year-old son, Mason Cook, who was diagnosed with alpha-gal syndrome when he was 11 years old. Three days before Halloween 2022, Mason, 12 years old at the time, was bitten by a copperhead on his big toe. The swelling began to spread up his leg, and once he was admitted to the emergency room, the medical staff asked his mother about any allergies Mason might have. After Brandy revealed that her son had alpha-gal syndrome, the hospital providers contacted Poison Control Center and were strictly instructed to avoid the use of antivenom.
“That was a scary time for us because Mason’s leg was so swollen that it looked like you could pop it with a pin,” Brandy recalled. “The doctors were scared to give him medications for fear of a severe reaction. We were in the hospital for three days, but Mason’s swelling took a full three weeks to go away enough for him to put a shoe on again.”
When asked about how Mason was diagnosed with alpha-gal syndrome, Brandy responded, “We noticed that Mason would seem to have an allergic reaction whenever he went to his dad’s house. A friend of mine told me about alpha-gal syndrome and convinced me to take Mason to an allergist to be tested. Sure enough, his blood tests were positive. Then, we realized that he almost always ate red meat when he went to visit his dad.
“Mason was retested recently, and his blood values were lower than previously,” Brandy continued, “but he is still affected. We are going to celebrate with a steak when his numbers are zero!”
Brandy went on to say that she has never found a tick on her son but that he has had numerous chigger bites in his life, so his alpha-gal sensitivity likely came from chiggers.
“The diagnosis of meat allergy can be challenging for medical professionals,” said Dr. Lancaster. “It all starts with suspicion, as with Jamie’s doctor or Brandy’s friend. Proper history taking is a must. Testing for certain immune cells, like food-specific immunoglobulin E, is not always accurate, so food tests may be advised. DO NOT attempt a food challenge without consulting a medical professional. Food tests require the patient to eat the suspected offending meat and then be closely monitored by a professional who is prepared to administer epinephrine at the onset of clinical signs.”
The best way to manage food allergy is to avoid the culprit meats, but a patient with alpha-gal syndrome should be equipped with an epinephrine auto-injector at all times and be knowledgeable of how to use it at first recognition of symptoms. Alpha-gal allergy, thankfully, resolves over time, typically one to five years, as long as the patient is not bitten by additional ticks or chiggers. Many allergists recommend retesting annually to determine if a patient is still affected. There is research suggesting that blood groups A and O may be more sensitive to alpha-gal, but any individual could acquire the allergy if exposed to ticks or chiggers. The exact reason why some people are affected while many are not is still a bit vague.
In closing, anyone reading this article could be affected by alpha-gal syndrome, even if it is unlikely. If you have a severe allergic reaction, please keep this condition in mind and remember to mention it to your medical provider, especially if you have recently ingested red meat (which includes pork). Knowledge of this scary disease might just save your life. Thank you to Jamie Stewart and Brandy Abbott for sharing your experiences to help the GON Community become aware of alpha-gal syndrome.