- Beef Allergy
- Beef Allergy Symptoms
- Beef Allergy Diagnosis
- Beef Allergy Treatment
- Beef Allergy Frequently Asked Questions
- Red Meat Allergy and Lone Star Tick Bites
- Lone Star Tick Bite Facts
- Lone Star Tick Bites and Food Allergy Symptoms
- Red Meat Allergy Diagnosis and Treatment
- Tips for Tick Bite Avoidance
- Alpha-gal allergy: What you need to know
- Meat Allergy
- Managing a severe food reaction with epinephrine
- Managing Food Allergies in Children
- Allergies: Causes, diagnosis, and treatment
- Dust and pollen
- Insect stings
- Using an auto-injector
- As Tick Bites Rise, So Do Meat Allergies
Beef allergies are becoming more common in the U.S. and other parts of the world. This allergy is related to alpha-gal, a carbohydrate found in mammalian cell membranes. Because of this, a beef allergy is also called alpha-gal syndrome. This allergy can be caused by Lone Star ticks. A bite from this tick has caused many people to develop an allergy to beef.
A food coloring allergy can also explain an allergic reaction to beef. Some people show reactions to carmine, the main dye found in red meat. A typical allergic reaction to beef or alpha-gal has a delayed onset. Most symptoms occur 3-8 hours after consumption, which has made the allergy hard to diagnose.
Beef Allergy Symptoms
- Hives, itching, or beef allergy rash
- Swelling of the lips, face, tongue, and throat, or other body parts
- Runny nose and sneezing
- Abdominal pain, diarrhea, nausea or vomiting
- Wheezing or shortness of breath
Some medications also contain alpha-gal. So, if you experience symptoms of a beef allergy after eating beef, you may need to avoid medications with alpha-gal epitopes.
Medications that include alpha-gal epitopes:
Cetuximab, used in chemotherapy
Crotalidae antivenom, used to treat snake bites
Equine antivenom, used to treat snake bites
Infliximab, used to treat rheumatoid arthritis
For a full list of medications that include alpha-gal epitopes, contact your pharmacy. You should also consult with a food allergy doctor for a beef allergy food list.
Beef Allergy Diagnosis
This allergy is best diagnosed with a blood test. An allergy blood test can measure the amount of alpha-gal antibodies in your blood. This test is more accurate than other methods of beef allergy testing, but it can take several days to get your results. During this time, avoid beef allergy foods.
Beef Allergy Treatment
There isn’t a cure for food allergies; however, you can possibly prevent a beef allergy. Start by protecting yourself from tick bites. When outside, use tick repellent. Also, wear long sleeves while hiking in rural areas where Lone Star ticks are present. They can be found in the southeastern part of New York.
To treat your symptoms related to this beef allergy sensitivity, ask an allergist about the best medications for your condition. For most severe food allergies, an epinephrine injection needs to be prescribed to treat possible anaphylaxis. Your allergist will teach you to use an Epipen or Auvi-Q. You should carry this with you in the event of a beef allergy reaction.
Beef Allergy Frequently Asked Questions
Is Beef Allergy Curable?
No, beef allergy is not curable. However, if you’re allergic to beef, contact NY Allergy & Sinus Centers for allergy management.
Why Are People Allergic to Beef?
Most people are allergic to beef because of a Lone Star Tick bite. If you’ve been bitten by a tick, seek treatment from a board-certified allergist.
Can I Be Allergic to Beef?
If you’ve been bitten by a Lone Star Tick, you might be allergic to beef. Call one of our allergy specialists for a diagnosis.
How Is Beef Allergy Treated?
Beef allergy is treated with strict avoidance and antihistamines. For more serious allergies, you may need an epinephrine auto-injector. Your allergist can train you how to use it.
How Is Beef Allergy Diagnosed?
An allergist can diagnose your beef allergy with a quick allergy test. In many cases, you will need a food challenge to confirm the diagnosis of a beef allergy.
For a beef allergy diagnosis and other allergy care, contact a board-certified allergist.
At NY Allergy & Sinus Centers, all of our physicians are board certified with extensive experience in allergy, immunology, sinus, and asthma care.
We offer seven convenient allergy and sinus clinics throughout Manhattan and Queens. Our allergists are available six days a week. Call (718) 416-0207 to book your appointment today!
Red Meat Allergy and Lone Star Tick Bites
With the warmer weather and spending more time outdoors, we are all more susceptible to tick bites. By now, most are familiar with Lyme disease from deer ticks. But did you know another tick variety prevalent in our area, the Lone Star tick, can trigger red meat allergy?
This red meat allergy is also known as alpha-gal allergy. Alpha-gal is a carbohydrate found in red meat including beef, pork, lamb and venison.
Since 2009, Lone Star tick bites have been linked to the development of delayed allergic symptoms (usually 3-6 hours) following the ingestion of red meat. Individuals bitten by Lone Star ticks may develop allergy (IgE) antibodies to alpha-gal.
Upon ingesting mammalian meat containing alpha-gal (red meat), delayed allergic symptoms can develop.
Red meat allergy is uncommon in the United States, and was only recently recognized in 2009. However, the increased population of Lone Star ticks in our region increases the threat of red meat allergy.
An essential part of any food allergy treatment program is avoidance, and triggers can be particularly difficult to identify.
This is particularly true with Lone Star tick bites and red meat allergy because the allergic reaction is often delayed, thereby “hiding” the true cause of the allergic reactions.
The Asthma Center Allergists have put together the following guides to help recognize the signs and symptoms of red meat allergy caused by Lone Star tick bites.
Lone Star Tick Bite Facts
- The Lone Star female adult tick has a distinctive white dot. The Lone Star adult male, on the other hand, has markings similar to those of a “deer tick.”
- Lone Star tick bites often cause an extremely itchy rash around the bite within 7 days. Note: Tick bites related to Lyme Disease and other illness by contrast, may also develop a rash that feel warm to the touch but generally are not itchy.
- Some individuals may be unaware that they have experienced a tick bite.
- Lone Star tick bites do not usually cause Lyme Disease; however, Lone Star ticks feed on warm blooded mammals which may have Lyme Disease and other tick-borne illnesses. In rare cases, the Lone Star tick can become a “carrier” of these illnesses.
Lone Star Tick Bites and Food Allergy Symptoms
After a Lone Star tick bite, the following food allergy symptoms can occur with the ingestion of red meat (including beef, pork, lamb or venison):
- Hives or skin rash
- Nausea, stomach cramps, indigestion, vomiting, diarrhea
- Stuffy/runny nose
- Anaphylaxis (life-threatening allergic reaction)
Red Meat Allergy Diagnosis and Treatment
At The Asthma Center, our allergists and pediatric allergists help our patients manage their food allergies by first determining what foods cause symptoms.
Commercially available allergy skin tests for red meat (beef, pork, and lamb) are usually negative, but skin tests to fresh meat may be positive.
When a meat allergy is causing any of the above symptoms, and a Lone Star tick bite is suspected, a blood test can help diagnosis this condition.
Many cases of what has previously been diagnosed as “idiopathic anaphylaxis (where the cause is unknown) may actually be cases of red meat allergy. The delayed reaction caused by red meat allergy (which can occur 3-6 hours after eating red meat) is often misleading since most allergic food reactions occur within one hour of ingestion of the culprit food.
Avoidance of foods that trigger symptoms is a key part of living with red meat food allergy. The Asthma Center allergists pair these results and any other testing results which may apply to an individual’s unique history and set of symptoms to identify specific triggers.
The Asthma Center allergists also help our patients find relief of symptoms with antihistamines and corticosteroids, and prepare for anaphylaxis by carrying epinephrine auto-injector to reverse severe reactions to any unforeseen exposure or accidental ingestion of a triggering food.
Tips for Tick Bite Avoidance
No tick bite is a “good” tick bite.
With a greater than usual tick population predicted for our region, increases in Lyme Disease which is spread by the “deer tick” (black legged tick) are not the only concern. It has been widely reported that a small percentage of deer ticks may also carry the Powassan virus.
Avoid Tick bites:
- Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours
- Walk in the center of trails and avoid wooded and grassy areas
- Wear long sleeves, long pants and thick socks
- Learn more about preventing tick bites from the Centers for Disease Control
If you are concerned about a tick bite or other rash, please see a medical professional.
The allergists, pediatric allergists, and asthma specialists at The Asthma Center treat patients in 9 convenient locations throughout the Delaware Valley including Philadelphia (Center City Philadelphia, Society Hill Philadelphia, Northeast Philadelphia), The Main Line – Montgomery County (Bala Cynwyd – Lower Merion PA), Bucks County (Langhorne PA), and South Jersey (Mt. Laurel NJ, Woodbury NJ, Hamilton NJ, Forked River NJ).
The health information contained in this article is meant for basic informational purposes only. It is not intended to serve as medical advice, substitute for a doctor’s appointment or to be used for diagnosing or treating a disease.
For interviews and tours of the Delaware Valley’s only National Allergy Bureau (NAB) certified pollen, ragweed, and mold spore counting stations in Philadelphia, PA and Mt. Laurel, NJ, please email email@example.com.
Alpha-gal allergy: What you need to know
Alpha-gal allergy is a condition more commonly known as red meat allergy. An alpha-gal allergy can cause a person to have anaphylactic and hypersensitivity reactions when they eat meat.
The term alpha-gal is short for galactose-alpha-1, 3-galactose, a carbohydrate molecule that can cause an allergic reaction in people with an alpha-gal allergy.
The molecule is found in the meat of mammals, including cows, sheep, venison, bison, and pigs.
Alpha-gal allergy is chiefly spread by the bite of the Lone Star tick, so named for the marking on its back.
Share on PinterestAlpha-gal may enter the body via a Lone Star tick bite.
Although Lone Star tick bites are not the only significant cause of alpha-gal allergies, they are estimated to be responsible for around 80 percent of cases.
In the United States, the Lone Star tick is most common in Southeast Texas, Iowa, and New England. However, cases of the allergy have been noted in other parts of the country, including Hawaii, where the tick does not typically live.
The alpha-gal allergy was only identified in 2006 and doctors are still learning about the condition. Cases of alpha-gal allergy are becoming increasingly common but are still considered rare.
When alpha-gal enters the body, via a tick bite or otherwise, the immune system produces antibodies to fight the molecule.
Allergy researcher Thomas Platts-Mills of the University of Virginia started studying the alpha-gal reaction in 2002 after discovering an allergic reaction to the cancer drug cetuximab.
Cetuximab contains the same alpha-gal sugar as meat, although the association was not made with tick bites until Platts-Mills himself was later bitten by ticks and developed the allergy.
It remains unclear exactly what substance in the tick’s saliva causes the development of alpha-gal antibodies.
Most people discover they have an alpha-gal allergy after eating red meat. However, they can also have a reaction after eating foods that contain gelatin or taking medications that use gelatin as a stabilizer.
Common symptoms of an alpha-gal allergy include:
An anaphylactic reaction restricts breathing and can be fatal, so it needs immediate medical treatment. Although rare, it has been known for people with an alpha-gal allergy to be admitted to the intensive care unit (ICU).
In some instances, it can take up to 4 to 6 hours after eating red meat before a reaction occurs. So, people with an alpha-gal allergy do not always associate the reaction with what they have eaten. Symptoms do not necessarily occur every time the person eats red meat.
The immune system of people with an alpha-gal allergy treats the alpha-gal molecule in meat as a physical threat to the body. Histamine and other chemicals are released to try to “protect” the person, and these cause an allergic reaction.
Share on PinterestTo determine if alpha-gal antibodies are present in the body, a blood test may be recommended by a doctor.
Many people who acquire an alpha-gal allergy have no history of other allergies or allergic symptoms.
However, discovering whether the person has had a tick bite in the preceding weeks or months will help a doctor make a diagnosis.
Often a doctor or allergist will ask:
- what and how much the person ate before the reaction
- how long it took for symptoms to develop
- what symptoms occurred and how long they lasted
Characteristics of red meat allergies differ from other allergies, as people do not usually experience symptoms until at least 2 hours after eating red meat. This delay can help doctors diagnose an alpha-gal allergy.
However, as the connection between the symptoms and the consumption of red meat is not always clear, often it takes an allergist with expert knowledge of the condition to diagnose it.
A blood test will identify whether alpha-gal antibodies are present in an individual’s bloodstream. Results usually take 1 to 2 weeks.
A skin test can also be done, which involves a small amount of the food allergen pricked onto the skin.
If a wheal (a bump similar to a mosquito bite) develops, then it is a positive result. The test takes about 20 minutes and can be uncomfortable, but not usually painful.
Once an allergy is diagnosed, the best treatment is for the person to avoid the trigger. In this case, all mammal meats should be avoided.
A person diagnosed with an alpha-gal allergy will probably have to change their diet and be careful when they eat out. Seafood, poultry, and eggs are acceptable protein choices for those with alpha-gal allergies. Many people can also tolerate dairy products.
How cautious a person needs to be will depend on how severe their symptoms are. For example, some people experience a reaction if their food was prepared in the same kitchen as red meat.
The first-line treatment for the serious reactions of anaphylaxis is epinephrine, which is available on prescription as an auto-injector. Epinephrine auto-injectors are sometimes called by the name of one brand of the device, EpiPen.
People diagnosed with an alpha-gal allergy will probably be prescribed an epinephrine auto-injector and be shown how to use it.
Anyone with the allergy should carry two doses of epinephrine with them at all times. They should use the auto-injector immediately if they have symptoms of an allergic reaction, including:
- shortness of breath
- repetitive coughing
- weak pulse
- tightness in the throat
- difficulty breathing or swallowing
Side effects of epinephrine can include:
Rare and more serious side effects of epinephrine include:
The best way to avoid contracting an alpha-gal allergy is to avoid getting bitten by ticks.
If people live in an area where Lone Star ticks are prevalent, there are ways to avoid getting bitten. These include:
- avoiding wooded, overgrown areas, or high grass where ticks live
- wearing light-colored clothing that fully covers the limbs when hiking or camping
- checking pets and livestock for ticks regularly
- using insect repellent
- washing clothing in hot water after returning from a wooded area
There is some evidence that a person may recover from alpha-gal allergy if they are not re-infected by another tick bite.
Once a meat allergy is diagnosed, the best treatment is to avoid the trigger. Carefully check ingredient labels of food products and learn whether what you need to avoid is known by other names.
Be extra careful when you eat out. Waiters, and sometimes the kitchen staff, may not always know the ingredients of every dish on the menu.
Anyone with a food allergy must make some changes in what they eat. Your allergist can direct you to helpful resources, including special cookbooks, patient support groups, and registered dietitians who can help you plan meals.
Managing a severe food reaction with epinephrine
A food allergy, including a meat allergy, can cause symptoms that range from mild to life-threatening; the severity of each reaction is unpredictable. People who have previously experienced only mild symptoms may suddenly experience a more severe reaction, including anaphylaxis. In the US, food allergy is the leading cause of anaphylaxis outside the hospital setting.
Epinephrine is the first-line treatment for anaphylaxis, which results when exposure to an allergen triggers a flood of chemicals that can send your body potentially into shock if not treated promptly. Anaphylaxis can occur within seconds or minutes, can worsen quickly, and can be deadly.
Once you’ve been diagnosed with a food allergy, your allergist will ly prescribe an epinephrine auto-injector and teach you how to use it. Check the expiration date of your auto-injector, note the expiration date on your calendar, and ask your pharmacy about reminder services for prescription renewals.
If possible, have two epinephrine auto-injectors available, especially if you are going to be far from emergency care, as the severe reaction may reoccur.
Epinephrine should be used immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, generalized hives, tightness in your throat, trouble breathing or swallowing, or a combination of symptoms from different body areas such as hives, rashes, or swelling on the skin coupled with vomiting, diarrhea, or abdominal pain.
Even if you are uncertain whether a reaction calls for epinephrine, you should use it, as the benefits of epinephrine far outweigh the risk.
Common side effects of epinephrine may include anxiety, restlessness, dizziness, and shakiness. If you have certain pre-existing conditions, you may be at a higher risk for adverse effects with epinephrine.
Your allergist will provide you with a written emergency treatment plan that outlines which medications should be given and when.
Once epinephrine has been administered, immediately call 911 and inform the dispatcher that epinephrine was given.
Other medications may be prescribed to treat symptoms of a food allergy, including antihistamines and albuterol, but it is important to note that there is no substitute for epinephrine: It is the only medication that can reverse the life-threatening symptoms of anaphylaxis. These other medications can be given after using epinephrine, and antihistamines alone may be given for milder allergic reactions per your food allergy action plan.
Managing Food Allergies in Children
Because fatal and near-fatal food allergy reactions, other food allergy symptoms, can develop when a child is not with his or her family, make sure your child’s school, daycare, or other program has a written emergency action plan with instructions on preventing, recognizing, and managing these episodes in class and during activities such as sporting events and field trips.
If your child has been prescribed an auto-injector, be sure that you and those responsible for supervising your child understand how to use it. See an allergist for expert care and relief from meat allergy.
This page was reviewed and updated 5/8/2019.
Allergies: Causes, diagnosis, and treatment
In March 2020, the Food and Drug Administration (FDA) released a safety alert to warn the public that epinephrine auto-injectors (EpiPen, EpiPen Jr., and generic forms) may malfunction.
This could prevent a person from receiving potentially life saving treatment during an emergency.
If a person has a prescription for an epinephrine auto-injector, they can view the recommendations from the manufacturer here and talk with their healthcare provider about safe usage.
An allergic reaction occurs when a person’s immune system becomes hypersensitive to certain substances, such as foods, pollen, medications, or bee venom.
A substance that causes an allergic reaction is called an allergen. Many allergens are everyday substances that are harmless to most people. However, anything can be an allergen if the immune system has a specific type of adverse reaction to it.
One of the roles of the immune system is to destroy harmful substances in the body. If a person has an allergy to a substance, their immune system will react as though that substance is harmful and will try to destroy it.
Over 50 million people in the United States experience an allergic reaction each year. This reaction can lead to symptoms such as swelling. If swelling affects the airways, it can become life threatening.
In this article, learn about the risk factors, symptoms, and treatments associated with allergies.
Share on PinterestAn allergy develops when the immune system overreacts to a substance that is usually harmless.
Allergies develop when a person’s immune system overreacts to substances that are usually harmless.
The first time a person is exposed to an allergen, they do not usually experience a reaction. It often takes time for the immune system to build up a sensitivity to the substance.
In time, the immune system learns to recognize and remember the allergen. As it does so, it starts making antibodies to attack it when exposure occurs. This buildup is called sensitization.
Some allergies are seasonal. For example, hay fever symptoms can peak between April and May, when the tree and grass pollen count in the air is higher. A person may experience a more severe reaction as the pollen count rises.
Is it an allergy or an intolerance? Learn about the differences here.
An allergic reaction causes inflammation and irritation. However, the specific symptoms will depend on the type of allergen. For example, allergic reactions may occur in the gut, skin, sinuses, airways, eyes, or nasal passages.
Below are some triggers and the symptoms they may cause in people with an allergy.
Dust and pollen
- a blocked or congested nose
- itchy eyes and nose
- a runny nose
- swollen and watery eyes
- a cough
- a swollen tongue
- tingling in the mouth
- swelling of the lips, face, and throat
- stomach cramps
- shortness of breath
- rectal bleeding, mainly in children
- itchiness in the mouth
- significant swelling at the site of the sting
- a sudden drop in blood pressure
- itchy skin
- shortness of breath
- hives, or a red and very itchy rash that spreads across the body
- a cough
- chest tightness
- swelling of the tongue, lips, and face
- a rash
If symptoms become severe, anaphylaxis can develop.
Anaphylaxis is the severest form of allergic reaction. It is a medical emergency and can be life threatening. Anaphylaxis can develop quickly, with symptoms appearing within minutes or hours of exposure to the allergen.
Research suggests that anaphylaxis most commonly affects the skin and respiratory system.
Some symptoms include:
- hives, flushing, and itchiness
- difficulty breathing
- low blood pressure
- changes in heart rate
- dizziness and fainting
- loss of consciousness
Recognizing these symptoms can be crucial to receiving timely treatment.
Learn more about the symptoms of anaphylactic shock here.
When an allergic reaction occurs, allergens bind to antibodies that the body produces called immunoglobin E (IgE). Antibodies combat foreign and potentially harmful substances in the body.
Once the allergen binds to IgE, specific types of cells — including mast cells — will release chemicals that trigger the symptoms of the allergic reaction.
Histamine is one of these chemicals. It causes the muscles in the airways and walls of the blood vessels to tighten. It also instructs the lining of the nose to produce more mucus.
People may have a higher risk of allergies if they are under 18 years old or have a personal or family history of asthma or allergies.
Some researchers have suggested that those born by cesarean delivery may also have a higher risk of allergies, as they do not have exposure to the mother’s microbiome during childbirth.
Potential allergens can appear almost anywhere.
In theory, a person can have an allergy to any food. Specific components — such as gluten, the protein present in wheat — can also trigger reactions.
The eight foods most ly to cause allergies are:
- eggs, especially the whites
- tree nuts
- crustacean shellfish
Learn more about food allergies here.
Some other common allergens include:
- pet fur, dander, skin flakes, or saliva
- mold and mildew
- medications, such as penicillin
- insect stings and bites
- cockroaches, caddisflies, midges, and moths
- plant pollens
- household chemicals
- metals, such as nickel, cobalt, chromium, and zinc
If a person believes that they may have an allergy, their doctor will be able to help them identify what is causing the reaction.
The person should be ready to explain:
- any symptoms they have noticed
- when and how often they occur
- what seems to cause them
- any family history of allergies
- whether or not other household members have a similar reaction
The doctor may recommend some tests or refer the person to a specialist.
Below are some examples of allergy tests:
- Blood tests: These measure the levels of IgE antibodies to specific allergens in the immune system.
- Skin prick tests: A doctor will prick the skin with a small amount of a possible allergen. If the skin reacts and becomes itchy, red, or swollen, the person may have an allergy.
- Patch tests: To check for contact eczema, a doctor may tape a metal disc with a small amount of a suspected allergen to the person’s back. They will check for a skin reaction 48 hours later, and then again after 2 days.
The American College of Allergy, Asthma & Immunology can help a person find a certified allergist.
The best way to manage an allergy is to avoid the allergen, but this is not always possible. In these cases, medical treatment can help.
Drugs will not cure an allergy, but they can help a person manage the symptoms of a reaction.
Many treatments are available over the counter. Before using a medication, however, a person should speak to a pharmacist or doctor.
- Antihistamines: These block the action of histamine, which the immune system releases during a reaction.
- Decongestants: These can help relieve a blocked nose.
- Corticosteroids: These are available in the form of a pill, cream, nasal spray, or inhaler. They help reduce inflammation.
- Immunotherapy: This can help a person develop long-term tolerance. A person will take gradually increasing doses of the allergen, either as a tablet or an injection.
- Leukotriene receptor antagonists (antileukotrienes): These may help with some allergies if other treatments have not worked. The drugs block some of the chemicals that cause swelling.
Anaphylaxis is a potentially life threatening medical emergency that may require hospitalization.
If a person has difficulty breathing following exposure to an allergen, they will need immediate treatment. This will usually be in the form of an auto-injector.
Using an auto-injector
The Food and Drug Administration (FDA) recommend that people at risk of anaphylaxis carry two epinephrine auto-injectors with them at all times. If one dose is not effective, the person will need the second.
Use an auto-injector to deliver a measured dose of epinephrine (adrenaline) within minutes of any severe symptoms appearing. Someone should also call the emergency services.
EpiPen is a common auto-injector. When using an EpiPen, the FDA advise people to:
- Hold the injector in one fist, with the orange end pointing downward.
- Remove the blue safety release with the other hand, without bending, twisting, or making any sideways movements.
- Swing and push the orange end firmly against the outer thigh, at a right angle to the leg. There will be a click as the needle exits from the orange end.
- Hold the needle in place for at least 3 seconds.
- After activation, the orange end will cover the needle, and the window will be blocked. If the needle tip is still visible, do not reuse it.
Do not use the thumb to flip off the blue safety release. Always use two hands to prepare the injector.
Incorrectly removing the safety device can cause the injector to release its contents too early. As a result, there may be no medication in the device when a person needs it.
The EpiPen is just one type of injector; there are many different versions. All injectors have the same effect, but the ways of using them may differ.
The links below contain instructions on how to use the different types:
Learn more about medicines for allergies here.
There is no way to prevent or cure an allergy, but it is possible to prevent a reaction or manage the symptoms if a reaction occurs.
Those at risk of an allergic reaction should:
- Take measures to avoid exposure to known allergens.
- Carry two auto-injectors and know how to use them correctly.
- Inform friends, relatives, colleagues, and others about the allergy and how to use the auto-injector.
- Consider wearing a medical identification bracelet with details of the allergy.
- Seek allergy testing to know which substances to avoid.
- Food Allergy
- Immune System / Vaccines
As Tick Bites Rise, So Do Meat Allergies
From the WebMD Archives
Aug. 3, 2018 — Barbara Newman didn’t think much about it when she first noticed a large tick in her hair one day after hiking in September 2012.
She had several bites on her arms from tiny tick nymphs, too. But she hikes frequently and works for the Jefferson County Health Department in Alabama and knows how to remove them.
So she did, and she put some cream on her arms and carried on.
Newman and her husband ate roast beef for lunch the next day, and the following night, her husband made bell peppers stuffed with ground beef for dinner. About 8 hours after that, Newman’s scalp started to itch so badly, it woke her up in the middle of the night.
“My head felt it was on fire, and when I got up and looked in the mirror, my lips were so swollen. I looked Daffy Duck,” she recalls. “I got up to take some Benadryl and figured I would go to the doctor in the morning. But it kept getting worse and worse, so I went to the ER.”
Emergency crews wasted no time when she walked in, immediately recognizing the symptoms of anaphylaxis — a severe allergic reaction that can be life-threatening. They laid her on a gurney and gave her epinephrine as quickly as possible.
“The whole time I remember thinking, ‘Whoa. How did this happen?’ ” Newman says.
She followed up with an allergist, and testing revealed high levels of resistance to beef and pork — even though Newman, who was then 53, had been eating meat her entire life.
“The doctor told me he knew of a researcher looking into this phenomenon where if you are bitten by a tick, you can develop this bad allergic reaction to mammalian meat, so he wanted to do a more specific test,” Newman said.
Further testing revealed she did indeed have high levels of alpha-gal in her blood, meaning she had been bitten by a Lone Star tick, which triggered the anaphylactic reaction to meat.
“The time between when I ate the meat and the allergic reaction was about 8 hours, and I feel it could have been hard to correlate the two things,” Newman says. “I feel so lucky my doctor knew about this.”
The CDC says tick, mosquito, and flea bites tripled in the United States between 2004 and 2016, and Lone Star ticks — named for the white shape on the back of adult females that resembles the shape of Texas — have increased in “distribution, range and abundance” in the last 20 to 30 years. They can now be found as far north as Maine and as far west as Texas and Oklahoma, while they’re normally found across the Eastern, Southeastern, and South-Central states.
Researchers have discovered that a Lone Star tick bite can make some people react to the alpha-gal carbohydrate, a complex sugar found in red meat beef and pork.
Alpha-gal syndrome isn’t listed on the CDC website as a tick-borne disease. Scott Commins MD, PhD, an associate professor of medicine and pediatrics at the University of North Carolina, says that makes sense, because this is more of an allergy than a disease.
He is part of the team that first discovered that the Lone Star tick can cause a meat allergy. He did that while working at the University of Virginia with Thomas A.E.
Platts-Mills, MD, the doctor who discovered alpha-gal was the cause of allergic reactions to a cancer drug.
“We had a couple of patients who described this delayed reaction to red meat,” Commins says. “At first we were the only center reporting this, and there was a healthy amount of skepticism. But over time, an awareness of this allergy began to grow.”
Platts-Mills published his first paper on alpha-gal in 2008, and he and Commins published about the link to a meat allergy in 2009, although they say they’ve have heard of cases as far back as the 1970s.
And around the same time their research was beginning, Platts-Mills himself got the meat allergy after being bitten by a number of ticks during a 5-hour hike in Virginia.
Three months later, he ate two lamb chops and woke up 6 hours later in the middle of the night covered in hives.
“I think in part it shows how common this is and that the kind of people who get it spend hours on a mountain walking off trail,” Platts-Mills says. In fact, a crowdsourcing website has almost 3,000 reports from people around the world who say it happened to them.
Now, a study published last week in Annals of Allergy, Asthma and Immunology reports the alpha-gal meat allergy was the most common known cause of anaphylaxis at the University of Tennessee Health Science Center between 2006 and 2016 — accounting for 33% of 218 cases reviewed.
Debendra Pattanaik, MD, lead author of the study and an associate professor of medicine at the University of Tennessee Health Science Center in Memphis, says an increase in the Lone Star tick population since 2006 is the ly cause of the jump in cases, as is a better understanding in the medical community that tick bites may cause the alpha-gal allergy.
“Our research clearly identified alpha-gal as the cause of anaphylaxis in the majority of cases where the cause was detected. Food allergies were the second leading cause, accounting for 24%,” Pattanaik says.
In previous studies at the center, researchers often couldn’t identify the source of severe allergic reactions. “When we did the same review in 1993, and again in 2006, we had a great many cases where the cause of the anaphylaxis couldn't be identified,” Pattanaik says. The number of unexplained cases is now at 35%, down from 59% in 2006, he says.
Researchers acknowledge that Tennessee has a big population of Lone Star ticks, which ly influenced the numbers of alpha-gal cases they identified. Still, they point out that while the Lone Star tick is mostly found in the Southeastern U.S., cases are being reported nationwide.
Laura Stirling can attest to that. The Severna Park, MD, resident ate Italian sausage for dinner one night in 2017 and woke up 6 hours later covered head to toe in hives. They were itchy, painful, and had nearly swollen one eye shut. She was also dizzy, lightheaded, and nauseated.
That morning, she went to her primary care doctor, who had no idea what was going on and referred her to an allergist who asked if she’d been bitten by a tick. She had, about 3 weeks earlier. The 51-year-old’s blood test came back with an alpha-gal number of 89. Normal is below 0.35.
“I was lucky I never stopped breathing. In my reactions, hives, upset stomach, and lightheadedness are the signs,” Stirling says. “The whole concept of this is totally crazy, but being able to control it makes it just fine. I have not had another reaction since I was told a year ago to stop eating red meat.”
Researchers still don’t know the molecular trigger for the allergic response. Platts-Mills, the UVA professor, says it can happen anywhere from 2 weeks to 3 months after a tick bite when someone eats any red meat, including beef, pork, and venison.
The allergy is best diagnosed with a blood test checking a person’s sensitization to these meats. It can cause hives, itching, swelling, difficulty breathing, and a variety of digestive symptoms, including cramping, pain, and nausea. The National Institutes of Health describes an anaphylactic reaction as one that involves two or more organs. It can be stopped with epinephrine.
Commins, the UNC professor, says cases often happen to people in their 40s or 50s, but he’s published research on nearly 50 cases in children, too. This food allergy does have one big difference from most others: Un other food allergies that happen within seconds or minutes of having a certain food, symptoms of allergic reactions to alpha-gal aren’t seen for 3 to 6 or even 8 hours.
“We think the timing of the allergy has to do with the fat content of meat and that fat gets absorbed slowly into the bloodstream,” Commins says. “We are actively investigating that now.”
Researchers are also trying to figure out what it is about ticks that causes this reaction.
They’re looking at deer blood, tick saliva, and bacteria from ticks as possible causes, and there’s now research around the world, with cases of meat allergies resulting from tick bites coming from Australia and Europe, although as a result of different kinds of ticks.
Commins says once this is better understood, there’s hope of someday having a treatment that could desensitize people through allergy shots — what’s available for bee or wasp venom.
In the meantime, researchers say it’s important that medical professionals other than allergists know about this condition. They say doctors need to understand that abdominal pain is a key marker of this allergy and that symptoms are delayed.
“Allergists are aware, but I’m not sure about ER and primary care doctors,” says Pattanaik, the lead author of last week’s alpha-gal meat allergy study.
“Many doctors think allergic reactions happen right away since that happens with milk and peanuts.
I think it is even hard for many patients to make the connection when it’s several hours later, so we need to spread the knowledge that you can have this reaction to meat you ate hours before.”
Commins says it’s also important to educate doctors that this allergy often has symptoms at night — ly because many people eat red meat for dinner. “Typically these patients often have nighttime reactions.
They have a history of being outdoorsy. Sometimes they even know they had a recent bad tick bite,” Commins says.
“Even though it seems remote, an important question for doctors to ask is, ‘What did you eat, the meal before your symptoms started?’ ”
Many who get the alpha-gal allergy have it not only to meat, but to all animal products, including dairy. That’s happened to Stirling. Her symptoms have reappeared with dairy — she even reacted once to organic soap made with goats’ milk.
She now checks all food and product labels, asks restaurants to cook her food in separate pans if possible to avoid cross-contamination, and she frequently calls manufacturers to see if they’re using animal products as seasoning or a minor ingredient.
“It is a crazy allergy, but I don’t let this restrict my life,” the real estate agent says. “I just got back from Greece. I travel. I go out to dinner. I just ask a lot of questions.”
A year after her reaction, Stirling’s alpha-gal numbers have dropped 30%. But when her allergist encouraged her to try a small slice of cheese, she still got a stomachache within 30 minutes. So she’s continuing to avoid all animal-based products and doing what she can to educate people about the condition along the way.
“I’ve had chefs actually come to a restaurant table to ask questions because they want to learn more about this,” Stirling says. “I really feel a lot of people don’t get it. I think they feel it isn’t a real thing, and that is extremely dangerous. It was very overwhelming in the beginning and terrifying, too, because I was always wondering if I would have a reaction.
“But I have educated myself, and now I have it under control. You can live with this. It’s tough, but it’s not the end of the world.”
Newman, the Alabaman who got the allergy in 2012, agrees. She’s avoided beef and pork for 6 years now and says she does just fine with a diet that relies on turkey bacon, chicken, and fish for protein.
She says that has made it easy to maintain a healthy weight, and food has become cheaper.
And while her bloodwork last year also indicated her alpha-gal levels have gone down and her allergist says she could try to start eating meat again, she says she’s not interested.
“No way. I’m off meat. My reaction was so bad. I’m not going to do that again,” says Newman, who’s now 59. “I’ve lived without meat just fine, and I’m outside a lot, so nope — I’m not taking that chance again.”
Scott Commins, MD, associate professor of medicine, University of North Carolina, Chapel Hill.
Barbara Newman, Birmingham, AL.
Debendra Pattanaik, MD, associate professor of medicine, University of Tennessee, Memphis.
Thomas A.E. Platts-Mills, MD, professor of medicine and microbiology, University of Virginia, Charlottesville.
Laura Stirling, Severna Park, MD.
Journal of Allergy and Clinical Immunology: “Red meat allergy in Sweden: Association with tick sensitization and B-negative blood groups.”
Pediatrics: “Galactose-α-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in children.”
Annals of Allergy, Asthma & Immunology: “The changing face of anaphylaxis in adults and adolescents.”
Current Opinion in Allergy and Clinical Immunology: “Understanding the mechanisms of anaphylaxis.”
Journal of Allergy and Clinical Immunology: “The alpha-gal story: Lessons learned from connecting the dots.”
CDC: “Tickborne Diseases of the United States,” “Illnesses from Mosquito, Tick, and Flea Bites Increasing in the US,” “STARI or Lyme?”
Zeemaps: “Where in the world is alpha gal?”
Mayo Clinic: “Anaphylaxis, Symptoms & causes, Overview.”
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