New Jersey man dies from meat allergy triggered by tick bite
A New Jersey man has died in the first documented fatal case of alpha-gal syndrome, a meat allergy triggered by tick bites.
In September 2024, the 47-year-old collapsed and lost consciousness about four hours after eating a hamburger at a barbecue, doctors wrote in a report on the case. Despite attempts by the man’s son and paramedics to revive him, he was pronounced dead later that night after being transferred to hospital.
The authors of the case report, who published details of the case on Thursday, November 13 in The Journal of Allergy and Clinical Immunology in Practicewrote that it was important to document this deadly case because many American doctors ignore alpha-gal syndrome – even though the ticks that most often spread the disease are moving to new territories.
“We would say there is a major need for public education in areas where the tick is increasing,” they said.
Alpha-gal is a sugar found in all mammals except for humans and other primates. In alpha-gal syndrome, the human immune system overreacts to this sugar, causing symptoms that can range from mild to potentially fatal. These symptoms may include hives, vomiting, stomach pain, difficulty breathing, drops in blood pressure, dizziness, and in more severe cases, anaphylaxis.
Tick bites can trigger this alpha-gal allergy because they expose a person to sugar via the tick’s spit, setting off a chain reaction that leads to sugar hypersensitivity, aka an allergy. So the next time a person consumes a product containing alpha-gal, their body overreacts, even if they safely ate that product several times before being bitten by a tick.
Beef, pork, lamb, venison and rabbit meat contain a high concentration of alpha-gal. Additionally, dairy and mammal-derived products – such as gelatin, lard and gravy – may also contain enough sugar to trigger reactions in some people with the syndrome. Non-mammalian animal products, including poultry, eggs, fish and seafood, do not contain alpha-gal.
In the New Jersey man’s case, his alpha-gal syndrome may have gone unnoticed because his family typically ate chicken, the case report suggests.
A few weeks before his death, the man went camping with his family, and during the trip they ate beef steak for dinner. About four hours later, he developed severe abdominal discomfort and was “writhing in pain, having diarrhea and vomiting.” His symptoms disappeared a few hours later, and he felt well enough the next day to take a 5-mile walk and eat breakfast.
Two weeks later, after the camping trip was over, the man and his wife attended a barbecue, where he ate a hamburger. Again, he felt fine for about four hours before developing gastrointestinal distress, and from there his symptoms quickly progressed to anaphylaxis.
“The fact that severe abdominal pain without other allergic features may constitute an important, or even dangerous, form of anaphylaxis is not well recognized,” the report’s authors wrote. When the man’s body was examined shortly after his death, the autopsy revealed no clear signs of anaphylaxis and it was initially documented as a “sudden, unexplained death.”
After his death, the man’s wife asked her friend Dr. Erin McFeelyNew Jersey-based pediatrician and co-author of the case report, to review the autopsy report. This review raised the question of whether alpha-gal syndrome could be an explanation, and they contacted experts at the University of Virginia (UVA) School of Medicine in Charlottesville to examine the case in more detail.
An analysis of the man’s blood revealed that he carried antibodies against alpha-gal, as well as extremely high levels of tryptase, an enzyme released by immune cells into the bloodstream during allergic reactions. The UVA team asked the man’s wife if he had recently been bitten by ticks, and she noted that he had not been bitten by ticks in the past year, but had been bitten by chiggers.
Chiggers are a species of miteit is not a type of tick, but the study authors noted that people sometimes think they have been bitten by chiggers when they have actually been bitten by lone star tick larvae (American Amblyomma). Several species of ticks can spread alpha-gal syndrome, but The lone star tick is the most common culprit in the United States.
In particular the white-tailed deer (Odocoileus virginianus) are a key host for these ticks. Like the the deer population has exploded in New Jersey, the report’s authors pointed to this as one of the factors leading to increased tick populations.
“The significance of this case is that a large and growing population in the United States is exposed to the Lone Star tick, both because the tick is moving north and because there are now large populations of deer in many states,” they wrote. They added that the specific symptoms of an alpha-gal reaction may not alert patients that it is an allergic reaction, which could delay much-needed medical care.
“Even though the first episode frightened the patient, neither he nor his wife considered it ‘anaphylaxis’ and, therefore, did not connect the pain to the beef eaten 4 hours earlier,” they wrote. “So he had no reason to avoid eating a hamburger two weeks later.”
This article is for informational purposes only and is not intended to offer medical advice.
