What was once a rare tick-borne illness causing severe allergic reactions to red meat has seen a rapid rise in recent years, impacting as many as 400,000 people across the U.S.
Alpha-gal syndrome (AGS) is caused by infected bites from the lone star tick, a parasite known for carrying Lyme disease and Rocky Mountain spotted fever.
Lori Dawson, a wildlife rehabilitator based in Bowling Green, knows the firsthand impacts of AGS all too well. In 2020, she was diagnosed with AGS after a year-long battle with recurring allergic reactions, weight loss, and varying opinions from doctors. She said that mounting confusion and the overwhelmed nature of medical facilities at the height of the COVID-19 pandemic made a diagnosis almost impossible.
“Anytime I ate, I would break out in hives. I would have difficulty breathing, I would have a lot of diarrhea, things like that. I really had no idea, I couldn’t even get into a doctor, everything was closed down, so I finally talked to my doctor on the phone and she was like, ‘start logging everything you eat, really keep track.’”
‘No cases of Alpha-gal here’
After another eight months of tracking her diet, Dawson spoke to a friend who told her about a tick-borne disease she’d heard of in Georgia called Alpha-gal syndrome.
“When I looked it up, it sounded just like my symptoms. So I called an allergist here in town and said, ‘Hey, I think I might have Alpha-gal,’ and she was like, ‘There are no cases of Alpha-gal here. If you want to be tested, we can test you, it’ll take about a week to get the results back, but that’s probably not what you have,'” Dawson said.
After another week, the test came back positive. Dawson was diagnosed with one of the first recorded cases of AGS in Kentucky. For over a year, she’d been having allergic reactions to red meat and other products derived from red meat, including dairy items, gelatin, shampoo, and body wash.
That diagnosis meant making some drastic changes in her wildlife rehab operation. On her property, Dawson typically rehabilitated foxes, squirrels, opossums, skunks, raccoons, and white-tailed deer.
“The most I’ve ever had was 400. That was kind of a crazy year, that’s when I was doing deer, but I would say now, without taking deer in, I’m probably more around the 300 mark,” Dawson said.
Dawson’s property houses a facility that is one of few in Kentucky equipped to handle white-tailed deer. It’s been used to house herds of at least 30 deer at a time. Unlike many other species, ticks are practically unavoidable when handling deer, and any additional tick bites after initial infection increase the disease’s effects.
“Everything else, you can kind of hold in your hands with gloves on, you can take precautions, but with the deer they’re just all over you. They have to be in the weeds, I had to walk out into the field to get to them, it just didn’t make sense anymore,” Dawson said.
She said letting go of that portion of her rescue was a difficult decision. The enclosure on her Warren County property was one of the only facilities certified for deer rehabilitation in the state.
“There’s a lot of specifications you have to meet to be able to do deer. I hadn’t had this new fence for two or three years before I had to quit doing them, so now it’s just kind of sitting out there taking up space,” Dawson said.
She recalled that it was a white-tailed deer that carried the tick that infected her with AGS.
“I got a call for a deer that was down in the middle of a field in February, when you don’t really think of ticks. But I remember getting the tick bite because, well, it was February and it was weird. It was like two or three weeks after that that I started having my symptoms,” she remembered.
Leading experts in tick-borne diseases say that changes in winter weather are one of the main factors in the rapid rise in AGS and other tick-borne diseases.
Tick bites are on the rise. Why?
Hannah Tiffin is an assistant extension professor of entomology at the University of Kentucky. She leads the newly developed Biting Insect & Tick Ecology (BITE) Lab at UK, where the lab focuses on developing education, surveillance, and management resources to reduce vector-borne diseases of animals and people in Kentucky. She leads studies on tick disease management, education, surveillance and control. She says cases of Alpha-gal have increased since the early 2000s, when around 1,000 cases had been confirmed nationwide.
“Now it’s thought to be closer to, like, 400,000 cases in the U.S., but reported incidents are much lower than that just because it’s not a reportable or nationally notifiable disease to the CDC,” Tiffin said.
She said the rapid rise in Alpha-gal cases has taken place along with a spike in other tick-borne diseases like Lyme disease and Rocky Mountain Spotted Fever, largely due to a combination of residential development into wooded areas and the lasting effects of climate change on winter weather.
“We’re seeing less cold days in a row, and so that’s what usually kills off tick populations, you need these cold days that are in a row and last long enough that ticks can’t survive,” she said.
According to Tiffin, those changes in regional climates are also impacting the ranges of tick host species.
“We’re seeing higher populations or changes in ranges of generalist host species, so these species that can exist in a variety of different environments, so white-tailed deer, mice, rodents. So, as they’re increasing their ranges and populations, ticks are also expanding their ranges and populations,” she said.
Tiffin added that lone star ticks specifically are a generalist species, and will work aggressively to out compete other species of ticks in an environment. That combination of expanded ranges, higher populations, and increased aggression has led to the disease-spreading tick to become more prevalent for both human and animal infections.
Origin of AGS and how it infects
Tiffin explained that AGS was first discovered in the U.S. during a cancer treatment trial in the early 2000s. In 2009, Australian researchers concluded that AGS was related to tick bites, and shortly afterwards, a U.S. team narrowed that range to that of lone star ticks that also carry Rocky Mountain spotted fever.
She explained that some aspects of how AGS is transmitted are still a mystery.
“Essentially what happens is, the tick bites you. For whatever reason, the Alpha-Gal molecule gets transferred through the tick bite into your system. Science is still kind of fuzzy on how that happens or where Alpha-Gal comes from, but the Alpha-Gal molecule gets transferred into your system along with a bunch of other things in the tick’s saliva. So, your system mounts an immune response, notices Alpha-gal as a foreign body, and then produces antibodies against it. So, then, the next time you come into contact with something that has Alpha-gal, so, for instance, red meat, your body notices that same molecule again and says, ‘Oh, this was a foreign invader last time, this is a foreign invader this time.”
Tiffin said that tick bite prevention is both the best way to ward off AGS and the best method of treating it. Symptoms flare up drastically with each tick bite after infection, but by limiting consumption of red meat and products derived from red meat, Tiffin and Dawson agree that over time, symptoms dissipate and small doses of red meat can be re-integrated into diets.
Dawson shared that she’s also been experimenting with holistic remedies like acupressure, with some positive results. She’s been able to switch back to her regular shampoo, body wash, and makeup brands, as well as enjoy ice cream occasionally. Those were all aspects of her life that had to be removed when she was first diagnosed.
Despite not being able to rehabilitate deer, the remainder of her wildlife rescue operation remains in full swing with hundreds of new animal patients entering her care every year.
