How TICK BITES is now making people allergic to red meat and even toothpaste… Hundreds of thousands test positive for this scary new allergy – here are the signs to look out for

Val Smith was on a river cruise in France when she woke up in the early hours and felt an incredible itch on her arms, torso and legs. “I was in pain,” recalls the former family support worker who lives in Holbury, Hampshire.

‘I couldn’t sleep, so I walked into the main lounge of the ship and sat there itching all night. I kept thinking, ‘What caused this?’

It wasn’t the first time her skin had reacted this way: a few weeks earlier Val, now 74, had gone to bed feeling very unwell. “I woke up itchy and felt like I’d been bitten by a thousand mosquitoes,” she says. Her body was covered in bumps and welts, so she took an antihistamine. “The next morning it was gone.”

A week later the same thing happened, again in the early hours.

After the third time, during the 2018 cruise, she discovered that she had eaten beef every time that night.

She searched online and came across reports of alpha-gal syndrome, a condition caused by a tick bite that causes an allergy to red meat. Val immediately thought of the tick bite she had suffered seven years earlier.

At the time, Val and her husband Les, now 82, had recently moved to the New Forest to be close to family. ‘I had built a den with my grandchild and the next day I saw a small red spot the size of a mosquito on my knee.’

The bite got bigger and caused swelling “like a plate wrapped around my knee – big, round and red,” she says.

A few months later, with the bite still swollen, she went to her doctor, who sent her to the local hospital to be tested for Lyme disease, an infection caused by ticks that carry the Borrelia bacteria .

If treatment (usually antibiotics) is delayed or left untreated, it can lead to painful joints, memory problems and other debilitating symptoms. The test confirmed that Val had Lyme.

What she didn’t realize was that the infection not only caused the swelling of her leg, but also triggered an immune response called alpha-gal syndrome (AGS), an allergy to meat that can be caused after someone is bitten by a tick that has alpha-gal syndrome. bile, a type of sugar molecule, in his saliva.

In response, some people produce antibodies against alpha-gal,’ in which case we call the person ‘hypersensitive’, explains Andrew Whyte, an allergist and immunologist at Derriford Hospital, Plymouth.

‘The alpha-gal molecule is also present in the muscles of all mammals – except humans and most primates – so a sensitive person may have an alpha-gal reaction if they eat red meat.’

According to him, AGS has ‘completely nothing to do’ with Lyme disease, which is ‘an infection rather than an allergy’.

In the US, more than 110,000 people tested positive for the antibodies against alpha-gal in tests conducted between 2010 and 2022, according to the Centers for Disease Control and Prevention in July, although the actual number is thought to be closer to 500,000. with rising cases.

Although there are no figures for this in the UK, ‘it is probably more common than we think because the diagnosis is often missed, but specialists are seeing more cases,’ says Dr Whyte.

He adds: ‘The onset of AGS after a tick bite often lasts four to six weeks, but in some cases it can last months, although we don’t know why. Of course, if there is a very long delay, it could be that the person was bitten by a tick but did not notice it.”

Another feature of AGS is that symptoms can be delayed for several hours after eating red meat. ‘Normally an allergic reaction occurs within an hour of eating (the food causing the reaction), but with AGS this can often take four to six hours,’ says Dr Whyte.

In Val’s case, the reactions occurred about seven hours later.

AGS is most common in the southern and southeastern regions of the US, where a specific tick called the Lone Star is “the source of alpha-gal transmission to humans,” says Dr. Whyte.

It has also been reported in many other countries, says Professor Hasan Arshad, Professor of Allergy and Clinical Immunology, Clinical and Experimental Sciences at the University of Southampton.

AGS symptoms can range from mild – such as a rash and swelling – to severe, including difficulty breathing and anaphylaxis, where blood pressure drops dangerously and organs can fail. ‘But it is entirely possible that you are hypersensitive to alpha-gal and do not respond or have no clinical manifestations,’ says Professor Arshad.

Although alpha-gal is mainly found in ‘mammal’ meat (not chicken) and organs (for example the kidneys), milk and gelatin can also contain it, he explains. ‘Therefore, drugs, vaccines and even sweets containing mammalian cells/tissues or even a small amount of gelatin can occasionally cause a reaction.’

He adds: ‘It has been reported that people with blood types A and O are at greater risk – and that blood group B is protected.’ This is because people with blood types A and O have antibodies that can respond to alpha-gal, he explains.

When someone with AGS eats red meat, their response may be delayed if they eat fatty meat instead of lean meat (because fats take longer to digest).

Many with AGS “may have mild symptoms and have never been diagnosed,” adds Professor Arshad. ‘And there may even be some patients with severe symptoms who suffer from anaphylaxis, but their anaphylaxis is diagnosed as idiopathic (without any observable cause) rather than being related to meat, because the reaction occurs several hours after consuming the food .

“In about 30 percent of people with anaphylaxis, no cause is identified,” he says.

Professor Arshad adds that ‘diagnosis is often delayed because the condition is uncommon and allergy as a subject is not well taught in medical schools’. But once AGS is suspected, diagnosis is ‘relatively simple’ with a blood test that can be done by a GP.

After the cruise, Val went to her GP, who said she had ‘probably had a heat rash’. ‘It wasn’t until I got home that I realized I should have mentioned AGS, so I called and asked if she’d heard of it.’

Her doctor replied that ‘it wasn’t in Britain’. Although the condition was originally identified in the US in 2002, Britain is among the many other countries where the condition has now been found.

Dr. Whyte says: ‘Although Lone Star ticks are mainly responsible for AGS in North and Central America, other species in other parts of the world may be involved.’

Val continued to eat meat, but noticed that the reaction started ‘even when I ate pork and sausages or bacon – anything with four legs!’ she says. ‘I started having worse and worse skin reactions.’

Later in 2018, Val insisted on being referred to an allergy specialist. A blood test showed she had grade 4 AGS, meaning she’s “strongly positive” for it (the scale goes from one, “equivocal,” to four) — “which explained why I reacted so poorly every time,” says them.

She was referred to her hospital’s immunology department, where she was warned that the reaction could get worse. She prescribed her an EpiPen (a device filled with an injection of adrenaline to reduce severe allergic reactions).

She was told to avoid all red meat. ‘This applies to everything from a mammal, such as gelatin or fat. So many foods contain these, like certain sweets, desserts, even toothpaste and some vaccines, so I have to be extra careful.”

As Professor Arshad explains: ‘There is no cure for alpha-gal syndrome, so affected people should strictly avoid meat.’

He said life can be difficult for people with severe allergies. ‘The reaction can occur with even small amounts of meat or even from inhaling fumes while cooking meat, as airborne molecules of alpha-gal can be inhaled.’

Val adds: ‘It’s very difficult at hotel buffets as there can be cross-contamination from spoons and utensils and I have to check food labels everywhere.

‘I thought the idea that a tick would cause all this was ridiculous and it drove me crazy. I hope my story raises awareness that AGS is in the UK.”