Few health workers familiar with tick-bite meat allergy, survey finds
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Key takeaways:
- Alpha-gal syndrome is a serious allergic reaction that can occur after people eat red meat.
- According to the CDC, there is growing evidence that the syndrome may be triggered by a tick bite.
A survey showed few health care providers are familiar with the potentially life-threatening allergic reaction known as alpha-gal syndrome, which evidence suggests may be primarily associated with the bite of a tick, according to the CDC.
According to the CDC, more than 110,000 suspected cases of alpha-gal syndrome were identified in the United States between 2010 to 2022.
Also known as red meat allergy or tick-bite meat allergy, there is growing evidence that alpha-gal syndrome is primarily associated with a bite from the lone star tick, although the CDC said bites from other ticks have not been ruled out.
Alpha-gal is a sugar found in mammal meat and mammal-derived products. Symptoms of the syndrome can include hives or itchy rash, nausea or vomiting, heartburn or indigestion, diarrhea, cough, shortness of breath or difficulty breathing, drop in blood pressure, swelling of the lips, throat, tongue, or eye lids, dizziness or faintness, or severe stomach pain, the CDC noted.
According to the agency, patients with the syndrome commonly develop symptoms 2 to 6 hours after eating red meat or dairy products or being exposed to other products containing alpha-gal, like medications coated in gelatin.
Due to a lack of knowledge and testing, researchers estimated in a newly published MMWR that as many as 450,000 people may have been affected by the syndrome since 2010.
“Alpha-gal syndrome is an important emerging public health problem, with potentially severe health impacts that can last a lifetime for some patients,” Ann Carpenter, DVM, an officer in the CDC’s Epidemic Intelligence Service and a co-author of two related MMWRs, said in a press release. “It’s critical for clinicians to be aware of AGS so they can properly evaluate, diagnose, and manage their patients and also educate them on tick-bite prevention to protect patients from developing this allergic condition.”
Carpenter and colleagues surveyed 1,500 health care workers — including pediatricians, primary care physicians and nurse practitioners — about their knowledge of alpha-gal syndrome. According to the responses, 42% had never heard of the syndrome, 35% were “not too confident” in their ability to diagnose it, and 5% reported being “very confident” in their ability to diagnose it.
“The burden of alpha-gal syndrome in the United States could be substantial given the large percentage of cases suspected to be going undiagnosed due to non-specific and inconsistent symptoms, challenges seeking healthcare, and lack of clinician awareness,” Johanna Salzer, DVM, PhD, an author on both papers, said in the press release. “It’s important that people who think they may suffer from AGS see their health care provider or an allergist, provide a detailed history of symptoms, get a physical examination, and a blood test that looks for specific antibodies to alpha-gal.”
The authors recommended further research, expanded tick surveillance, and said that increased education efforts are needed to improve public health outreach and prevention and support clinician understanding of AGS.
They said clinicians should talk to patients about protecting themselves from tick bites and encourage them to use EPA-registered insect repellents and check their bodies, clothing, and gear for ticks after spending time outdoors.
According to the second MMWR, the highest numbers of cases of alpha-gal syndrome identified through testing were in Suffolk County, New York, and Bedford County, Virginia. The highest number of suspected cases per 1 million population per year were in Charlotte County, Virginia, and Muhlenberg County, Kentucky, but the highest prevalence of suspected cases “were found throughout a nearly contiguous region of the southern, midwestern, and mid-Atlantic United States, particularly parts of Oklahoma, Kansas, Arkansas, Missouri, Mississippi, Tennessee, Kentucky, Illinois, Indiana, North Carolina, Virginia, Maryland, and Delaware.”
References:
- Carpenter A, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7230a1.
- CDC. Alpha-gal syndrome. https://www.cdc.gov/ticks/alpha-gal/index.html. Last reviewed April 14, 2023. Accessed July 27, 2023.
- Thompson JM, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7230a2.
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