A Tick Bite Could Make Your Next Burger A Problem

NEW YORK CITY— A tick bite can turn a hamburger, steak or even a scoop of ice cream into the trigger for a delayed allergic reaction.

The condition, known as alpha-gal syndrome, develops when a tick bite triggers the immune system to produce antibodies against alpha-gal, a sugar found in red meat and other products from mammals.

The Lone Star tick, marked with white and silver patches across its back, carries alpha-gal in its saliva.

When the tick bites, it can introduce the sugar through the skin and trigger an immune response.

How Many New Yorkers Have Tested Positive?

New York City began receiving laboratory reports for alpha-gal in 2023. The City has recorded nearly 600 positive tests since laboratory reporting began, according to the Health Department.

A separate city Health Department tally cited by state and federal reporting puts the number of suspected cases reported since 2024 at 280.

A positive antibody test does not establish that someone experienced an allergic reaction, and the City's data does not identify people who have the condition, but never receive testing.

A federal analysis of commercial laboratory data estimated that 3,800 to 18,000 people in Suffolk County had alpha-gal antibodies between 2010 and 2022, potentially representing as much as 1.2 percent of the county's population.

What Are The Symptoms Of Alpha-Gal Allergy?

Stephanie L. Mawhirt, a doctor of osteopathic medicine and allergist at NYU Langone Health, said those antibodies can cause an allergic reaction when a person encounters alpha-gal again.

The antibodies can remain in the body for weeks or months before a person develops symptoms, she said.

Allergic reactions typically appear two to eight hours after eating red meat or other foods derived from mammals.

"Alpha-gal reactions are sometimes referred to as 'midnight anaphylaxis' as patients may be awakened in the middle of the night by symptoms caused by dinner several hours prior," Mawhirt told Patch.

Symptoms can include nausea, vomiting, diarrhea, abdominal pain, flushing, hives and swelling.

Severe reactions can cause anaphylaxis, a potentially life-threatening allergic reaction.

About 20 percent of patients experience only gastrointestinal symptoms, without hives, according to Mawhirt.

Those patients can mistake the condition for irritable bowel syndrome or another digestive disorder.

What Foods Can Trigger A Reaction?

Beef, pork, lamb and venison can all contain alpha-gal.

Some people also react to:

• Milk and other dairy products
• Gelatin
• Certain medications containing mammalian-derived ingredients

The severity varies from person to person.

A large serving of meat, fattier meat and alcohol can worsen reactions in people who already have alpha-gal allergy, according to Mawhirt.

Who Faces The Greatest Risk?

Repeated Lone Star tick bites and outdoor exposure rank among the biggest risk factors, Mawhirt said.

People who hike, hunt, work in forestry or spend time in wooded areas face greater exposure. Many people never realize a tick has bitten them.

In New York City, surveillance has found the ticks on Staten Island and occasionally in northern Bronx and eastern Queens, according to the city Health Department.

Most New York City residents with positive alpha-gal tests live in Manhattan and Brooklyn.

Health officials cannot determine where those residents encountered ticks, but the pattern suggests many bites occurred outside the City.

Can The Allergy Go Away?

Avoiding additional tick bites can allow alpha-gal IgE levels to decline, Mawhirt said.

Some people eventually regain the ability to eat red meat without a reaction, but Mawhirt recommends doing so under an allergist's supervision.

“If there is concern for alpha-gal allergy, patients should stop ingesting alpha-gal containing foods or medications and seek allergy consultation,” Mawhirt said.

Patients with the allergy should also carry an epinephrine auto-injector.