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to this molecule, and who are bitten by the right tick, become allergic to meat. TICK BITES AND MEAT ALLERGIES The connection between tick bites and the development of meat allergies is a recent phenomenon. It has been tracked for about 10 years, although the first recorded instances may date to the 1990s when a group of patients in a drug trial for colorectal cancer developed symptoms triggered by the gel caps of their medications. It took several years, but scientists eventually associated the geographical distribution of previously healthy adults who suddenly developed extreme allergic reactions to meat with the distribution of Rocky Mountain spotted fever—an infection spread by lone star ticks. This led them to look for allergic markers related to tick bites, and the discovery of a new phenomenon: tick- triggered mammalian meat allergies. The allergen in this situation is a sugar molecule called galactose-alpha- 1,3-galactose, but scientists use the term alpha-gal. Alpha-gal is found in the cell membranes of all mammals, with the exception of most primates. It is a component of beef, pork, lamb, and game meats, but it is not found in poultry. If someone is sensitive to this molecule, the condition is called alpha-gal syndrome. Alpha-gal gets into the human bloodstream when an affected lone star tick regurgitates into its host. A reaction may develop within a few weeks after only one tick bite, but repeated exposures appear to make immune system reactivity to alpha-gal more extreme. In alpha-gal syndrome, the body suddenly begins to make a big immune response to the alpha-gal that occurs naturally in ingested meat. A widespread immune system response develops when alpha-gal molecules cross from the intestines into the bloodstream. The result usually involves a delay of several hours, followed by digestive discomfort, a rash, extreme itching, swelling, and a dangerous drop in blood pressure—in short, life-threatening anaphylactic shock. The only treatment for alpha-gal syndrome is to avoid all mammalian meat. This also includes any substances or medications that use meat products. Many people find they have reactions to milk, butter, cheese, and other dairy products too. However, with time, this extreme allergic reaction may subside. After a couple of years, many people with alpha-gal syndrome find they can rebuild tolerance for some meats, especially lean cuts that are prepared without fats. Interestingly, lone star ticks are not the only species that can trigger this reaction. The same response is seen in Australia, Japan, Sweden, and several other countries, with ticks endemic to those regions. In fact, this situation is so common in Australia (often as a reaction to kangaroo steaks) that EpiPens there are carried for meat allergies more often than for any other type of allergic reaction. QUESTIONS? LOTS! Does all this make you curious? You're not alone. This situation has piqued the interest of many researchers and allergy specialists. Here is a short list of the most burning questions and possible answers—any of which may change as we learn more about the ticks, their saliva, and our immune system responses. Our healthy, regular clients probably see us more often than they see their primary care providers and sometimes tell us things they don't tell their doctors. Yo u r M & B i s w o r t h 2 C E s ! G o t o w w w. a b m p . c o m / c e t o l e a r n m o r e . 45