New cases of alpha-gal syndrome (AGS), a rare, but potentially life-threatening allergic condition to red meat, suggest that more tick species may be responsible. The novel insight comes from two new cases identified - one in a 45-year-old woman in Maine, and the other in a 61-year-old woman from Washington, had not been in areas where the lone star tick, the primary suspect, is typically found.

Both women reported being bitten by ticks, however, contrary to previous beliefs, scientists the culprits are other species, including Ixodes scapularis, also called black-legged or deer ticks.

The new evidence has raised concerns about the spread of AGS, especially in regions like Long Island, where ticks are a growing problem.

Here is everything you need to know about the rare, but serious illness.

What is alpha-gal syndrome?

Alpha-gal syndrome (AGS) is a serious, potentially life-threatening allergic condition that can occur after a , according to the US Centers for Disease Control and Prevention. The disease is named after a molecule, galactose-α-1,3-galactose, which is found in most mammals.

The lone star tick is the major culprit associated with AGS, however, recent cases suggest the involvement of other kinds of . Symptoms occur after consuming red meat, or when people get exposed to products derived from these mammals such as milk, other dairy products, and some pharmaceutical products. This is a severe response to the sugar, galactose-α-1,3-galactose (alpha-gal), that is in meat from mammals, and in tick spit. When the sugar enters the body through the skin, it triggers an immune response, resulting in a severe allergic reaction.

According to a CDC report, more than 110,000 suspected cases of AGS were identified between 2010 and 2022. A second report says that as many as 450,000 Americans have developed the allergy. That would make it the 10th most common food allergy in the US.

What are the symptoms of alpha-gal syndrome?

• Hives or itchy rash
• Nausea or vomiting
• Severe stomach pain
• Heartburn or indigestion
• Diarrhea
• Cough, shortness of breath, or difficulty breathing
• Drop in blood pressure
• Swelling of the lips, throat, tongue, or eyelids
• Dizziness or faintness

Foods that may contain alpha-gal

• Beef, pork, lamb, venison, rabbit, or other meat from mammals
• Mammal organ meat, such as liver, kidneys, intestines, or sweetbreads
• Rocky mountain or prairie oysters
• Milk and milk products

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How to prevent the illness?

The best way to prevent AGS is to prevent tick bites. Here are some tips that may help.

Before you go outdoors:

• Avoid grassy, brushy, and wooded areas where ticks may be found.
• Walk in the center of the trails.
• Treat clothing and gear with permethrin, or buy pre-treated items.
• Use Environmental Protection Agency (EPA)-registered insect repellent.

After you come indoors:

• Check your clothing for ticks.
• Examine gear and pets for ticks.
• Shower and perform a thorough tick check.
• If you see an attached tick, remove it immediately.