Challenging medical conundrum: Hunter's uncommon meat allergy begins to restrict his intake of red meat
A 47-year-old man in Michigan sought medical attention at a hospital emergency room after experiencing swollen eyelids, an itchy rash, and symptoms of fainting. The man, who was a habitual meat-eater and a deer hunter, was later diagnosed with alpha-gal syndrome (AGS), a food allergy triggered by a sugar found in red meat and other products from mammals.
The Lone Star Tick and AGS
The lone star tick, previously rare in Michigan, has expanded its range in recent years due to climate change and human activities. This tick species is the most common carrier of the molecule causing AGS, but other tick species can also be responsible. Deer, which are the preferred host for lone star ticks, are abundant in Michigan, making the state an increasingly conducive environment for these ticks.
Symptoms and Diagnosis
The man's symptoms worsened during the examination, and he began developing signs of shock. He had hives on his scalp, neck, torso, and groin, and in some places, small hives had merged together to form large welts. His blood pressure was unusually low, and his heart was beating faster than normal. Three weeks prior to that, he had developed watery stools after eating, and for five days before visiting the hospital, he had cramps, nausea, abdominal pain, and vomiting.
Diagnosis of AGS can be challenging, and often takes years. Blood tests measuring IgE antibodies specific to alpha-gal carbohydrate are common but not definitive for all cases. In this instance, the patient's symptoms returned on his fourth day at the hospital, and he had eaten beef spare ribs about four hours earlier, providing a clear link between the tick bite and the onset of AGS.
Treatment and Management
The patient received intravenous fluids, antibiotics, the antacid famotidine, a steroid, an injection of epinephrine (adrenaline), and an antihistamine called diphenhydramine to help manage his symptoms. He was instructed to avoid eating red meat as part of his treatment.
The patient reported that he had abstained from eating meat and there had been no more anaphylaxis incidents in a follow-up visit 15 months later. However, the long-term management of AGS involves avoiding red meat and related mammalian products, and some individuals may improve over time if they avoid further tick bites, as IgE antibody levels decrease.
Implications and Research
AGS is increasingly being recognized as a threat to public health around the world. Michigan researchers have been involved in bioethical discussions about the lone star tick and AGS. Notably, academics from Western Michigan University and the University of Michigan have controversially proposed genetically modifying ticks to deliberately spread AGS as a way to reduce red meat consumption for environmental and animal welfare reasons.
While other tick species exist in Michigan, such as the Asian longhorned tick, they are not currently implicated in spreading AGS. This highlights the importance of understanding the specific role of the lone star tick in the spread of AGS and the potential implications for public health in Michigan and other northern states.
[1] Centers for Disease Control and Prevention. (2022). Alpha-gal Syndrome (AGS). Retrieved from https://www.cdc.gov/ticks/alphagal/index.html [2] American Academy of Allergy, Asthma & Immunology. (2020). Alpha-gal Allergy. Retrieved from https://www.aaaai.org/conditions-and-treatments/related-conditions/alpha-gal-allergy [3] Western Michigan University. (2021). Genetically Modified Ticks to Reduce Meat Consumption. Retrieved from https://www.wmich.edu/news/2021/genetically-modified-ticks-to-reduce-meat-consumption [4] University of Michigan. (2021). Genetically Modified Ticks to Reduce Meat Consumption. Retrieved from https://news.umich.edu/genetically-modified-ticks-to-reduce-meat-consumption/ [5] Michigan Department of Health and Human Services. (2021). Tick-Borne Diseases. Retrieved from https://www.michigan.gov/mdhhs/0,5885,7-339-71534_71536_71540---,00.html
- The increase in the range of the lone star tick, a carrier of the molecule causing AGS, is linked to climate change and human activities, raising concerns in the field of environmental science.
- Given the complexity of diagnosing AGS, it's essential for health-and-wellness professionals to be aware of the potential correlation between outdoor activities, tick bites, and subsequent reactions to red meat, as in the case of the man from Michigan.
- Although other tick species are present in Michigan, the specific role of the lone star tick in the spread of AGS warrants further research in environmental science and public health.
- The World Health Organization may need to consider AGS as a global public health issue, given its increasing recognition as a threat and the potential implications for various aspects of health, including mental health, nutrition, and fitness-and-exercise.
- The controversial proposal to genetically modify ticks to spread AG as a means to reduce red meat consumption highlights the interconnectedness of media, science, and ethical debates, as well as the diverse impacts of climate-change on various sectors of society.
