Introduction
A recent addition to the other food allergies that we come across is an alpha-gal allergy, also called the alpha-gal syndrome, tick bite allergy, red meat allergy, etc. It is a life-threatening yet manageable allergic reaction to red meat, which usually occurs after consuming mammal products after a recent lone star tick bite. The link between the tick bite and alpha-gal allergy is still unclear and under research.
What Is Galactose?
Galactose is a type of sugar found in many foods eaten. It is a basic building block of carbohydrates. It can be found in milk, cheese, and yogurt, as well as in other foods like fruits and vegetables. Galactose and glucose together make lactose, which is the sugar in milk. The body can change galactose into glucose using enzymes to use it for energy.
What Is Alpha Gal?
Alpha-gal also known as galactose-alpha-1,3-galactose, is a carbohydrate molecule that has gained prominence due to its role as a trigger for a unique allergic reaction known as alpha-gal allergy. It is found in the saliva of lone star ticks (Amblyomma americanum) and is transferred to humans through tick bites. Once introduced into the bloodstream, the body may develop an immune response to alpha-gal, resulting in the production of specific antibodies. Common sources of alpha galactose include beef, pork, and lamb.
What Triggers Alpha Gal Syndrome?
However, there are still debates to finalize the reason for an alpha-gal allergy. Some scientists claim that the lone star tick is the sole reason for alpha-gal allergies.
A few apparent triggers for alpha-gal allergy include;
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Red meat and products such as gelatin, dairy products, etc., are obtained from mammals such as cows, pigs, sheep, etc.
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It does not mean that products obtained from any mammal could act as a trigger; only the mammals containing alpha galactose are responsible.
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Personal care products, drugs, and medicines containing mammalian byproducts as active ingredients.
What Are the Symptoms of Alpha Gal Allergy?
Symptoms vary with individuals; it is unnecessary for every person experiencing an alpha-gal allergy to show all the symptoms.
Alpha-galactose is a sugar (carbohydrate) that takes longer to get absorbed into the body. Hence the symptoms of alpha-gal allergy appear many hours (around three to eight hours) after encountering the causative factor, such as red meat.
The symptoms are similar to other allergic reactions but take longer to appear, which is unusual in other allergies.
The common symptoms include;
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Hives.
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Skin itch.
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Swelling of face, lips, and eyelids.
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Dizziness.
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Wheezing and breathing difficulty.
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Sometimes alpha-gal allergy exclusively shows gastrointestinal symptoms.
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Alcohol and exercise can increase the reaction.
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It can also show severe symptoms like constriction of airways, severe drop in blood pressure, rapid pulse, and loss of consciousness.
Who Gets Alpha Gal Syndrome?
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The people experiencing alpha-gal allergy do not have a history of prior allergic reactions; it is a developed allergy due to external factors.
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Anyone can get an alpha-gal allergy, but that does not mean that everybody who encounters the trigger will be susceptible to similar reactions.
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It is straightforward that people who enjoy outdoor activities are more prone to tick bites than others, ranking among the top susceptible people.
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Vegetarians and vegans have no probability of alpha-gal allergy.
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It is usually common in adults, but children could also get an alpha-gal allergy.
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Though there is inadequate evidence to prove this correlation, research shows similar allergic reactions to Cetuximab (anticancer drug) after developing antibodies for alpha-gal allergy.
How Can One Determine if They Have Alpha Gal Syndrome?
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Recording a detailed history of the patient narrows down the possible diagnoses of this condition. The patient's history of allergy for the first time confirms alpha-gal allergy.
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Consulting an allergist is essential to identify potential meat allergies, especially those related to alpha-galactose. If allergic to meat in general, there is a possibility of being allergic to meat containing alpha-galactose.
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Allergy tests, such as blood and skin tests, are sensitive methods to determine specific food allergies. A positive test indicates the likelihood of alpha-gal allergy but does not confirm it.
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History of a recent tick bite, but the person itself might be unaware of the tick bite in some cases.
How Is Alpha Gal Allergy Treated?
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Adrenaline is the emergency treatment for any alpha-gal allergy reaction.
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In case of unavailability of injectable Epi-pens, antihistamines such as Diphenhydramine can be taken and called for an ambulance immediately.
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The patient must be positioned in a comfortable position and taken to emergency care.
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Patients suffering from breathing difficulty require artificial breathing aids.
What Are the Foods and Products That Need to Be Avoided for Someone With Alpha Gal Allergy?
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Most healthcare providers advise avoiding mammalian meat, including beef, lamb, pork, rabbit, and venison.
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Depending on sensitivity and severity, recommendations may extend to avoiding other alpha-gal-containing items like cow's milk, gelatin, and milk products.
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Thoroughly scrutinize food product labels to ensure avoidance of problematic ingredients.
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In rare instances, severe AGS may lead to reactions to ingredients in specific vaccines or medications.
What Can Be Done to Prevent Alpha Gal Syndrome?
There is no specific treatment for alpha-gal allergy. The following measures can help prevent a person from having an alpha-gal allergy:
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Avoid consuming red meat.
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Before consuming packed food, check the ingredient list to avoid accidental intake.
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Consult an allergist and dietician to know what foods should be avoided.
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Show caution when eating out in restaurants and inform the servers or the chef about allergies in an understandable way.
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Areas that are highly prone to ticks, such as grassy areas, bushes, etc., should be avoided.
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If one has pets, he/she should check them for ticks and eliminate them using anti-tick products.
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Try to avoid getting caught in plant crowds and follow the trail during outdoor activities.
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Inspect clothing for ticks after being involved in outdoor activities; if present, pull them out using tweezers and freshen up immediately after reaching home.
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Use repellents with Picaridin 20% or DEET 20% to 30% while traveling to rural areas. Permethrin can be used to prevent ticks from invading belongings.
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Wear full-sleeved clothing and cover the legs completely.
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Avoid sitting on random grounds.
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On noticing any symptoms after consuming red meat, report them to a physician immediately for management.
Conclusion:
Though avoiding meat as a precautionary measure for this condition can make meat-eaters frown, certain people following the precautions have seen no recurrence of alpha-gal allergy and tolerate meat well after a certain period. There is a high cure rate for this condition, and hence the possibility of suffering from this condition lifelong is close to nil.
