In 2024, what is thought to be the first-ever fatal case of Alpha-Gal Syndrome was reported in the United States. The individual, a 47-year-old man from New Jersey who had no known health issues before his death, had passed away suddenly in the summer of 2024. His death was initially a mystery for months, at first being determined as an “unexplained sudden death.” However, his wife was skeptical of this conclusion. She continued to look for answers, which led to Dr. Thomas Platts Mills, a world-renowned allergy specialist, beginning to investigate his case.
Dr. Platts Mills’ findings led to an explanation of what had ultimately caused the man’s death and the symptoms that led up to it. First, it was determined that infected lone star tick larvae likely bit him. His wife recalled that, before his symptoms appeared, he had 12-13 itchy bites around his ankle and mistakenly thought they were from berry bugs, also known as chiggers, which are small red mites. The first symptom of the meat allergy happened one evening when he had eaten a steak dinner, then became extremely ill within four hours with stomach pain, nausea, diarrhea, and vomiting. He had recovered after several hours but stated to his son that it had felt “life-threatening”. He had not received medical treatment at this point, and two weeks later, he attended a barbecue where he ate a hamburger. He had reported feeling unwell at around 7 pm, then at 7:37 pm, he was found unresponsive in the bathroom by his son. Some factors that were thought to worsen this reaction were consuming alcohol, exposure to pollen, and physical exercise, which had exacerbated the reaction as well, and his family also reported that he rarely ate red meat.
After obtaining blood samples, testing showed the presence of alpha-gal as well as an extreme immune response consistent with fatal anaphylaxis. This case has set a precedent, and it is more important than ever to be aware of the risks of tick exposure. Dr. Platts Mills warns specifically about the rising deer populations, which further support tick populations, and to be alert to unexpected abdominal pain episodes possibly connected to exposure to alpha gal if there is a history of tick exposure.
What is Alpha-gal Syndrome?
Alpha-gal syndrome is a potentially life-threatening allergy to red meat, dairy, and certain medications that contain mammalian products. Alpha-gal itself is not a bacterium or virus, but a sugar molecule that is present in the saliva of a tick, as well as found naturally in some mammals such as cows and pigs. When a person is exposed to alpha-gal, it causes the body to release antibodies against alpha-gal. This, in turn, will trigger a reaction that can range from very mild to severe and life-threatening when the individual consumes red meat or other mammal products, as the body is reintroduced to alpha-gal (1).
This is like any other allergy, such as a peanut allergy. In both cases, when they are consumed, the body sees it as a threat and triggers an allergic reaction.
How is it Spread?
Alpha-gal is transmitted from a tick bite, where the molecule enters the bloodstream of the host. In the United States, it is largely believed that the lone star tick is responsible for most alpha-gal cases. Only a few cases have been reported as potentially being linked to blacklegged ticks, such as two confirmed cases in Maine of AGS. There is emerging evidence that suggests other tick species, such as the cayenne tick in southern Texas and the American dog tick, can be linked to AGS cases.
Alpha gal cases have been reported worldwide in Africa, Asia, Australia, Europe, and North America. It is also suspected that in cases in Europe, AGS can be caused by the castor bean tick. In parts of Japan and South Korea, the Asian Longhorned tick is thought to cause AGS. Additionally, it is important to note that the Asian Longhorned tick has been found in some parts of the U.S., which causes an additional risk if its populations continue to grow (5).
What Are the Potential Symptoms?
It can take weeks or even months for symptoms to appear. An alpha-gal allergic reaction usually occurs 2-6 hours after eating red meat or any mammal products such as dairy and gelatin. Symptoms are consistent with standard allergic reactions, such as hives, itching, swelling of the face, lips, eyes, throat, and/or eyelids, wheezing, shortness of breath, stomach pain, nausea, diarrhea, and/or vomiting. An anaphylaxis reaction is life-threatening and requires immediate medical attention. Symptoms include closing of the throat, trouble breathing, fast or weak pulse, and dizziness (2).
It is crucial to see a medical provider if you experience any unusual and unexplained illness after eating red meat or dairy products, especially if there is any history of tick exposure in the past year and no previous reactions to these foods.
What are the Current Rates?
Between 2010 and 2022, 110,000 suspected cases were identified in the United States. According to the CDC, it is estimated that over 450,000 people may be affected by alpha-gal syndrome. Alpha-gal syndrome is currently not on the list of nationally notifiable conditions, so cases are not reported to the CDC (1).
Reporting requirements differ by state. States that have mandatory reporting requirements of Alpha-gal Syndrome are Arkansas, Delaware, Iowa, Kentucky, Nebraska, North Dakota, Oregon, South Carolina, Tennessee, Virginia, West Virginia, and New York City (not state).
How to Get Tested for Alpha-gal Syndrome?
If it is suspected that an individual may have Alpha-Gal Syndrome, their medical provider, usually an allergist or family practitioner, can order blood tests that test for the antibodies associated with alpha-gal. Along with this, the medical provider will review a patient’s medical history and possibly conduct other tests, as there can be various explanations for allergy-like symptoms. It is important to seek medical care to receive the most accurate diagnosis and make note of all symptoms.
Why Can’t a Tick Be Tested for Alpha-gall?
Since alpha gal is not a virus, bacteria, or parasite, current lab testing is unable to accurately determine its presence or the risk of transmission in ticks. For instance, unlike something such as bacteria, which are alive, can replicate, and be detected by PCR, alpha gal does not share these characteristics (4).
What Does the Future of Research on Alpha-gal Look Like?
There is a significant lack of data and research surrounding alpha-gal. Due to inconsistent reporting from states in the northeast, such as Pennsylvania, New Jersey, and New York, which carry some of the highest tick exposure rates, more focus on alpha-gal should be prioritized.
The first reported case of death from alpha-gal has set in motion a call for attention to be put into advocating for the research and mandated reporting of cases to better understand incidence and prevalence rates and keep communities safe.
References
1. CDC (2026). About Alpha-gal Syndrome. CDC https://www.cdc.gov/alpha-gal-syndrome/about/index.html
2. Mayo Clinic (2026). Alpha-gal syndrome – Symptoms and causes. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/alpha-gal-syndrome/symptoms-causes/syc-20428608
3. University of Virginia Health System (2025). He ate a hamburger and died hours later. Doctors found a shocking cause. Virginia Health System https://www.sciencedaily.com/releases/2025/12/251217082457.htm
4. Yale Medicine (2025). Alpha-gal Syndrome. Yale Medicine https://www.yalemedicine.org/conditions/alpha-gal-syndrome-ags
5. Tickborne Conditions United (2025). Alpha-gal Syndrome: Tickborne Conditions United 2025 https://www.tbcunited.org/tick-borne-diseases/alphagal-syndrome/