Lone Star Ticks Spreading Fast, Causing Red Meat Allergy In Bite Victims; Tick Bite Prevention The Only Way To Avoid ‘Alpha-Gal Syndrome’

BREWSTER – It sounds like the plot of a second-rate horror movie: fleet-footed ticks that hatch “bombs” of hundreds of hungry biting larvae, leaving their hapless human victims with a bizarre, potentially life-threatening allergy to red meat. 

Sadly, it isn’t the stuff of a bad film script, but a report on the spread of lone star ticks and the illness they’re causing, known as alpha-gal syndrome.

 In her presentation to the Brewster Board of Health last month, Barnstable County Epidemiologist Lea Hamner showed a photo of ticks collected in her own backyard on Martha’s Vineyard. Many were deer ticks, “our usual suspects” that carry a number of diseases like Lyme and are still the primary vectors of tick-borne illness. But there were also plenty of lone star ticks, relative newcomers to the area.

 “Not all of them have white dots on their back. Those are just the female adults,” Hamner said. Present locally in the early 1900s, lone star tricks retreated south by the middle of the century, and are now expanding their range back up the East Coast, “climate change being a driver of that,” she said. The theory is that they are hitching rides on migratory birds and becoming established quickly in bird stop-over areas like the Cape and Islands. The eastern and western ends of Martha’s Vineyard are crawling with lone star ticks, which account for a third of the ticks collected there. 

“Lone star expansion has been a relentless trudge across Martha’s Vineyard, and I have no reason to believe it will not be next Nantucket, next Cape Cod,” she said.

 “One of the really unfortunate parts about lone star ticks is that the larvae, when they hatch, they stick together,” Hamner said. Unlike deer tick larvae which disperse, lone star larvae hatch in a “bomb,” and a host that encounters one is in for an unpleasant experience. “You can pick up hundreds at one time,” she said. “They look like dirt smudges, and then they start moving.”

 The good news is that lone star tick larvae — which have not yet fed on mice, deer or squirrels — do not vector any disease like Lyme. Instead, they cause a new kind of allergy, with victims suddenly and often inexplicably reacting to eating red meat, consuming dairy products or other mammalian products. Called alpha-gal syndrome (AGS) after the carbohydrate molecule that causes the reaction, the syndrome is extremely unpredictable and mysterious. About 60 percent of victims experience potentially fatal anaphylactic shock, typically two to 10 hours after being bitten, “which makes it very difficult for everyone to figure out what it is,” Hamner said. Unlike other allergies, it doesn’t typically begin in childhood, and a victim might have found it safe to consume meat their whole lives, “and then all of a sudden, it’s not.”

 Different people suffer to different degrees. Some experience no reaction, others are misdiagnosed with illnesses like irritable bowel syndrome, only to eventually learn it was AGS after eliminating certain foods from their diet. Others can react to the gelatin in a gel-cap pill. “Some people even are so sensitive to alpha-gals that they actually react to the smell of cooking meat,” Hamner said. Going to a restaurant, even making smart menu choices, can be risky for such people.

 While the allergy is “paradigm-shifting” for allergy experts, there’s no means of treatment and no official list of foods that are certified safe for AGS patients. While the website www.alphagalinformation.org offers lots of information, the only means of preventing the allergy is to prevent the tick bite in the first place.

 “Tick risk is year-round, and tick bite prevention is year-round,” she said. The safest approach is to wear shoes, socks and pants that have been treated with permethrin. 

 “That is our number one prevention message to everyone,” Hamner said. “It’s safe for us to wear, and it is toxic to ticks.” Permethrin is readily available in spray form and can be applied to garments, providing protection from ticks for six weeks or six washings. Professionally treated clothing, either purchased that way or sent to a vendor like www.InsectShield.com, can kill ticks and other insects on contact as long as 70 washings after treatment. It costs $9 to treat a pair of pants, and thanks to a partnership with the county, customers can receive 15 percent off their order with the promotional code capecod2024. “It’s a great solution for pants,” Hamner said.

 Choosing the right clothing for outdoor activities is key, she added. “Shorts and flip flops is a feast for them,” she said. Closed-toe shoes with high socks are best, with pants tucked into the socks, and shirts tucked into pants. Because nymphs are small enough to crawl through the weave of most socks, a clothing barrier is no substitute for permethrin treatment, she said. After outdoor work, hang clothes on the line to dry in the sun, which will cause ticks to drop off or die of dehydration. Once inside, do a thorough tick check, using a handheld mirror in the shower, Hamner said.

 She also advocates the use of “tick kits,” which include a lint roller for capturing ticks on clothing, tape for immobilizing caught ticks, fine-tooth tweezers to remove any attached ticks, and alcohol swabs for cleaning the tweezers and the wound.

 Lyme disease remains the top tick-borne illness, she noted, and there is a risk from other insect vectors like mosquitoes that carry West Nile Virus or EEE. Using the proper repellants, “if you prepare for ticks, it will be effective against mosquitoes,” Hamner said.