Murder by tick
University of Virginia Health System
Researchers at the University of Virginia School of Medicine have confirmed the first known death caused by the condition commonly referred to as the meat allergy, which is transmitted by ticks.
The case involved a 47 year old man from New Jersey who was
previously healthy and died suddenly about four hours after eating beef. For
months, the cause of his death remained unclear. That changed when Thomas
Platts Mills, MD, PhD, a UVA Health physician and internationally recognized
allergy specialist, took a closer look. Platts Mills originally identified the
condition years ago and continues to lead research into how it affects
patients.
How Lone Star Tick Bites Trigger Alpha Gal Allergy
The allergy develops after a bite from the Lone Star tick.
These bites can cause the immune system to become sensitive to alpha gal, a
sugar naturally found in meat from mammals. Once sensitized, people may
experience allergic symptoms after eating foods such as beef, pork, or lamb.
Common reactions include skin rashes, nausea, and vomiting.
Scientists have long suspected that severe cases could
escalate into life threatening anaphylaxis. Until now, however, no fatal cases
had been officially confirmed.
"The important information for the public is: First,
that severe abdominal pain occurring 3 to 5 hours after eating beef, pork or
lamb should be investigated as a possible episode of anaphylaxis; and, second,
that tick bites that itch for more than a week or larvae of ticks often called
'chiggers' can induce or increase sensitization to mammalian-derived
meat," said Platts Mills, former chief of UVA Health's Division of Asthma,
Allergy and Clinical Immunology. "On the other hand, most individuals who
have mild to moderate episodes of hives can control symptoms with an
appropriate diet."
What Happened Before the Man's Death
The man, whose name was not made public, had gone camping
with his wife and children during the summer of 2024. One evening, the family
ate a late steak dinner at 10 p.m. Around 2 a.m., the man woke up with intense
stomach pain, diarrhea, and vomiting. Although he felt better by morning, he
later told his son that the episode had felt life threatening.
About two weeks later, still unaware that he had developed
the meat allergy, he attended a barbeque and ate a hamburger. He began feeling
unwell shortly after 7 p.m. At 7:37 p.m., his son found him collapsed in the
bathroom.
Autopsy Raises More Questions Than Answers
An autopsy did not reveal a clear explanation for his death.
The official cause was listed as "sudden unexplained death."
His wife was not satisfied with that conclusion and asked
another physician to review the findings. That doctor contacted Platts Mills
and his team to explore whether alpha gal sensitivity could be involved.
Blood Tests Reveal Severe Allergic Reaction
Platts Mills obtained blood samples that had been collected
after the man's death. Testing showed that he had indeed been sensitized to
alpha gal. The results also pointed to an extreme immune response consistent
with fatal anaphylaxis.
When asked about recent tick exposure, the man's wife said
he had not noticed any tick bites in the past year. However, she recalled that
he had suffered 12 or 13 itchy bites around his ankles earlier in the summer,
which they believed were caused by chiggers. Platts Mills recognized that many
bites thought to be from chiggers in the eastern United States are actually
from Lone Star tick larvae.
Factors That May Have Worsened the Reaction
Platts Mills and his colleagues believe several conditions
may have intensified the man's allergic response. These include drinking a beer
with the hamburger, exposure to ragweed pollen, and physical exercise earlier
that day. Family members also noted that he rarely ate red meat, which may have
influenced how his immune system reacted.
Growing Tick Populations Increase Risk
Following the case, Platts Mills is urging doctors to stay
alert for patients who may have developed this allergy or who face higher
exposure risk. He pointed out that deer populations are rapidly increasing in
many states, creating ideal conditions for the Lone Star tick to spread.
"It is important that both doctors and patients who
live in an area of the country where Lone Star ticks are common should be aware
of the risk of sensitization," Platts Mills said. "More specifically,
if they have unexpected episodes of severe abdominal pain occurring several
hours after eating mammalian meat, they should be investigated for possible
sensitization to the oligosaccharide alpha-gal."
Case Findings Published in Medical Journal
Details of the case have been published in the Journal
of Allergy and Clinical Immunology: In Practice. The article is open
access, meaning it is available to read for free. The authors include Platts
Mills, Lisa J. Workman, Nathan E. Richards, Jeffrey M. Wilson, and Erin M.
McFeely.
The research team obtained consent from the man's widow before releasing the findings.
