James, who lives in Charlottesville, has normal, mild allergies to the usual seasonal substances — mold, pollen, etc. But recently, after eating a fine steak dinner, he began to have some serious symptoms: itching, a burning sensation on his skin (especially the chest), difficulty breathing, and hives on his arms and chest.

The reaction was so severe; he was taken to the University of Virginia hospital emergency room. The ER doctor took a look and said, "I have seen this before. Have you been bitten by a tick lately?" The answer was yes. "And, did you just eat beef?" Yes, again.

The disorder is referred to as alpha-gal, short for galactose-alpha-1,3-galactose, a type of sugar found in certain meats. It’s estimated that at least 1,500 people in America have been diagnosed with it and there are probably many with untreated cases.

"The answer to the allergy is sugar," said Dr. Thomas Platts-Mills, professor and researcher at UVA. While most allergens are proteins, alpha gal is a type of sugar. He began researching the possible connection between tick bites and an allergic reactiwon to meat after developing the allergy himself. He and his junior colleague, Dr. Scott Commins published a report on the topic in 2009. Alpha-gal is essentially a bunch of sugars stuck together in the blood, which is in the meat of all non-primate mammals, including deer, cats and dogs. "We have seen anaphylaxis in France with horse and goat meat as well," Platts-Mills said.

The two doctors found that the alpha-gal reaction is specifically related to the common lone star tick (Amblyomma americanum). Ticks, including the lone star tick, come out of the ground when weather turns warm, and climb grasses or trees to grab onto animals or humans passing by. It’s important to note that alpha-gal is not a disease like Lyme disease or Rocky Mountain spotted fever, it is an allergy.

Reactions: Typical reactions including, itching, burning sensation, hives and difficulty breathing, sometimes including life-threatening anaphylactic shock, and unlike typical allergic reactions, can occur hours after the meat is ingested. Some people also experience gastrointestinal reactions.

Treatment: The only real treatment is to avoid beef, pork, lamb, venison, goat and bison and all products containing these meats. Chicken, turkey and other poultry, as well as fish, are OK to eat. Be aware that some food products and medications that contain gelatin can also cause a reaction. The cancer drug Cetuximab also has alpha-gal in it and should be avoided if you have developed this allergy. If you are having a severe allergic reaction, a physician can give you epinephrine to prevent anaphylactic shock. He may also prescribe an EpiPen for you to carry in case of accidental ingestion of meat.

Is there a test for it? If you have or have had this kind of reaction following a meat meal, your doctor can send your blood sample to the lab for an alpha-gal test.

Will the reaction to meat go away? In some cases it does, especially if you do not get bitten again. Several months after your initial reaction, your doctor can test your blood IgE levels to determine if you are still reacting.

Other diseases you can get from tick bites: Rocky Mountain spotted fever and Lyme disease. Although many people become ill within the first week after infection, signs and symptoms may not appear for up to 14 days.

Initial signs and symptoms of Rocky Mountain spotted fever are often nonspecific and can mimic those of other illnesses: high fever, often around 102 F (38.9 C), chills, severe headache, muscle aches, nausea and vomiting, fatigue. A distinctive red, non-itchy rash typically appears a few days after the initial signs and symptoms begin. The rash usually makes its first appearance on your wrists and ankles, and can spread in both directions — down into the palms of your hands and the soles of your feet, and up your arms and legs to your torso. Some people who are infected with Rocky Mountain spotted fever don’t ever develop a rash, which makes diagnosis much more difficult.

Lyme Disease is an autoimmune disease that can develop after a tick bite. The person develops flu-like symptoms, fever, headache, nausea, vomiting, muscle aches, or a rash within one month after the bite. The bite area may develop a ring-like red rash within 30 days. There may be signs of infection such as redness, warmth, or inflammation. Arthritis and nerve damage can result. If you save the tick, take it with you to the doctor’s.

If either of these diseases are suspected it is very important see a doctor immediately.

First aid for tick bites: It is important to remove ticks quickly and cleanly. The risk of infection increases with the amount of time the tick has been attached. Use blunt tweezers to pull it off in one piece. Put the tick in a small jar of alcohol in case you need it for identification purposes. Apply alcohol to the bite area to disinfect. Do not use petroleum jelly, fingernail polish, hot matches or other substances to kill it. The tick may react to this by regurgitating toxins into your bloodstream.

For more information on alpha-gal: Visit the University of Virginia website http://allergytomeat.wordpress.com/frequently-asked-questions/ FP