The Delaware Division of Public Health (DPH) has identified six cases of Alpha-gal Syndrome (AGS), making it a reportable condition in the state. AGS causes an allergy to mammalian meat and is linked to lone star tick bites. Here is what you need to know.

● The Delaware Division of Public Health (DPH) has identified six cases of Alpha-gal
Syndrome (AGS) in Delaware residents.
● AGS makes people allergic to meat, specifically mammalian meat.

● AGS is not currently reportable at the national level and has just been made reportable
in Delaware in 2024.
● How does AGS present in patients?
○ After ingestion of mammalian meat or products made from mammals patients
can begin to have symptoms 2 to 8 hours later. These symptoms can be broad
and range from hives and gastrointestinal distress to swelling of the lips and
tongue or complete anaphylaxis.
○ Other symptoms like abdominal pain, nausea, diarrhea, vomiting, dizziness,
itching, or heartburn can occur.

● What is AGS?
○ AGS is an IgE-mediated allergic condition. It is not an infection.
○ It is associated with the bite of a lone star tick, but may also be caused by other
types of tick bites.
○ When a lone star tick bites a human host, it transmits the alpha-gal sugar
molecule to people which can cause the human immune system to produce IgE
antibodies against alpha-gal sugar molecules. Affected persons become allergic
to the alpha-gal sugar molecule found in mammalian meat and dairy products.
○ It is also known as mammalian meat allergy, alpha-gal allergy, red meat allergy,
and tick bite meat allergy.
○ AGS is a serious and potentially life-threatening allergic condition, with symptoms
and severity varying among persons. Symptoms generally appear two to eight
hours after eating foods or being exposed to other products containing alpha-gal
(for example, mammalian meat and dairy products).

● Diagnosis with AGS is typically done by an allergy specialist who will test your blood for
various markers.
● To prevent AGS, the best thing to do is avoid tick bites. Stay out of wooded or bushy
areas with high grass or leaf litter, stick to the center of hiking trails, wear long sleeve
clothes when going out in these areas and spray your clothes with repellents such as
DEET or 0.5% permethrin.
● Providers that suspect AGS should use the CDC case report form and emailing it to
reportdisease@delaware.gov, or by calling the Office of Infectious Disease at
1-888-295-5156.
● For more information on AGS, check out the CDC page on Alpha-gal Syndrome or
Delaware’s Department of Public Health Frequently Asked Questions Page.
● References:
○ https://dhss.delaware.gov/dph/php/files/HAN517.pdf. Accessed July 17, 2024.