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Summary
What is already known about this topic?
Alpha-gal syndrome (AGS) is an emerging, tick bite–associated allergic condition characterized by potentially life-threatening hypersensitivity to an oligosaccharide found in most mammalian meat and products derived from it; however, in the absence of national surveillance, the geographic distribution and number of cases are largely unknown.
What is added by this report?
The number of suspected AGS cases in the United States has increased substantially since 2010, and states with established populations of lone star ticks are most affected, although suspected AGS cases were also identified in areas outside of this tick’s range.
What are the implications for public health practice?
These data can facilitate initiating AGS surveillance, improve health care provider education in high-risk areas, and enhance targeted public health outreach and prevention.
Abstract
Alpha-gal syndrome (AGS) is an emerging, tick bite–associated allergic condition characterized by a potentially life-threatening immunoglobulin E (IgE)–mediated hypersensitivity to galactose-alpha-1,3-galactose (alpha-gal), an oligosaccharide found in most nonprimate mammalian meat and products derived from these mammals. Specific symptoms and severity of AGS vary among persons, and no treatment or cure is currently available. During 2010–2018, more than 34,000 suspected cases of AGS were identified in the United States, but current knowledge of where cases occur is limited. This study examined alpha-gal–specific IgE (sIgE) antibody testing results submitted to the commercial laboratory responsible for nearly all testing in the United States before 2022 to assess the geographic distribution and magnitude of this emerging condition.
During January 1, 2017–December 31, 2022, a total of 357,119 tests were submitted from residences in the United States, corresponding to 295,400 persons. Overall, 90,018 (30.5%) persons received a positive test result in the study period, and the number of persons with positive test results increased from 13,371 in 2017 to 18,885 in 2021. Among 233,521 persons for whom geographic data were available, suspected cases predominantly occurred in counties within the southern, midwestern, and mid-Atlantic U.S. Census Bureau regions. These data highlight the evolving emergence of AGS and can be used to help state and local health agencies initiate surveillance and target public health outreach and health care provider education to high-risk localities.
Published in MMWR (July 28, 2023):
