A Report on the Public Health Response to Alpha-Gal Syndrome in the United States

ABSTRACT. Alpha-gal syndrome (AGS) is a unique, life-threatening tick-borne disease. It typically presents as an allergy to meat and other mammalian products because of the presence of IgE antibodies against the carbohydrate galactose-alpha-1,3-galactose (alpha-gal). Alpha-gal syndrome is induced by bites from certain tick species that naturally contain alpha-gal in their saliva. In some people, tick bites can elevate levels of alpha-gal IgE antibodies. In the United States, lone star tick ( Amblyomma americanum ) bites are the most common cause of AGS. The public health response to AGS requires education of health care providers and the public, novel methods for lone star tick control and tick bite prevention, improved surveillance for AGS, and evaluation of medical management strategies. A more specific diagnostic laboratory test would improve both diagnosis and surveillance, and tests to evaluate levels of alpha-gal present in food and other products would facilitate dose–response studies to better define the risk of reactions.