Tick bites and red meat anaphylaxis: What's the link?

Tick bites and red meat anaphylaxis: What's the link?

Can a tick bite really cause anaphylaxis after a steak dinner? 

Known as mammalian meat allergy (MMA), this condition is a growing concern, particularly in areas with high tick populations. 


Learn how to recognise and reduce the risks of tick bites, and how to provide first aid in the event of an anaphylaxis.

What is Mammalian Meat Allergy?

Mammalian meat allergy is identified and reported more frequently than ever before. 

It is a food allergy triggered by the paralysis tick,  which is found along the east coast of Australia. 

These ticks, while feeding on the hosts blood, introduce a sugar molecule called alpha-gal into your system. 

Your body, mistaking alpha-gal as a threat, produces antibodies against it. 

The catch? Alpha-gal is also present in the meat of mammals like cows, pigs, and sheep. 

So, weeks after your tick bite, and a few hours after having some red meat, your immune system launches an attack, leading to allergy and sometimes anaphylaxis.

This concerning delayed allergic reaction makes MMA very different from other food allergies. 

While most food allergies cause an immediate reaction, mammalian meat allergy symptoms appear hours after eating red meat. This makes connecting the food to the reaction harder.

Above: tick bites

Tick Anaphylaxis: Immediate reaction after the bite.

Tick anaphylaxis is a fast and serious allergic reaction, occurring directly after you are bitten.
It's important to note that this immediate reaction is different from the delayed mammalian meat allergy. 
Tick anaphylaxis is caused by a reaction to the tick's saliva duing your bite.
Mammalian meat anaphylaxis is caused by the sugar alpha-gal molecule.

Symptoms of Tick Anaphylaxis (Saliva Reaction):

Skin Reactions: Hives, itching, and swelling at the bite site are common. The swelling can sometimes be extensive, affecting a large area around the bite.
Breathing Problems: Difficulty breathing, wheezing, coughing, and a tight feeling in the throat can indicate airway constriction. This is a serious symptom and requires immediate medical attention.
Facial Swelling: Swelling of the face, lips, tongue, and even the throat can occur, potentially obstructing the airway.
Brain & Nerve Symptoms: Dizziness, fainting, confusion, and weakness can occur due to a drop in blood pressure.
Abdominal  Symptoms: Nausea, vomiting, stomach cramps, and diarrhea can also accompany tick anaphylaxis.

    Case Study: The Backyard Playground

    Hemi, a 9-year-old girl playing in her backyard in suburban Brisbane was bitten by a tick. 
    Her parents found the tick attached to her leg and removed it. 
    But almost immediately, she developed hives, swelling of her face, and difficulty breathing. 
    Her parents recognised the symptoms of anaphylaxis and immediately  gave first aid with her EpiPen (epinephrine auto-injector) while calling for an ambulance. 
    Taken to the hospital, she received further treatment with IV adrenalin and made a full recovery. 

    Mammalian Meat Allergy: A Delayed Reaction

    Unlike tick anaphylaxis, which occurs immediately, mammalian meat allergy symptoms do not. They occur weeks after the tick bite and typically appear 2-6 hours after eating red meat. 
    This delay makes it challenging to identify the trigger, as people tend not link symptoms with meat they ate hours earlier.

    Symptoms of Mammalian Meat Allergy:

    Skin Reactions: Hives, itchy skin rashes, and swelling can occur anywhere on the body.
    Breathing Problems: Difficulty breathing, wheezing, and tightness in the chest can be signs of a severe reaction.
    Abdominal Symptoms: Abdominal pain, nausea, vomiting, and diarrhea are common.
    Heart and Brain Changes: Dizziness, fainting, and a rapid heartbeat can indicate a drop in blood pressure.

      Above: How MMA (alpha-gal) syndrome occurs

        Case Study: The Delayed Reaction

        A family in rural Victoria enjoyed a BBQ after a weekend camping trip. 
        Several hours later, dad Brendan began to have  severe abdominal cramping, vomiting, and hives. 
        Taken to the hospital immediately, the doctor initially thought Brendan had food poisoning. 
        However, after recalling a recent tick bite, he was tested for mammalian meat allergy and diagnosed with MMA. 
        Sadly for any Aussie man, he can no longer eat red meat and carries an adrenaline auto-jector. 
        This case highlights the importance of tick bites potential to cause delayed allergic reactions after consuming red meat.

        High Risk Places & Pastimes

        While ticks can be found all around Australia, some areas and activities carry much higher likelihood of exposure to being bitten

        Location: Coastal areas of east Australia, south-east QLD and north NSW, have the highest tick density and are considered high-risk areas for tick-borne illnesses.
        Season: Ticks are more active during warm months, from spring to autumn, as they prefer humid conditions.
        Habitat: Wooded areas, grasslands, and areas with long grass or leaf litter are perfect environments for ticks.
        Activities: Bushwalking, camping, gardening, farming, and any activity that involves spending time in tick-prone areas increases the risk of bites.
        Time of Day: Ticks are most active in the  cooler parts of the day, dusk and dawn, when they hunt for hosts by climbing to the tips of grasses  and shrubby type bushes.

          Prevention & Management of Tick Anaphylaxis

          The only way to avoid mammalian meat allergy is to stop tick bites in the first place. 
          When heading outdoors, especially in grassy or scrubby areas:
          Smart Clothing: Choose light-colored clothing that covers your skin, including long sleeves, long pants tucked into socks plus a hat. This makes it easier to spot ticks and creates a barrier between your skin and the ticks.
          Only DEET Insect Repellent: Apply a repellent containing DEET to exposed skin and clothing. Follow the instructions carefully and make sure you reapply when necessary.
          Tick Check-Tick! Look properly on yourself, your children, and pets for ticks after being outdoors. Pay close attention to areas like the hair, behind the ears, bum cracks, armpits and behind the knees.

            Tick Removal: First Aid

            Freeze Never Squeeze! First line of treatment is products like TickTox. Alternatively, use a specialised tick removal device or fine-tipped tweezers to grasp the tick as close to the skin as possible. Pull upwards with steady, even pressure. Avoid twisting or squeezing the tick with your fingers, as this casues the tick to inject more saliva and alpha-gal molecules.
            Anaphylaxis-Lay the patient down and administer adrenaline via an auto-injector held in the upper thigh muscle for 3 seconds. Call 000 immediately and stay with the patient. Consider buying a trainer epipen to practice for emergencies.
            Clean: After removing the tick, clean the bite site with a basic wound clean and antiseptic.
            Monitor symptoms: Watch for any signs of tick anaphylaxis (Call 000) or delayed allergic reactions in the next few days and weeks. It is a good idea to note tick bites on your calendar.
            Allergy App: AllergyPal is a new, free smartphone app The aim of AllergyPal is to help increase the safety of children with food and insect allergies. Get the app here!

              Diagnosed with  Mammalian Meat Allergy?:

              Avoid Mammalian Meat: This includes beef, pork, lamb, venison, and other red meats. Be careful of processed foods-many contain mammalian products.
              Read the Label Always!: Analyse all  food labels for ingredients like gelatin, which is made using mammalian collagen. Gelatin can be found in lots of common products, including desserts, candies, and medications.
              Carry Adrenalin (e.g., EpiPen or Ana-Pen): If you have been diagnosed with MMA or have experienced tick anaphylaxis, always carry an epinephrine auto-injector and know how to use it in case of an allergic reaction. All Australian First Aid Courses train you how to use both epi and ana pens.
              Share What you Learn: Make sure all your friends, carers, educators and family understand your allergy and know how to respond in an emergency. Take a first aid course as soon as possible!
              See your Doctor: Get a referral for an allergist for personalised advice, management as well as support.

                Things are different: Temperature Increases & Land Clearing

                While tick bites have always been a concern in Australia, there's increasing concern that climate change and land use practices may be making the problem worse, contributing to the rise of mammalian meat allergy.
                Climate Change: Warmer temperatures and changes in rainfall patterns have  expanded the geographic range and activity of ticks, increasing the likelihood of human encounters. Changes in vegetation patterns has also created more suitable habitats for ticks.
                Land Use: Land clearing, development, interruptions to natural habitats disrupts ecosystems and brings us  into closer contact with tick populations. Higher levels of human activity in tick-prone areas does increase the risk of bites.

                  Where to get help

                  If you're worried about tick bites or mammalian meat allergy, don't hesitate to seek professional help.
                  Consult an allergist: They can provide accurate personalised diagnosis and ongoing management of your allergy.
                  Connect with support groups: Organisations like Tick Induced Allergies Research & Awareness (TiARA
                    and ASCIA offer valuable resources, support networks, and a sense of community for those affected by tick-induced allergies.
                    By increasing awareness, taking preventive measures, and seeking urgent medical attention, you can still enjoy the Australian outdoors while limiting the risk of this unusual but serious allergy.

                    References

                    Australasian Society of Clinical Immunology and Allergy (ASCIA): https://www.allergy.org.au/
                    Australian Institute of Health and Welfare (AIHW): https://www.aihw.gov.au/
                    Murdoch Children's Research Institute: https://www.mcri.edu.au/
                    Tick Induced Allergies Research & Awareness (TiARA): https://www.tiara.org.au/
                    Department of Health, Australian Government: https://www.health.gov.au/

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