New Jersey has reported the first known death from the mysterious condition known as alpha-gal syndrome.
A 47-year-old airline pilot has become the first confirmed person to die from a rare red-meat allergy caused by a tick bite, according to researchers at the University of Virginia School of Medicine.
His death was initially ruled “sudden and unexplained” after an autopsy found no signs of a heart attack or any other obvious medical emergency.
But months later, blood tests revealed the true cause - a severe allergic reaction that struck hours after he ate a hamburger at a barbecue in September 2024.
Although he had felt well enough earlier in the day to mow the lawn and relax at home, his condition quickly deteriorated.
By 7:30 p.m., his son found him unconscious on the bathroom floor, surrounded by vomit, with no other explanation for his sudden collapse.
The man started feeling sick four hours after eating a hamburger at a barbecue in September 2024. Credit: Alexander Spatari / Getty
It has also emerged that two weeks earlier, the pilot had experienced severe gastrointestinal symptoms following a steak dinner during a camping trip with his wife and children.
At 2AM, he awoke with intense diarrhea, vomiting, and stomach pain, and later told his son: “I thought I was going to die.”
But because both he and his wife were unsure of what happened, they did not consult a doctor.
“The tragedy is that they didn’t think of that episode as anaphylaxis, and therefore didn’t connect it to the beef at the time,” said Dr. Thomas Platts‑Mills, the UVA allergist who discovered alpha‑gal syndrome and diagnosed the New Jersey pilot’s case, NBC News reported.
Platts‑Mills first learned of the man’s death in February from Dr. Erin McFeely, a New Jersey‑based paediatrician and co‑author of the new paper.
The pilot’s daughters had been in the same ballet class as Dr. McFeely’s children.
“Erin McFeely and the wife discussed what had happened,” Platts‑Mills said.
“The two of them, talking, put it together and said, ‘Could this be that red meat thing?’”
In April, blood testing arranged by Platts‑Mills revealed the pilot’s antibody level for alpha‑gal was 2,000, which is “only seen in fatal cases of anaphylaxis,” he said, adding: “The highest level I’ve seen in practice of a person who survived is 100.”
The tests also showed antibodies to the sugar molecule alpha‑gal, which is found in cows, deer, goats, and pigs and can be transmitted to humans via ticks.
Alpha-gal is found in the blood of cows, deer, goats and pigs. Credit: Kathrin Ziegler / Getty
Why is this allergy becoming a bigger threat?
Alpha‑gal syndrome causes sensitivity to the alpha‑gal sugar molecule found in many mammals.
When a tick, often the Lone Star tick in the US, bites a mammal and then a human, the sugar can transfer and trigger allergic reactions when red meat is consumed.
Symptoms include nausea, stomach cramps, diarrhoea, hives, or breathing trouble.
Dr. Scott Commins, an allergy immunology specialist at the University of North Carolina School of Medicine, said the biggest risk factors for severe reactions are exercise and alcohol, which can increase absorption of food allergens.
The pilot had consumed a beer and exercised the afternoon he died, according to the researchers.
“Food allergy deaths are really rare, and they usually happen in people that have underlying asthma or some other kind of medical condition. So it takes a perfect storm,” Commins said.
The researchers also suspect that the “chigger” bites the pilot’s wife reported around his ankles last summer may have been larvae of Lone Star ticks rather than mites.
The paper notes that alpha‑gal syndrome is becoming more of a threat as Lone Star ticks and their primary host, the white‑tailed deer, migrate northward into new regions.
“A large and increasing population of the United States is being exposed to the Lone Star tick, both because the tick is moving north and because there are now large populations of deer in many states,” the paper says.
Warmer winters and climate change are likely factors in these shifts, leading to exposures in places where the ticks were previously uncommon.
Per a 2023 report from the Centers for Disease Control and Prevention, suspected cases of alpha‑gal syndrome have risen substantially in the U.S. since 2010.
Doctors say people who have been bitten by a tick don’t need to get tested for antibodies to alpha-gal unless they have symptoms. Credit: rbkomar / Getty
What doctors and the public should know
Commins said the allergy can affect anyone with an outdoor lifestyle where tick exposures are likely, including children.
He stressed that people bitten by ticks don’t automatically need testing unless they have symptoms.
“When someone has a tick bite, we just ask them to be mindful about stomach upset or itching or hives that might occur three to six hours after eating either red meat or maybe some high‑fat dairy like ice cream or milkshakes,” he said.
One obstacle in dealing with the condition is that many doctors are unaware of it. In a 2023 CDC survey, 42 % of physicians said they had never heard of alpha‑gal syndrome, and 35 % were not confident in diagnosing or treating it.
Even when someone develops the syndrome, it may not be permanent: “It’s possible, through tick bite avoidance, that after three to four, maybe five years, it’ll fade,” Commins added.
For now, the most effective prevention remains avoiding tick bites and knowing the warning signs.