By Matthew Hersh
Lyme disease is typically at the center of any discussion around ticks and taking preventive action when outdoors. This year, however, local health officials say residents should also be aware of another emerging condition that can leave someone suddenly allergic to red meat months after a tick bite.
The Princeton Health Department recently issued a public advisory about alpha-gal syndrome (AGS), a rare but potentially serious allergy linked primarily to bites from the lone star tick. Although only a small number of confirmed cases have been identified locally, Princeton Deputy Administrator and Director of Health Jeffrey Grosser said the condition can have a major impact on those who develop it.
The advisory comes as June and July mark the height of tick season, when residents are spending more time in parks, preserves, athletic fields and their own backyards.
“The purpose of the advisory is to ensure residents understand the risk and know how to protect themselves from tick bites,” said Grosser. “While it is difficult to determine whether rising numbers reflect more cases or better recognition and diagnosis, reports continue to emerge throughout New Jersey and the Mid-Atlantic region.”
One of the challenges in diagnosing the condition is that symptoms often appear three to six hours after eating, making it difficult for patients to connect the reaction with a particular meal. Symptoms can include hives; itching; abdominal pain; nausea; vomiting; diarrhea; swelling of the lips, tongue or throat; wheezing; and, in severe cases, anaphylaxis, Grosser said.
AGS is a relatively new development amid a changing climate that is bringing about new public health concerns in New Jersey.
“Climate and weather patterns are creating conditions that allow ticks to survive and expand into new areas,” said Grosser. “Changing wildlife populations, particularly deer, help support larger tick populations. Expanding suburban development increases the interaction between people, wildlife, and tick habitat.”
He added that improved surveillance and greater awareness among healthcare providers have also made it easier to identify conditions that may once have been overlooked or misdiagnosed.
“From a public health perspective, alpha-gal syndrome is a good example of how local health departments are adapting to emerging environmental health challenges,” Grosser said. “A decade ago, most conversations about ticks focused almost exclusively on Lyme disease. Today, we are educating residents about a much broader range of tickborne diseases and conditions because the landscape of public health risks is changing alongside our environment.”
Lone star ticks have expanded their geographic range over the past several decades and are now well established throughout much of New Jersey, including Central Jersey. While Lyme disease remains the tickborne illness most residents associate with the state, Grosser said AGS is another condition the public should recognize.
“Many exposures occur in backyards, neighborhood green spaces, and along trail edges, not just deep in the woods,” he said.
Groups at elevated risk include landscapers, grounds crews and other outdoor workers, gardeners, homeowners working in wooded or brushy areas, youth sports families spending long hours near athletic fields, campers, hikers, hunters, pet owners, and residents living near wooded properties or areas with abundant deer populations.
Grosser said residents should take precautions anywhere there is tall grass, brush, leaf litter, or wildlife activity. That includes many of Princeton’s parks and natural areas, particularly Mountain Lakes Preserve, Herrontown Woods, Institute Woods, and Princeton Battlefield State Park.
Grosser said the best defense is preventing tick bites before they happen. Residents are encouraged to use EPA-approved insect repellent, wear long sleeves and long pants when walking through wooded or grassy areas, stay on maintained trails whenever possible, perform thorough tick checks after spending time outdoors, and check pets before they come inside.
Despite the advisory, Grosser emphasized that residents should continue enjoying Princeton’s parks, trails, and open spaces.
“Spending time outdoors is one of the healthiest things we can do,” he said. “Our message is simply that residents should be aware that the environmental health risks we face today are evolving. Taking a few simple precautions against tick bites can help people continue to enjoy the outdoors safely.”
Anyone experiencing allergic symptoms after eating red meat or other meat products, especially if they have a history of tick bites, should contact a healthcare provider, Grosser said.