Report Warns Health Care Providers of Rare Emerging Tick Bite–Associated Meat Allergy, Alpha-Gal Syndrome

Between 2010 and 2022, the CDC reported more than 110,000 suspected cases of alpha-gal syndrome (AGS), according to a recent news release.¹

Alpha-gal syndrome (AGS) is an emerging, tick bite–associated, IgE–mediated allergic condition. Alpha-gal can be found in meat products, such as pork, beef, lamb, and venison, as well as in products from mammals, including gelatin, cow’s milk, milk products, and some pharmaceuticals.

Symptoms can range from a mild rash or gastrointestinal issues to severe anaphylaxis. However, despite these potentially life-threating consequences, no treatment or cure is currently available, with a study suggesting that limited awareness and knowledge of AGS has likely contributed to the underdiagnosis and lack of patient management in the United States.

In a recent study published in CDC’s Morbidity and Mortality Weekly Report,² researchers aimed to assess the knowledge of AGS among survey respondents who had been in practice for more than 3 years.

Using a composite knowledge score, the researchers were able to assess multifactorial knowledge for all respondents with a maximum score of 3 points. One point was awarded for each correct answer concerning how AGS is acquired, an appropriate diagnosis of AGS, and counseling of patients with AGS.

The study recruited health care providers (HCPs) using the SERMO Global Medical Panel, which included an opt-in, verified panel of medical professionals who receive honorary recognition for participating in market research surveys. These respondents included family practitioners, general practitioners, internists, pediatricians, nurse practitioners (NPs), and physician assistants (PAs).

A total of 1500 HCPs completed the survey between March 2022 and May 2022, including 1000 primary care physicians, 250 pediatricians, and 250 PAs and NPs. Of these respondents, 974 (65%) worked in a group outpatient practice or clinic, 235 (16%) in an individual outpatient practice, and 291 (19%) in an inpatient practice or hospital.

Of the respondents, 635 (42%) had never heard of AGS, and the 530 (35%) respondents who knew of AGS were “not too confident” in their ability to diagnose the condition or manage patients with AGS. Furthermore, only 74 (5%) of respondents felt “very confident” in their ability to diagnose or manage patients with AGS.

Additionally, among 865 (58%) respondents who knew of AGS, 74 (78%) reported that they had not made a diagnosis of AGS in the previous year.

However, this report had limitations, as it was concentrated in the United States and may lack generalizability. Additionally, there exists the possibility that HCPs may have interpreted and responded differently to the survey, which may have led to the misclassification of answers.

Because AGS is not currently a nationally notifiable condition, understanding of the condition has been limited to laboratory-based surveillance, in which increased education and awareness is needed to speed up and improve physician knowledge of AGS. The study suggests the importance of that aim and the need to increase education and awareness to improve care for patients with AGS.

References

1. Emerging tick bite-associated meat allergy potentially affects thousands. Centers for Disease Control and Prevention. July 27, 2023. Accessed August 4, 2023. https://www.cdc.gov/media/releases/2023/p0727-emerging-tick-bites.html#:~:text=Studies%20show%20that%20many%20healthcare,the%20tick%20bite%20meat%20allergy.

2. Carpenter A, Drexler NA, McCormick DW, et al. Health care provider knowledge regarding alpha-gal syndrome — United States, March–May 2022. MMWR Morb Mortal Wkly Rep. 2023;72(30):809-814. doi:10.15585/mmwr.mm7230a1