A 47-year-old man from New Jersey died hours after eating beef, in what University of Virginia researchers say is the first confirmed death from alpha-gal syndrome, a tick-associated allergy to red meat. Post-mortem testing at UVA Health revealed severe sensitization to the sugar alpha-gal, implicating a fatal anaphylactic reaction. The condition, associated with bites from Lone Star ticks, can trigger delayed allergic responses to mammalian meats such as beef, pork and lamb.
In the summer of 2024, a previously healthy 47-year-old man from New Jersey went camping with his wife and children, according to a case report from University of Virginia (UVA) Health.
One evening during the trip, the family ate a late steak dinner at about 10 p.m. Roughly four hours later, around 2 a.m., the man awoke with intense stomach pain, diarrhea and vomiting. He improved by morning but later told his son that the episode had felt life-threatening, UVA Health reported.
About two weeks later, still unaware he had developed a meat allergy, he attended a barbecue and ate a hamburger shortly before 7 p.m. He soon began to feel unwell. At 7:37 p.m., his son found him collapsed in the bathroom, according to the UVA account. He died suddenly about four hours after eating beef.
An autopsy did not identify a clear cause of death. The official determination was recorded as "sudden unexplained death," leaving his wife dissatisfied with the findings. She sought further review from another physician, who contacted Thomas Platts-Mills, MD, PhD, a UVA Health allergy specialist who originally identified what is now known as alpha-gal syndrome and continues to study the condition.
Platts-Mills obtained blood samples that had been collected after the man's death. Laboratory testing showed that he had been sensitized to alpha-gal, a sugar found in mammalian meat, and that he experienced an extreme immune response consistent with fatal anaphylaxis, UVA Health reported. Researchers concluded that this represented the first confirmed death linked to alpha-gal syndrome.
The man's wife told investigators that he had not noticed any tick bites in the preceding year. However, she recalled that earlier in the summer he had suffered 12 or 13 intensely itchy bites around his ankles, which the family initially thought were caused by chiggers. Platts-Mills noted that in the eastern United States, many bites assumed to be from chiggers are actually from the larval stage of the Lone Star tick, which is associated with sensitization to alpha-gal and subsequent allergy to red meat.
UVA researchers reported that several factors may have intensified the man's allergic reaction: he drank a beer with the hamburger, had been exposed to ragweed pollen, and had exercised earlier in the day. Family members also said he rarely ate red meat, which the team suggested might have influenced how his immune system responded.
Platts-Mills emphasized the importance of recognizing possible warning signs. "The important information for the public is: First, that severe abdominal pain occurring 3 to 5 hours after eating beef, pork or lamb should be investigated as a possible episode of anaphylaxis; and, second, that tick bites that itch for more than a week or larvae of ticks often called 'chiggers' can induce or increase sensitization to mammalian-derived meat," he said in a statement released by UVA Health. He added that most people with mild to moderate hives can control symptoms by following an appropriate diet.
He also warned that expanding deer populations in many states are creating favorable conditions for Lone Star tick populations to grow, potentially increasing the risk of alpha-gal sensitization in affected regions, according to UVA Health.
Details of the case have been published in the Journal of Allergy and Clinical Immunology: In Practice. The open-access article, authored by Platts-Mills and colleagues Lisa J. Workman, Nathan E. Richards, Jeffrey M. Wilson and Erin M. McFeely, describes the implications of a fatal anaphylactic reaction occurring four hours after eating beef in a man with IgE antibodies to galactose-α-1,3-galactose (alpha-gal). The research team obtained consent from the man's widow before releasing the findings.
