"Tick Bites, Meat Allergies, and Chronic Urticaria"
Tick bite induced meat allergies are really
unlike any other food allergy we know.
The most interesting feature of the reaction
may be the first symptom can occur hours after eating meat.
Normally you have an allergic reaction to a bee sting or something,
it happens within minutes.
But with this, you could eat a piece of bacon for breakfast
and your throat doesn't start closing off
until the afternoon, and so you blame lunch,
or doctors just call it 'spontaneous' or 'idiopathic' anaphylaxis.
Idiopathic is just doctor speak for
"we have no idea what the cause is."
The delay is because the alpha-gal is thought to be absorbed
along with the fat in the meat, given that the allergic reaction
occurs four to five hours after meat ingestion
corresponding to the peak absorption time
of the fat from the digestive tract.
And what makes it even more difficult to diagnose
is that the majority of victims experience
only occasional overt reactions,
despite regular meat consumption.
Fattier meats like pork rinds may provoke
episodes more consistently and severely,
but still it's not like it happens every time.
And it's on the rise.
Ten years ago we didn't even know the thing existed,
but now in tick-ridden states,
as many as 20% of the population
have these anti-meat allergic antibodies,
and more and more people are coming in affected,
though probably no more than 10% who test positive
go on to experience hives or serious allergic reactions to meat.
We're also seeing it more and more in kids,
researchers in Virginia finding it not uncommonly,
though identification of these cases may not be straightforward.
Unlike in adults, who frequently present with systemic reactions,
the majority of children with this syndrome
present with just skin manifestations, such as hives.
Doesn't mean it's not serious.
In fact, nearly half the kids ended up in the ER,
and about 1 in 12 need to be hospitalized.
Up to a quarter of the population
breaks out in hives at some point in their lives,
but some children can be affected for weeks or months.
And it can be triggered by infections,
foods, drugs, parasites, autoimmune,
but in a large subset of cases
we don't know what the trigger is,
and so we call it chronic idiopathic urticaria.
It's a common thing pediatricians see,
and the only cure is avoiding and eliminating whatever's triggering it,
but in three quarters of cases we have no clue.
But now we know that many children
who had been diagnosed with mysterious hives or allergic reactions
and may have been specifically told
that the reactions were not a result of a food allergy,
may have actually been suffering from anti-gal meat allergies.
Given the serious nature of the reactions
and the rising frequency of allergic swelling
and hives across all age groups
this underscores the importance of identifying what's going on,
and clearly physicians should keep this new diagnosis in mind.
Allergies to meat might be more common than previously thought.
Two percent would mean millions of people.
But just to put it in context, Americans are much more likely
to suffer an anaphylactic reaction due to seafood,
tick bite or not, no matter where they live.
A national survey of emergency rooms
found shellfish was by far the most frequently implicated food,
and unlike many other allergies,
kids don't tend to outgrow fish and shellfish allergies.
And many fish allergies are actually allergies not to the fish,
but to worms within the fish, like anisakis.
Exposure to these parasites, living or dead in fish,
is a widespread problem.
In fact, you can even have an allergic reaction to the parasitic fish worm
eating chickens that were fed on fishmeal.
This is one of the ways someone who's allergic to fish
could get triggered by just eating chicken.
Reminds me of pork-cat syndrome where your mouth
can get all itchy eating bacon in people with cat allergies,
because of an allergic cross-reaction
between cat skin and pig blood proteins.
Anisakis worms are found particularly in cod, anchovies, and squid,
and can also cause chronic hives and intractable chronic itching.
Because of these worms, researchers recommend
people stop eating all seafood, sushi altogether
because besides inducing allergenic reactions,
the worms may cause a leaky gut syndrome,
which often is unrecognized and it can predispose to other,
more important pathologies than just being itchy all over.