The range of lone star ticks has expanded, and they are now found in southern New York, but not yet central New York. They can carry the bacteria that cause ehrlichiosis and tularemia.
A map of the estimated distribution of lone star ticks in America.
Barnstable County entomologist Larry Dapsis is pictured holding an image of a female lone star tick.

An airline pilot from New Jersey is the first person to have died of alpha-gal syndrome, a red meat allergy triggered by tick bites, researchers at the University of Virginia School of Medicine announced on Nov. 13.

The 47-year-old man, who was not identified, had two severe reactions hours after eating beef in the summer of 2024 — when he had been bitten multiple times by Lone Star ticks, according to research published in the Journal of Allergy and Clinical Immunology. The man died after the second allergic attack.

The cause of his death "had been a mystery" until Dr. Thomas Platts-Mills, an allergist at the UVA School of Medicine who discovered alpha-gal syndrome, and his team examined the case, UVA Health said in a news release. Researchers later obtained samples of the man’s blood and determined that he had died from the tick-borne meat allergy.

Following the man's death, Platts-Mills is urging clinicians to keep watch for people who have developed alpha-gal syndrome or are at risk of exposure, according to the news release. The allergy is primarily associated with bites from Lone Star ticks, found in the eastern, southeastern, and south-central parts of the United States.

Lone Star tick populations have flourished in recent years as white-tailed deer populations have rebounded in many states, according to Platts-Mills and the Centers for Disease Control and Prevention.

"It is important that both doctors and patients who live in an area of the country where Lone Star ticks are common should be aware of the risk of sensitization," Platts-Mills said in the news release. "More specifically, if they have unexpected episodes of severe abdominal pain occurring several hours after eating mammalian meat, they should be investigated for possible sensitization to the oligosaccharide alpha-gal."

Researchers: New Jersey man died hours after eating hamburger at a barbecue

The man, who had no known underlying health conditions, had his first attack during a camping trip with his family in summer 2024, according to the research article published on Nov. 12. The man's family told researchers that he did not eat red meat frequently, but had a steak late one night on the trip.

About four hours later, the man awoke writhing in stomach pain so severe that he later told his son: "I thought I was going to die," the article states. But two hours later, his symptoms improved, and he went back to sleep.

"In the morning, he felt well enough to walk 5 miles and then ate breakfast," according to the article. "Discussing the event with his wife, they considered consulting a doctor but concluded 'what would we say happened?'"

Two weeks later, the man and his wife went to a barbecue in New Jersey, where he ate a hamburger at about 3 p.m., the article states. He felt fine at the time, went home, and mowed the lawn for an hour.

His wife told researchers that he had no gastrointestinal symptoms when she left their home at around 7 p.m., according to the article. The man then became very ill and went to the bathroom at about 7:20 p.m.

Shortly after, the couple's son found his father unconscious on the floor of the bathroom with vomit around him and called 911, the article states. Resuscitation efforts from the couple's son and paramedics failed, and the man was declared dead at the hospital at 10:22 p.m.

'Sudden unexplained death'

Researchers said an autopsy was inconclusive, with the cause reported as "sudden unexplained death." But the man's wife wanted answers and enlisted the help of a friend, a pediatrician, who contacted UVA researchers to see if alpha-gal syndrome played a role in the man's death.

Samples of the man’s blood were received on April 7, and researchers found that he had been "sensitized to alpha-gal," according to the news release. The man's blood also indicated an extreme reaction that could be anaphylaxis.

When asked about the man's history of tick bites, his wife told researchers that he had been bitten by 12 or 13 "chiggers" on his ankles that summer, the article states. Researchers concluded that the "chiggers" were actually small Lone Star tick larvae. "It all added up," Platts-Mills said.

Platts-Mills and his team believe other factors may have contributed to the reaction, including the man drinking a beer with the hamburger, exposure to ragweed pollen, and exercise that afternoon. It was an unusual event.

"Most individuals who have mild to moderate episodes of hives can control symptoms with an appropriate diet," Platts-Mills said.

Alpha-gal syndrome and Lone Star ticks

Alpha-gal is a sugar molecule found in most mammals, including cows, pigs, and sheep, but not in humans, according to Yale Medicine. Lone Star ticks get alpha-gal when they feed on animals, and they can transfer it to humans through their saliva when they bite.

Though alpha-gal syndrome — which was first reported in 2009 — is still considered rare, the number of cases has increased in recent years. From 2010 to 2022, more than 110,000 suspected cases of alpha-gal were identified, according to the CDC. But the agency said the actual number of cases could be up to four times higher.

Cases have most commonly appeared in the south, east, and central United States, where Lone Star ticks live. The CDC has described Lone Star ticks as "very aggressive." According to the CDC, nymph and adult female Lone Star ticks most frequently bite humans and spread disease.

What are the symptoms of alpha-gal syndrome?

Once a person is bitten and infected, symptoms appear after eating red meat, including beef, pork, and lamb, the CDC said. Some also have allergies to dairy and other animal-derived products, like gelatin.

Symptoms of the condition appear two to six hours after eating meat with the alpha-gal molecule, and they can range from mild to life-threatening, according to the Mayo Clinic. Nausea, diarrhea, and hives are common, but it can also induce anaphylactic shock that swells the airways and can lead to death.

There are currently no treatments available for alpha-gal syndrome. Abstinence from red meat and dairy products is the most effective way of preventing illness for those with the condition, according to the Mayo Clinic.

How to prevent Lone Star tick bites

Lone Star ticks are small and hard to detect, USA TODAY previously reported. Adult females grow to the size of an apple seed and have a tiny white dot on their back. Tick larvae, which are translucent and the size of a pinhead, can also bite.

Experts advise people living in areas where ticks are common to be cautious when going outside. Though tick activity is year-round, they are most active in the warmer months of April through September.

The CDC recommends wearing closed-toe footwear, long clothing, and tucking in shirts and pants into socks. The agency also advises people to avoid high grassy areas and use insect repellents that are safe for clothing and skin.

Contributing: Karissa Waddick and Janet Loehrke, USA TODAY

This article originally appeared on NorthJersey.com: First death linked to red meat allergy triggered by tick bites, researchers say

Reporting by Scott Fallon and Thao Nguyen, USA TODAY NETWORK / NorthJersey.com

USA TODAY Network via Reuters Connect