Pennsylvania health officials are stepping up efforts to track alpha-gal syndrome, a tick-related allergy that can trigger serious reactions to red meat and other animal products.

The push comes as the state tries to get ahead of a growing public health issue tied to tick bites, particularly after New Jersey last year reported what researchers described as the first documented death in the U.S. connected to the condition, according to the Philadelphia Inquirer.

What's happening?

Pennsylvania began asking testing laboratories in February to voluntarily report positive cases of AGS, the Inquirer reported.

Using that voluntary reporting approach, Pennsylvania health officials say they have identified about 600 cases over the last two years. Officials say the tally will likely rise as awareness and testing continue to expand.

In the United States, AGS is most often associated with bites from lone star ticks. Those bites can introduce a sugar called alpha-gal into the body, and in some people, that exposure prompts an immune reaction. Later, that reaction can be set off by foods or products from mammals, including beef, pork, lamb, dairy, and gelatin.

Attention around the condition intensified after researchers said a New Jersey man who died after eating a hamburger in 2024 appeared to be the first known death from alpha-gal-related anaphylaxis in the U.S. The death of an Australian teenager in 2022 was also recently determined to be caused by AGS. Fatal reactions remain rare, but the case underscored how severe the syndrome can be.

The issue is emerging in a state that already carries a heavy tick burden. The state consistently sits near the top nationally for tick-related illness reports and often ranks first for reported Lyme disease cases, according to the Inquirer.

For residents, that makes this more than just another tick story. A tick bite is no longer only associated with Lyme disease or a short-lived rash. Doctors and public health officials are increasingly focused on delayed food reactions, unexplained allergic episodes, and how to better alert people who spend time outdoors.

Why is alpha-gal syndrome concerning?

One reason AGS can be difficult to recognize is that its symptoms do not always resemble a typical food allergy. A person can eat red meat or related products and then develop hives, gastrointestinal problems, or even life-threatening anaphylaxis hours later.

Experts say many questions remain about who develops the condition and why. Nicole Chinnici, director of the Pennsylvania Tick Research Lab at East Stroudsburg University, told the Inquirer that it may happen after one bite, several bites, or not at all, depending on the individual.

There is another complicating factor — it may not be limited to lone star ticks. Chinnici said emerging research suggests other species, including the black-legged tick, which is the most common tick in Pennsylvania, may also be capable of triggering alpha-gal syndrome.

That is especially notable in a state like Pennsylvania, where more than half the land is forested, and tick habitat is abundant. Researchers have also tied lone star tick expansion to rebounding forests, a warming climate, and larger deer populations, which together can broaden where the ticks live, according to the Inquirer.

State health officials say they are trying to improve their data before the problem grows larger. As Eli Steiker-Ginzberg, a public information officer for Pennsylvania's health department, told the Inquirer, the goal is to act before "an outbreak or a worsening trend develops."

What's being done about alpha-gal syndrome?

For now, Pennsylvania says it is using voluntary lab reports of positive cases to build a baseline picture of the problem, according to the Inquirer. The condition is not on Pennsylvania's formal list of reportable diseases, so providers are not required by law to report cases.

Some experts believe that should change. Chinnici described the state's new reporting effort as "a good step forward," but said mandatory reporting would give officials a clearer picture of the scope of the issue. Arkansas, New Jersey, and Massachusetts are among the states that have already moved in that direction.

Pennsylvania also supports free tick testing through the Pennsylvania Tick Research Lab. That program is meant to find pathogens in ticks, not diagnose AGS, according to the Inquirer. People who think they may have the condition are advised to seek allergy testing.

There are also straightforward ways to lower the risk of tick bites. Health officials advise using permethrin-treated clothing and insect repellent, performing tick checks, and promptly removing ticks after time outdoors. Pets should be checked as well, since they can carry ticks inside.

Chinnici told the Inquirer that in wooded areas, she wears a hat, braids her hair, and tucks her pants into her socks to make ticks easier to notice before they attach. In Pennsylvania, where ticks can be active year-round, prevention has to be a year-round habit.

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