On Martha’s Vineyard we have witnessed a shocking development over the past 3-4 years. The lone star tick has invaded the island and has created an alarming phenomenon: the Alpha Gal Syndrome, which afflicts an ever increasing percentage of our year-round population and (who knows how many?) Island visitors.

The lone star is a different kind of beast. Deer ticks and wood ticks are considered “questing” predators, because they climb up onto a twig or a leaf and wait passively - front legs outstretched - to latch onto a passing victim. By contrast, the lone star is known as an “assassin” predator, sensing heat, movement and carbon dioxide sources from as far away as three meters and then charging forward to attach to that victim’s skin. In addition, so-called “tick bomb” nests, which some victims can penetrate unwittingly as they hike or bike through woodsy terrain, can result in hundreds of bites.

The compelling detective story of exactly how the lone star tick was discovered to be the culprit is detailed in a superb article written by Danielle Gerhard, PhD, from last year’s The Scientist. Briefly, in the early 2000s, cancer centers across the US were administering the newly-approved cancer drug cetuximab, a chimeric mouse-human immunoglobulin G1 (IgG1) recombinant monoclonal antibody to treat lymphomas. Soon, they noticed something odd: An unusually high number of patients experienced anaphylaxis following their first infusion of the drug.

“One study found that 22 percent of patients who were treated in Tennessee and North Carolina had severe hypersensitivity reactions to cetuximab, but less than one percent of patients at centers in the Northeast showed such responses.”

Eventually they discovered that patients from regions where lone star ticks were endemic were highly likely to react to the cetuximab with an allergic reaction. When questioned these patients confirmed that they had been bitten by ticks. Further sleuthing by Dr. Thomas Platts-Mills at the University of Virginia and Dr. Scott Commins at the University of North Carolina identified the sugar galactose-α-1,3-galactose, (or alpha-gal for short), as the stimulant for the allergic outpouring of IgE and the severe histamine response in the allergic patients. The alpha gal is common to the saliva of lone star ticks as well four-legged mammal meat and dairy products derived from these animals.

Environmental factors, probably global warming, have resulted in the advance of lone star ticks to more northern geographic areas. Hence, New England is now experiencing the sharp rise in meat allergies, most likely due to increasing lone star tick bites in most states. Martha’s Vineyard’s super-saturated deer populations are the major vectors for Alpha Gal, along with other infectious diseases.

I strongly recommend patients and health professionals alike check out this article in The Scientist. As mentioned, the story is fascinating. And since we and our families are a part of this ongoing public health problem, it helps to be aware of how this story has unfolded. It might also help to guide us as we move forward to handle the personal and societal challenges alpha gal presents.