Tick-Borne Illnesses You Need to Know
A walk through the woods. An afternoon at the lake. A day spent gardening or hiking on one of Arkansas’ beautiful trails. For most of us, these are some of the best parts of living in the Natural State. But they also carry a risk with life-changing consequences.
Ticks have long been associated with illnesses such as Rocky Mountain spotted fever and ehrlichiosis, but in recent years another condition has gained increasing attention across Arkansas: Alpha-gal Syndrome. Unlike traditional food allergies, Alpha-gal doesn’t begin with something you eat. It begins with the bite of a Lone Star tick, and for some people, that single bite can permanently change the foods they eat, the places they dine, and the way they experience everyday life.
For Hot Springs residents Susan Bariola and her 13-year-old son, Jack, what started as unexplained digestive problems eventually changed the way they shop, cook, travel, dine out, and even think about spending time outdoors.
A DIFFERENT KIND OF ALLERGY
Alpha-gal Syndrome is unlike nearly every other food allergy physicians encounter.
“Most food allergies are reactions to proteins and symptoms occur within minutes of exposure,” explained Dr. Aubrey Ziegler, board-certified allergist and immunologist with Fayetteville Allergy & Asthma, Fayetteville, Arkansas. “Alpha-gal is different. It’s an allergy to a sugar found in mammals, and symptoms typically don’t appear until several hours after eating.”
Unlike peanut or shellfish allergies, Alpha-gal reactions are delayed. A person may enjoy a hamburger for dinner and not develop symptoms until hours later, making the connection difficult to recognize.
Researchers now understand that when a Lone Star tick feeds on mammals and later bites a human, substances in the tick’s saliva can trigger the immune system to react to alpha-gal, a naturally occurring sugar found in mammals. Once sensitized, the body may begin treating mammal products as a threat.
KNOW THE SIGNS
One of the reasons Alpha-gal Syndrome is frequently overlooked is that it doesn’t always look like a traditional food allergy. Some people develop hives, itching, flushing, nausea, vomiting, abdominal cramping, dizziness, chest tightness, or difficulty breathing. Others experience primarily gastrointestinal symptoms—including severe stomach pain, nausea, vomiting, or diarrhea—with few or no outward signs of an allergic reaction.
A key clue is timing. Symptoms typically develop three to six hours after eating mammal meat, rather than within minutes like most food allergies. If these symptoms occur repeatedly after eating beef, pork, lamb, venison, or other mammal products, especially following a tick bite, it’s worth discussing Alpha-gal Syndrome with your healthcare provider or an allergist.
SEARCHING FOR ANSWERS
For the Bariolas, finding an answer wasn’t easy.
“We had no idea about Alpha-gal until we were diagnosed,” Susan said. “Many trips to primary care doctors, thinking we had stomach bug after stomach bug, went on for over a year before we finally got answers.”
When Susan finally asked her gastroenterologist to test her for every tick-borne illness she could think of, the physician responded with an unexpected question:
“Have you heard of Alpha-gal Syndrome?”
She hadn’t.
A blood test later confirmed the diagnosis for Susan, and eventually for Jack.
“Jack and I are relieved to know what is wrong with us,” Susan said. “We can control our diet. It’s difficult, but we’re happy to finally know what was making us sick.”
Diagnosis combines blood testing with a patient’s symptoms, history of tick exposure, and reactions after eating mammal products. Because gastrointestinal disorders can produce similar symptoms, Dr. Ziegler notes it’s important to work with a healthcare provider or allergist to reach the correct diagnosis.
WHY ARKANSAS?
Arkansas’ mild climate, abundant wildlife, and year-round outdoor recreation make it ideal habitat for the Lone Star tick. Whether you’re hiking a state park, spending the weekend at the lake, working in the garden, or enjoying deer season, spending time outdoors is part of life in the Natural State, and so is the potential for tick exposure.
“It’s more common in our area because we have the species of tick that transmits the alpha-gal allergen,” Dr. Ziegler explained. “Between 15% and 30% of people may be sensitized, meaning they have been bitten by the tick and have antibodies against alpha-gal, but only around 1% to 5% of those people will ever show signs of an allergic reaction.”
A tick bite doesn’t automatically lead to Alpha-gal Syndrome, but because the condition can significantly affect quality of life, awareness remains important.
The Arkansas Department of Health also reminds residents that ticks transmit more human disease in Arkansas than any other arthropod. While not every tick carries disease, preventing tick bites remains the best defense against Alpha-gal Syndrome and other tick-borne illnesses.
LIVING WITH ALPHA-GAL
For many patients, avoiding beef and pork is only the beginning. Depending on the severity of the allergy, dairy products, gelatin, certain medications, nutritional supplements, lard, whey-based products, and even some medical products derived from mammals can trigger reactions. While some patients tolerate small amounts, others must carefully read ingredient labels and work with their physicians to determine what is safe, as every case is different.
For Susan and Jack, dining away from home has become one of the biggest challenges.
“We only eat at restaurants we trust,” Susan explained. “We’ve even been asked to leave a hotel restaurant after trying to explain our condition because they didn’t want to accommodate us.”
Beyond avoiding mammal products, Dr. Ziegler says many patients find the emotional adjustment just as challenging as the dietary changes.
“The most difficult thing for most of our patients is often getting bored with eating chicken, turkey, and fish,” he said. “They miss having a hamburger or a BBQ sandwich.”
Reading ingredient labels has become second nature for the Bariolas.
“We don’t chance anything,” Susan said. “Jack and I constantly watch over each other.”
PROTECTING YOURSELF
The good news is that simple precautions can greatly reduce your risk. Use an EPA-approved repellent containing DEET or picaridin when spending time outdoors in wooded or grassy areas. Wearing long sleeves and long pants, tucking pant legs into socks, staying on established trails when possible, and checking yourself carefully after being outdoors can help prevent tick bites.
Showering soon after coming inside may help remove unattached ticks, and any attached tick should be removed promptly and carefully with fine-tipped tweezers. Grasp the tick as close to the skin as possible and pull upward with steady, even pressure.
MORE THAN ALPHA-GAL
While Alpha-gal Syndrome has received increasing attention in recent years, it is only one of several tick-borne illnesses found in Arkansas. Rocky Mountain spotted fever, ehrlichiosis, and Lyme disease can also be transmitted by ticks, making prevention, early recognition, and prompt medical care essential.
Although each illness has its own symptoms and treatment, the best defense against all tick-borne diseases is avoiding tick bites. Knowing what to watch for and seeking medical evaluation if symptoms develop can make all the difference.
(See the sidebar for a quick guide to common tick-borne illnesses found in Arkansas.)
LIVING LIFE OUTDOORS
Despite their diagnosis, the Bariolas haven’t given up the outdoor lifestyle they love.
“We still enjoy our outdoor lifestyle, with the aroma of DEET every time we leave the house,” Susan said.
There is no cure for Alpha-gal Syndrome, but many patients successfully manage it by avoiding trigger foods and preventing future tick bites. Some even become less sensitive over time if they avoid additional bites.
For the Bariolas, awareness brought answers. For the rest of us, awareness may provide prevention. Whether you’re hiking Arkansas’ trails, spending weekends at the lake, hunting, camping, or simply working in the backyard, understanding the risks and knowing what symptoms to watch for can help ensure that one tiny tick doesn’t become a life-changing bite.
TICK-BORNE ILLNESSES YOU NEED TO KNOW
ALPHA-GAL SYNDROME
Know this: Symptoms occur 3–6 hours after eating mammal meat.
Watch for: Delayed Hives, Severe Stomach Pain, Vomiting, Anaphylaxis
ROCKY MOUNTAIN SPOTTED FEVER
Know this: Early antibiotic treatment is critical.
Watch for: Fever, Severe Muscle Aches, Headache, Rashes, Nausea
EHRLICHIOSIS
Know this: Most people recover well with prompt treatment.
Watch for: Fever, Chills, Fatigue, Muscle Aches, Headache
LYME DISEASE
Know this: It’s less common in Arkansas but still possible.
Watch for: Bull’s-Eye Rash (not always present), Fever, Joint Pain, Fatigue
Medical review and expert commentary for this article were provided by Dr. Aubrey Ziegler, board-certified allergist and immunologist with Fayetteville Allergy & Asthma, Fayetteville, Arkansas. This article is provided for educational purposes only and is not intended to diagnose, treat or prevent any medical condition. It does not constitute medical advice and does not establish a physician-patient relationship. Individual health decisions should be made in consultation with a qualified healthcare professional.
