In 2023, the Centers for Disease Control reported that an estimated 450,000 Americans suffered from alpha-gal syndrome or AGS. Numbers may be higher since AGS is not a reportable condition, which means health care providers don’t have to notify public health authorities when it’s diagnosed. Even worse, there is currently no cure.

From barns and backyards to hiking trails and hunting blinds, Americans rethink how they live after a single tick sinks in. Alpha-gal syndrome is a life-altering food allergy triggered by a tick bite, and it’s changing careers and pastimes across the country.

AGS isn’t your typical food allergy. It’s a delayed allergic reaction to a sugar molecule found in mammalian meats, like beef and bacon, and products derived from them. Unlike other food allergies, which often cause immediate symptoms, AGS reactions can take hours to appear.

WHEN YOUR LIVELIHOOD IS ON THE LINE

Those who work outdoors face some of the highest risks for tick exposure. Occupations like military service, park management, landscaping and environmental sciences often require extended time in wooded or brush-filled areas where ticks thrive. Additionally, some people with AGS experience allergic reactions simply through contact with mammals.

Vicki Cook, a farmer at 4C Ag Service near Oklahoma City, has also had to change how she engages with the land and her community. She hosts a summer farm camp for elementary-aged kids, but can no longer lead it due to her AGS diagnosis and concerns about additional tick exposure.

Amy Pardus is the office manager at a water utility company in Kellyville, Oklahoma. She said field workers often track ticks into the building, and one found its way to the middle of her back where it latched on in a conference room during a board meeting.

“A month after that, I had my first anaphylactic reaction,” she said.

WHEN YOU LOVE BEING OUTSIDE

It’s not just jobs that take people outdoors. You may be at risk of developing AGS if you enjoy hiking, camping, hunting, birdwatching, trail running, foraging or even gardening in your backyard.

TICK-BORNE ILLNESSES ARE SPREADING

While researchers originally linked AGS to the lone star tick, found primarily in the Southeastern United States, its geographic reach has grown significantly. Today, entomologists have documented lone star ticks outside their traditional range as far north as Maine and west as Texas.

Additionally, CDC studies suggest that other species, including the blacklegged tick and the western blacklegged tick, also trigger AGS. These species are found across broad regions of the country, increasing the likelihood of exposure to AGS in places previously considered to be unaffected.

LEARNING TO LIVE WITH ALPHA-GAL SYNDROME

Being diagnosed with AGS is life-changing. Patients must avoid all mammalian meat and often switch to poultry, fish and plant-based diets. Although she can still work with cattle, Cook can no longer eat the beef they raise and sell.

Some, like Vaughan, also react to dairy. “It’s a bummer to be unable to eat the pork we raise or drink milk from my goats,” she said.

PROTECT YOURSELF

According to tick expert Dr. Thomas Mather, director of the University of Rhode Island’s TickEncounter Resource Center, the best defense is preparation. He promotes three key tactics: tucking pants into socks and shirts into pants to block access points, wearing clothing treated with permethrin, and opting for tight-fitting clothes to reduce the chance of ticks crawling under garments.

Insect repellents with DEET may not be enough to ward off lone star ticks. An infographic published by TickEncounter recommends wearing permethrin-treated shoes and clothing when in a lone star tick country. Once indoors, thorough tick checks are essential — especially under the arms, behind the knees, along the hairline and around the waist.

YOU DON’T HAVE TO BE DEEP IN THE WOODS

One of the most sobering lessons from the AGS community is that tick bites can happen anywhere. Despite applying bug spray, Judy Wheeler from Canton, Miss., found ticks on herself and her dogs after a walk on a neighborhood trail. She later got another bite while sitting on her own patio around a fire pit. “Never dreamed I was in danger there,” she said. “Since getting alpha-gal, we have our yard sprayed professionally every month, and I thought I was safe on the patio.”