Health Advisory #229 as of 09-11-2025
Situation
In June 2025, Alpha-gal Syndrome (AGS) became a reportable condition in West Virginia. Healthcare
providers and laboratories are required to report cases of AGS to the West Virginia Department of Health.
Since implementation, 14 confirmed cases have been reported, with several others under investigation.
Background
Alpha-gal Syndrome (AGS) is an IgE-mediated allergic condition associated with tick bites, particularly the lone
star tick, which is common in West Virginia. Ticks can transmit the alpha-gal sugar molecule through saliva. In
some individuals, this exposure triggers the immune system to produce allergen-specific IgE antibodies against
alpha-gal, which is found in mammalian meat and dairy products. AGS is also known as the “red meat allergy.”
It can range from mild to life-threatening and is often underdiagnosed.
Clinical Characteristics
Symptoms typically occur 2–6 hours after ingestion of mammalian products or within 2 hours after parenteral
exposure.
Symptoms may include:
• Nausea, vomiting, abdominal pain, heartburn, indigestion
• Hives, itching
• Swelling of lips, tongue, throat, and/or face
• Cough, wheezing, shortness of breath
• Acute hypotension
• Anaphylaxis
Common triggers include: beef, pork, venison, rabbit, dairy, gelatin, meat-based broths, and some
pharmaceuticals (including capsule coatings). Poultry and fish are not associated with AGS.
Diagnosis
Diagnosis should be made by a healthcare provider, often an allergist, using:
• Serum or plasma immunoglobulin E (IgE) specific to alpha-gal, or
• Allergy skin testing showing sensitivity to mammalian meat or mammalian-derived products
Recommendations for Healthcare Providers
• Consider AGS in patients with delayed allergic reactions following consumption of red meat, dairy, or
mammalian-derived products.
• Refer patients to an allergist for diagnostic testing and management.
• Counsel patients on strict avoidance of mammalian meat, dairy, and other triggers.
• Educate patients on tick bite prevention:
o Avoid wooded/brushy areas with tall grass and leaf litter
o Use 0.5% permethrin-treated clothing or EPA-registered repellents (e.g., DEET)
o Perform tick checks on self, children, and pets after outdoor activity
o Shower within 2 hours of being outdoors and tumble dry clothing on high heat
o Keep pets on veterinarian-recommended tick prevention
• Current research AGS does suggest that some individuals may experience improvement or even
remission over time, especially with strict avoidance of tick bites (particularly the Lone Star tick in the
U.S.) and adherence to an alpha-gal–free diet.
Public Health Reporting Requirements
Healthcare providers and laboratories must report suspected or confirmed cases of AGS to the West Virginia
Department of Health by:
1. Completing the Alpha-gal Syndrome Case Report Form
2. Faxing completed forms and positive laboratory results to the WV Office of Epidemiology and
Prevention Services: (304) 558-8736
3. Submitting laboratory results via electronic laboratory reporting (if available)
Resources
• CDC Case Definition: Alpha-gal Syndrome, 2022
• WV Bureau for Public Health: Alpha-gal Syndrome
Hancock County Health Department
P.O. Box 578
850 N. Chester Street
New Cumberland, WV 26047
(Get Directions)
Ami Arneault
Administrator
304 564-3343 ext 123
304-670-4278
Becky Weekley
Office Assistant II
304 564-3343 ext 121
Carolyne Baker
RS, REHS
304 564-3343 ext 130
Michelle Berneburg
Registered Nurse
304 564-3343 ext 129
304-670-5068
Posted 09/12/25
For the 2025-2026 flu season, the CDC still recommends most people 6 months & older get a flu vaccine. A recommended time frame suggested is between September and October- but hopefully by the end of October. You can get a flu vaccine all season long while supplies are available. This year, the Hancock County Health Dept. West Virginia will again be providing 𝐅𝐥𝐮𝐚𝐫𝐢𝐱, a pre-filled syringe, Trivalent formula, which does not contain thimerosal. Call for eli...
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