Starting April 1, Massachusetts health care providers and labs will be required to alert the state when they encounter cases of the tick-borne allergy alpha-gal syndrome.
Alpha-gal syndrome is an allergy to mammal products that can be caused by a lone star tick bite. It's been on the rise on Cape Cod and the Islands, to the point where it's caught the attention of the governor's office.
At a press conference in North Falmouth last week, Governor Maura Healey announced that alpha-gal syndrome will be considered a reportable condition for at least the next year. The designation will make it easier for the state to collect data on alpha-gal syndrome, which at this time has no treatment.
“As the global life sciences capital of the world, I hope that somehow our data and our collection can be used with science and research right now in our state to eradicate this once and for all,” Healey said.
Massachusetts Public Health Commissioner Dr. Robbie Goldstein was also at the event. Until recently, he said, there were no lone star ticks in Massachusetts. But climate change has made Massachusetts hospitable to lone star ticks, named for the single white dot on their backs.
“Warmer temperatures, shorter winters [and] shifting ecosystems all have allowed the lone star tick to crawl—literally crawl—northward,” he said. “We're seeing that expansion now on Cape Cod, on Martha's Vineyard and on Nantucket. And increasingly, we're seeing it in the mainland.”
Barnstable County has been working closely with public health partners on the Vineyard, where alpha-gal syndrome has emerged as a significant concern.
“By taking this data-driven, proactive approach, we are doing more than just simply responding to an emerging public health challenge,” Goldstein said. “We are helping people prevent alpha-gal syndrome.”
Alpha-gal is a sugar molecule that is in most mammals, but not humans. It’s also in the saliva of lone star ticks. When someone is bitten by a lone star tick, the alpha-gal in the tick’s saliva can get into the person’s bloodstream. The body’s immune system can see the presence of alpha-gal as a threat, causing an allergic reaction that is triggered when people are exposed to alpha-gal in the future by consuming mammal products. That can include meat and dairy, as well as non-food products, such as some medications that contain mammal additives or stabilizers.
Allergic reactions caused by alpha-gal can range from mild to severe, Goldstein said.
“There's oftentimes a very long delay between the tick bite and the time that the symptoms show up,” he said. “The symptoms can appear several hours after eating red meat, and in some cases, they can be severe and life threatening.”
Researchers identified the first known death from alpha-gal syndrome last year, determining that a New Jersey man died from an allergic reaction after eating a hamburger in 2024.
The best way to prevent alpha-gal syndrome at this time is to avoid being bitten by the lone star tick, such as by wearing long sleeves and long pants tucked into socks, using bug spray, conducting thorough tick checks and wearing clothing treated with permethrin. A complete guide to tick safety on Cape Cod is available on the Barnstable County website.
Healey’s announcement about making alpha-gal syndrome a reportable condition came alongside a proposal to expand hunting access in the state. She gave several reasons for the proposed changes, including management of Massachusetts’ overpopulation of deer. With deer come deer ticks, which cause Lyme disease and other tick-borne illnesses (but not alpha-gal syndrome) that pose risks to Massachusetts residents.
“These announcements are about solving problems, making life better and improving things for everyone—except maybe the deer,” Healey said. “Jokes aside, it's about smart public policy and doing what we need to do to take care of people here in this state.”
