Managing mammalian meat allergy and tick anaphylaxis

SHERYL VAN NUNEN OAM, MB BS, MM (Sleep Medicine), FRACP; ANDREW RATCHFORD MB BS, FRCS, DipIMC RCS(Ed), FCEM, FACEM

Tick-induced allergies, including mammalian meat allergy after tick bite and tick anaphylaxis, are increasingly prevalent, particularly on Australia’s eastern seaboard. Tick bite prevention and appropriate management are crucial to both primary and secondary prevention of these allergies. Sensitisation to alpha-gal in mammalian meat can have many consequences, mostly affecting use of certain medical therapies.

This article describes the spectrum of tick-induced allergies and their presentation, management and prevention. Spectrum of tick-induced allergies Tick-induced allergies comprise:

• mammalian meat allergy after tick bites (MMA), caused by allergy to the carbohydrate moiety alpha-gal in mammalian meat3-5

• rarely, probable T cell-mediated food carbohydrate-induced enterocolitis syndrome (FCIES)6

• large local reactions to tick bites and tick anaphylaxis, caused by allergies to tick salivary proteins.

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