An Australian teenager has been confirmed to be the first person in the country, and the second worldwide, to die from a severe allergic reaction to meat caused by a tick bite, sparking concern about the prevalence of the condition.
Jeremy Webb, 16, died from a deadly allergic reaction during a camping trip with his friends in 2022.
At the time, the death was ruled as caused by an acute asthma attack.
But a medical re-evaluation pursued by the boy’s parents found that he had a mammalian meat allergy triggered a history of tick bites.
This makes Webb only the second person in the world to die from the tick-induced meat allergy, known as the alpha-gal syndrome. The first confirmed death from this condition was of a man in America in 2024.
The condition has been widely reported in southern US states like Texas as well as in Australia’s west coast region.
In the US it’s caused by the bite of the lone star tick Amblyomma americanum and in Australia by the paralysis tick Ixodes holocyclus.
Studies have cautioned that ticks capable of causing the condition are spreading to newer areas due to climate change.
The saliva of these ticks contains a sugar molecule known as alpha-gal, or galactose-α-1,3-galactose, which is not normally present in humans. When the ticks bite, they inject the alpha-gal molecule into the person’s bloodstream, causing the body to produce IgE antibodies.
Alpha-gal is found in most mammals, such as cows, pigs, sheep, and kangaroos. As the person with the antibodies eats substances containing alpha-gal, including meat, they develop an acute allergic reaction.
In the case of Webb, the New South Wales Deputy State Coroner found he had a history of tick bites since childhood and had consumed beef sausages on his camping trip.
“Jeremy died as a result of anaphylaxis due to mammalian meat allergy after a tick bite, causing an acute exacerbation of asthma,” the coroner ruled in a findings report.
The report noted the boy and his family moved to a NSW Central Coast area surrounded by dense bush when he was about five years old. Since then, he had “experienced a number of tick bites”, his parents said.
The boy suffered from asthma throughout his life as well as adverse reactions to eating red meat, including shortness of breath.
A 2018 diagnosis suggested this was likely caused by house dust, prompting the boy’s parents to make changes around the house.
Although he had been taken to hospital a number of times for asthma attacks since 2018, he was discharged after treatment, with no recommendations for further investigations.
In the coroner’s inquest, immunologist Sheryl van Nunen identified the association between the development of mammalian meat allergy after tick bite.
“She examined all the records relating to Jeremy’s medical history and his death and determined that the cause of Jeremy’s death was anaphylaxis due to a mammalian meat allergy following tick bite,” the report noted.
Symptoms of the condition include cramping, diarrhoea or nausea. The allergy can also present like hives, red swelling in the skin around the eyes, lips, mucosal tissues, or the tongue.
“At its most severe,” the inquest report said, “it can result in anaphylaxis with respiratory or cardiac compromise.”
New report: Suspected cases of alpha-gal syndrome (AGS), a tick bite-associated allergic condition, have substantially increased since 2010. Between 2010-2022, CDC identified more than 110,000 people suspected of living with #AGS. Read more: https://t.co/B8fOpYfdsz pic.twitter.com/ZqEYb79KP0
— CDC (@CDCgov) July 27, 2023
Doctors caution the paralysis tick is prevalent in the eastern coastal regions of Australia, from North Queensland to northern Victoria.
“The three leading areas in terms of suspected cases per 100,000 population are Pittwater in NSW, the Richmond Valley hinterland in NSW, and the Gold Coast hinterland in Queensland,” they say.
The complexity in diagnosing the condition is mainly due to a lack of awareness about it among clinicians, and also the difficulty of identifying alpha-gal-specific antibodies in blood tests. “The difficulty is further compounded due to the delayed reactions after ingestion of mammalian meat,” doctors say, adding that specific training must be provided to clinicians to diagnose the condition better.
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