Archive for the ‘Alpha Gal Meat Allergy’ Category

Health Officials Warn Lone Star Ticks Multiplying In Connecticut

https://www.newtownbee.com/06282020/health-officials-warn-lone-star-ticks-multiplying-in-state/

Health Officials Warn Lone Star Ticks Multiplying In State

280px-Lone-star-tick-stages-cdc CDChttp://www.cidrap.umn.edu/news-perspective/2013/07/researchers-trace-novel-heartland-virus-missouri-ticks Public Domain

As if Newtown Health District Director Donna Culbert was not busy enough handling coronavirus issues, she is now grappling with the news that the aggressive lone star tick is proliferating in the region.

Culbert, who has made tickborne disease education a hallmark of her administration, told The Newtown Bee this week that the latest news from colleague Goudarz Molaei, PhD, at the Connecticut Agricultural Experiment Station (CAES) is disturbing considering how many local residents are already suffering from related illnesses.

“The Newtown Health District is always concerned about tick bites and tick-borne disease, and news of the lone star tick becoming established in the region adds to the concern,” Culbert said. “Although our office has not yet received a lone star tick submitted to our office for identification yet this year, I am not naive enough to think that they aren’t out there.”

Review Connecticut’s latest information about the lone star tick by CLICKING HERE  (See link for article)

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**Comment**

Key Quote:  

Previously limited to the southeastern US, lone star ticks have been detected in areas with no previous record of activity….

And that includes Wisconsin:

Excerpt:

….he diagnoses approximately 1 patient per month with Alpha-gal allergy and that the reactions can be severe, from passing out to life-threatening reactions.

The lone star tick is an aggressive biter that gives highly irritating bites.  It’s known to transmit:

 

 

 

 

 

 

 

Alpha Ga Syndrome AKA the Meat Allergy: Lyme Ninja Radio Podcast

 Approx. 45 Min.

In this episode you will learn three things:

1) What ticks carry Alpha – Gal
2) How this allergy is different from protein allergies
3) What Tick Borne Conditions United is doing to educate physicians

Beth Carrison was diagnosed with two tick-borne conditions, Lyme Disease and Alpha-gal Syndrome (aka the red meat allergy). She has been managing food allergies and Lyme disease, both her own and her families, since 1996. In 2018, Ms. Carrison co-founded Tick-Borne Conditions United (TBC United), with Dr. Jennifer Platt, and has been working with the federal Tick Borne Disease Working Group since 2019.
(From the Tick-borne United website. )

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For more:  https://madisonarealymesupportgroup.com/2019/08/17/alpha-gal-syndrome-how-to-diagnose-treat-and-prevent-the-tick-borne-red-meat-allergy/

https://madisonarealymesupportgroup.com/2019/06/30/lone-star-tick-known-to-cause-red-meat-allergy-found-in-northern-wisconsin-report/

https://madisonarealymesupportgroup.com/2019/05/20/how-a-tick-bite-can-give-you-a-red-meat-allergy/

https://madisonarealymesupportgroup.com/2019/07/12/sudden-red-meat-allergy-made-eating-painful-for-mom-and-its-all-because-of-a-tick-bite/

https://madisonarealymesupportgroup.com/2018/07/28/what-the-mystery-of-the-tick-borne-meat-allergy-could-reveal/

 

 

 

Alpha-Gal Syndrome: How to Diagnose, Treat, and Prevent the Tick-Borne Red Meat Allergy

https://rawlsmd.com/health-articles/alpha-gal-syndrome-how-to-diagnose-treat-and-prevent-the-tick-borne-red-meat-allergy?

Alpha-Gal Syndrome: How to Diagnose, Treat, and Prevent the Tick-Borne Red Meat Allergy

Alpha-Gal Syndrome: How to Diagnose, Treat, and Prevent the Tick-Borne Red Meat Allergy

By Jenny Lelwica Buttaccio
Posted 8/6/19

Jennifer Burton lives in a subdivision in Northwest Arkansas on more than two acres of well-maintained land — all except for the one part which contains poison ivy that she can’t get rid of, she jokingly says. Burton loves to garden, and 1.5 acres of her property are fenced off for her plants and birds; she has fruit trees, berry vines, chickens, and guinea fowl.

“My husband Eric used to spray the yard with insect repellent, but once we got the chickens and guinea fowl, we stopped spraying,” says Burton. “They are great tick eaters, but they are also very noisy.”

Behind Burton’s subdivision is a heavily wooded area, so coming in contact with ticks — especially lone star ticks, which are widely distributed across the southeastern and eastern U.S. — isn’t uncommon for her. “Lone star ticks are the most aggressive ticks I’ve ever seen. They hunt in packs, crawling like a bunch of ants,” Burton describes.

lone star stick on finger, over white background

Burton is well-acquainted with the tactics lone star ticks use to seek out hosts. She’s been bitten many times over the past several years — first in 2011, then again in 2013, and most recently in 2016.

For Burton, 2016 also brought about an eight to nine-month assault of symptoms, including itchy hives, gastrointestinal issues, and vomiting. Doctors chalked up her escalating symptoms to an irritable bowel syndrome (IBS)diagnosis they found in her medical chart from years before, “possible” food allergies, or something she was eating.

By 2017, Burton had experienced four anaphylactic reactions approximately three weeks apart from one another. The last one brought her close to death. “It was almost like something was building up in my body,” she says.

Then, her husband, who’d been a consistent source of strength and support for her, got fed up with the lack of a diagnosis and effective treatment and hit a breaking point. “He insisted that our primary care doctor do something because he wasn’t going to watch me die,” Burton says. Finally, her doctor agreed to perform allergy testing; when the results came back, she learned she was highly allergic to beef and dairy, and mildly allergic to peanuts, despite having no history of such food allergies.

Her doctor was at a loss. Indeed, though news headlines about a dangerous meat allergy had begun to splash across the pages of nearly every major publication, most doctors knew little about it, its origins, or the severe, widespread symptoms it could induce.

Eventually, Burton saw allergist and immunologist, Tina Merritt, MD, an expert in alpha-gal syndrome (AGS) in Bentonville, Arkansas. Dr. Merritt was able to accurately diagnose Burton with AGS, and she traced the onset of the illness back to Burton’s history of lone star tick bites.

“Lone star ticks are the most aggressive ticks I’ve ever seen. They hunt in packs, crawling like a bunch of ants.”

Today, Burton runs the Alpha Gal Encouragers nonprofit, an advocacy, outreach, and support group for those diagnosed with AGS, and she estimates she feels about 90% most days. But her life is far from normal: On her wrist, she wears an emergency alert bracelet, which reads, “Anaphylaxis.” Everywhere she goes, she brings six EpiPens, two inhalers, and Unisom Sleep Melts because it’s a fast-acting antihistamine that doesn’t contain any mammal ingredients.

“I still have stomach issues. I’m not as active as I would like to be — my sweat makes my skin itchy. So, there are things I’m a little bit more restricted with, but I’m doing okay. Finally, I came to the realization that I have to live with this,” she says.

And with no cure in sight for AGS, Burton always has a flashlight and a tick key on hand for a swift tick removal if necessary. She knows that, for now, avoiding more tick bites is her best defense.

What is Alpha-Gal?

Alpha-gal is an abbreviated name for a sugar molecule that’s found in many mammals, with the exception of humans and primates like apes and monkeys. The sugar’s full name is galactose-α-1,3-galactose, and for most people, it doesn’t pose a health threat.

alpha gal chemical structure, scientific image

But for people like Burton, who have developed AGS, their bodies react to the molecule with an exaggerated immune response to red meat like beef, pork, venison, or lamb. (Burton suspects her mild reaction to peanuts might be linked to some manufacturers using gelatin — a mammalian ingredient — to preserve their peanuts.) Sometimes, the immune response produces mild, allergy-type symptoms. Other times, life-threatening, anaphylactic reactions can occur.

AGS is thought to be the result of a tick bite by the lone star tick, a bloodsucking arachnid that’s fairly easily recognized: Females have a single white dot in the center of a brown body, while males have white spots or streaks around the outer edge of the body.

“It was almost like something was building up in my body.”

Unlike with ticks that transmit Lyme disease and coinfections, however, a lone star tick doesn’t have to be attached to its human host for any length of time — alpha-gal is present in tick saliva, which means an immune response can be triggered right as the tick bites you. In addition to alpha-gal, lone star ticks can carry other tick-borne infections like Rocky Mountain Spotted Fever, Ehrlichiosis, Rickettsia, and more.

But as with all things tick-related, the lone star tick and alpha-gal are spreading across other parts of the country and beyond. Cases of the illness have also been reported in Australia, Asia, Central America, Europe, Japan, and South Korea, though the illness is likely to come from different tick species in other parts of the world.

Symptoms

skin rash across female back from food allergy

Many food allergies have a rapid onset — think shellfish or peanut allergies. But alpha-gal is different, which can complicate the process of getting a proper diagnosis. Typical reactions to the sugar were delayed by at least two hours, with the majority of people experiencing reactions three to six hours after consumption, suggests a review in the journal Current Allergy and Asthma Reports.

Allergy symptoms associated with alpha-gal include:

  • Skin rashes like hives or eczema
  • Itching
  • Facial swelling, especially the lips, eyelids, tongue, or throat
  • Swelling in other parts of the body
  • Difficulty breathing or shortness of breath
  • Wheezing or coughing
  • Digestive upset, including abdominal pain, cramping, and diarrhea
  • Nausea and vomiting
  • Nasal allergy symptoms like runny nose and sneezing
  • Feeling faint or dizzy
  • Headaches
  • Low blood pressure
  • Anaphylaxis (a severe and sudden allergic reaction that requires immediate treatment)

To further compound the problem, alpha-gal reactions may not be confined to red meat allergies alone. People can be allergic to a variety of mammalian products: dairy products, gelatin, lanolin (found in cosmetics and personal care products), magnesium stearate, and certain vaccines and medicationscan pose a serious problem to the community of people with AGS. With a delayed immune response, it can be difficult to pinpoint the culprit that’s making you sick.

Testing and Diagnosis

An allergist or other healthcare professional will gather your health history and information about your symptoms and potential exposure to ticks. They can diagnose AGS through a blood test, which looks at the IgE antibodies to alpha-gal in your blood. They can also use a skin prick test to determine if you’re allergic to specific foods like red meat found in beef, pork, or lamb.

Treatments

There is no cure for AGS, but avoiding red meat and other mammalian products can help reduce the incidence of reactions. Also, keep in mind that alpha-gal can be found in a variety of other products. It’s important to read labels on all the products you consume and use for ingredients that could be derived from red meat.

You may need to carry prescription epinephrine (like EpiPens) and other antihistamines with you at all times. Though the symptoms of AGS can wax and wane, you’ll need to try your best to avoid further tick bites and reduce the chances of worsening your immune system’s response to the molecule.

Prevention

man spraying natural tick repellant on his skin, outdoor background

Since there is no cure for AGS, the best way to avoid contracting it is through preventing tick bites. Ultimately, an aggressive approach to prevention is key to protecting you and your family from a multitude of tick-borne diseases. Here’s what you need to know:

  1. Familiarize yourself with your outdoor surroundings. Be on the lookout for tick-friendly habitats like tall grasses, overgrown or unkempt grass, areas covered in brush, piles of leaf litter, and your pets.
  2. Protect exposed skin with tick repellant. Repellents like DEET, picaridin, and oil of lemon eucalyptus (OLE) are safe to use on adult skin.
  3. Use permethrin on clothing and outdoor gear. Permethrin is an insecticide that kills ticks. The CDC recommends products that contain 0.5% of permethrin to help you protect yourself. Follow the instructions on the bottle, and use it on clothing, shoes, and outdoor gear.
  4. Protect your pets. To find the right products, consult with your veterinarian, and use the product according to the instructions. Regularly grooming your pet, finding the right flea and tick collar, and maintaining your lawn can help keep you and your pet safe.
  5. When you return from being outdoors, take a shower. Showering right away can wash away ticks that are crawling on you before they attach, and it can help you find and remove attached ticks, reducing your risk of contracting Lyme disease and other tick-borne infections that take longer to transmit.
  6. Look for ticks on yourself and your family. Perform tick checks on yourself, your family, and your pets when you come in from the outdoors. Remember to investigate more concealed areas of the body.
  7. Promptly remove any ticks that have latched on. Use a pair of fine-pointed tweezers to firmly pull the tick straight out of the skin, then disinfect the bite with soap and water. Watch for signs of any tick-borne infection and follow-up with your doctor.

For a more comprehensive guide, visit 7 Steps to Preventing Lyme and Other Tick-Borne Diseases.

“Ultimately, I wish people would take tick prevention seriously. Don’t get bit. Don’t get sick.”

Further Reading and Research to Help You Cope

Coping with alpha-gal is challenging, to say the least. But knowing where to look for help and advice when you’re forced to make abrupt lifestyle changes can be lifesaving. Fortunately, there are some organizations and resources available, so you don’t have to go at this alone.

  • Alpha Gal Encouragers: A faith-based 501(c)(3) founded by Jennifer Burton in Northwest Arkansas with a mission to encourage, empower, and educate others with and about alpha-gal
  • The AlphaGal Kitchen: A website dedicated to providing alpha-gal-safe recipes to the community
  • Alpha Gal Support: A Facebook group to discuss all things related to alpha-gal
  • Mosaic: Why are so many people getting a meat allergy?: An article that discusses the history behind this emerging tick-borne disease
  • Ticked Off Mast Cell: An organization devoted to compiling resources on mast cell activation syndrome (MCAS) and tick-borne diseases
  • ZeeMaps: Interested to know if alpha-gal is in your area? ZeeMaps tracks the growth of tick-borne disease around the world.

Final Thoughts

Often, articles on the subject of alpha-gal suggest that the syndrome may simply disappear in people after two to five years. However, Burton has a different take on the illness: “Some people think it just goes away on its own. But I try to refer to it as remission because it can come back, and when it does, it comes back with a fury,” she says. “Ultimately, I wish people would take tick prevention seriously. Don’t get bit. Don’t get sick.”

REFERENCES
1. Alpha-gal syndrome. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/alpha-gal-syndrome/symptoms-causes/syc-20428608?fbclid=IwAR2XOuXrbynsDp18X-2CLcv01hIhCbZEMjmaZxzcF7_I5eLG3F57UOIPT2I
2. Alpha-Gal and Red Meat Allergy. American Academy of Allergy, Asthma, & Immunology website. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/alpha-gal
3. Wilson JM, Schuyler AJ, Schroeder N, Platts-Mills TAE. Galactose-α-1,3-Galactose: Atypical Food Allergen or Model IgE Hypersensitivity? Current Allergy and Asthma Reports. 2017; 17(1): 8. doi: 10.1007/s11882-017-0672-7
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Sudden Red Meat Allergy Made Eating Painful For Mom and It’s All Because of a Tick Bite

Sudden Red Meat Allergy Made Eating Painful For Mom And It’s All Because Of A Tick Bite

red meat allergy lone star tick bite

Featured Image: Youtube/Inside Edition

A red meat allergy seemed to come out of nowhere and suddenly made eating painful for Janine Baumiller. And the cause is truly shocking. A lone star tick bite is behind all of the mom’s agony!

Mother of two Janine Baumiller of Long Island, New York sits watching her family enjoy juicy burgers. But she can’t take part herself. And it’s all because of a red meat allergy she never had before.

RELATED: Grieving Family Cautions Others Of Tick Bites After Losing 2-Year-Old

All of a sudden, any time Janine ate red meat, she’d later break out in hives all over, as well as experience severe burning under her skin. But what was even more shocking than Janine’s sudden reaction to red meat was why it was happening.

The allergy developed all because, at some point, Janine got bit by a lone star tick. A bite from this particular tick can activate an allergy to red meat, and in some cases, dairy, too.

WATCH: Lone Star Tick Bite Causes Red Meat Allergy

Janine now has to abstain from all red meat, sticking instead to poultry, fish, and veggies. And she’s not alone.

Kristie Downen of Springfield, Missouri, had the same experience.

“Food started hurting. It got to the point where my stomach would swell up, I was vomiting,” she said. “It’s still unbelievable that a tick would make you allergic to food.”

Experts call it the alpha-gal allergy and alarmingly, it’s on the rise. Up from 3,500 cases three years ago, there are now 5,000 known cases just in the U.S.

“It does seem like it’s really growing,” said Dr. Scott Commins, allergist and associate professor at the University of North Carolina at Chapel Hill School of Medicine.

More On The Lone Star Tick

The alpha-gal allergy comes from a bite from the lone star tick — “a very aggressive tick that bites humans” according to the Centers for Disease Control and Prevention.

“It appears the range of this tick is expanding,” Dr. Commins went on to say. “I also think it’s driven by folks are just encouraged to go outside more and perhaps they have more tick bites.”

The lone star tick is primarily found in the southeastern and eastern U.S., but is also starting to move further north. A white spot on the back of the lone star tick is what helps distinguish it from other ticks.

red meat allergy lone star tick bite

Dr. Thomas Platts-Mills, of allergy and clinical immunology at the University of Virginia, is the one who helped make the link between the lone star tick and the alpha-gal allergy. He, too, was bit and suffers from the red meat allergy.

Dr. Platts-Mills believes we’re seeing more of these ticks and the allergy it carries because of the increased deer population. A deer can carry up to 500 ticks and Dr. Platts-Mills says most of those are going to be the lone star tick.

“We’ve got deer on the lawns and they’re dropping these ticks everywhere,” Dr. Platts-Mills says.

Another interesting fact Dr. Platts-Mills points out is that most ticks are specific to a particular animal and prefer biting the animal to humans. But that’s not the case for the lone star tick.

“The lone star tick really does like humans,” Dr. Platts-Mills said.

More On The Tick-Induced Red Meat Allergy

Experts aren’t sure if the alpha-gal allergy is caused by one bite or multiple bites from a lone star tick. But they do know anyone can develop the reaction, even children.

Symptoms of the allergy often occur several hours after consuming red meat like beef, pork or lamb. Sometimes the allergy also includes a sensitivity to dairy, especially heavy-fat dairy like ice cream.

Someone suffering from the allergy can break out into hives, redness, itching and swelling, and even strong stomach cramping. Some can even have an anaphylactic reaction, which is life-threatening and requires the use of an Epi-pen.

The good news is the allergy typically goes away after two or three years. And those who suffer from it can still eat meat from fish, chicken, and turkey.

“If it swims or flies, it’s fine,” Dr. Commins said.

Doctors are also working on a vaccine, though it will be several more years before it’s ready.

Expert Tips For Avoiding Tick Bites

  • Ticks prefer heavier vegetation. So try to keep the grass in your yard from getting too tall. Avoid hiking or playing in heavily wooded areas as much as possible.
  • Try to keep skin covered with long sleeves and pants when venturing into the woods or thick grasses.
  • Try using a safe bug spray that repels ticks.
  • After spending time outdoors, do a thorough check of both your clothes and body, then take a shower.
  • Use a plastic baggie to save any ticks you find on your body, especially if you suspect you’ve been bitten. Look for the white dot on the back to identify a lone star tick.
  • If you suspect you’ve been bitten, keep an eye out for symptoms and keep in mind the reaction from the red meat allergy occurs several hours after eating. Doctors can perform a simple blood test to confirm the allergy.

Please be sure to share this story with others to raise awareness of the lone star tick and the red meat allergy.

h/t: Today

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For more:  https://madisonarealymesupportgroup.com/2019/06/30/lone-star-tick-known-to-cause-red-meat-allergy-found-in-northern-wisconsin-report/  Yes, Martha, this fun-sucking tick is here in Wisconsin.

https://madisonarealymesupportgroup.com/2017/01/12/tick-related-red-meat-allergy-found-in-minnesota-wisconsin/

https://madisonarealymesupportgroup.com/2019/05/20/how-a-tick-bite-can-give-you-a-red-meat-allergy/

https://madisonarealymesupportgroup.com/2018/05/04/arkansas-woman-develops-deadly-meat-allergy-after-tick-bite/ For some, it’s way more than just red meat. For this woman, she had to omit ALL animal products, even ones found in supplements and personal care products.

 

Lone Star Tick, Known to Cause Red Meat Allergy, Found in Northern Wisconsin: Report

https://www.foxnews.com/health/lone-star-tick-wisconsin-red-meat-allergy

Lone Star tick, known to cause red meat allergy, found in northern Wisconsin: report

By Madeline Farber for Fox News. You can follow her on Twitter @MaddieFarberUDK.

The Lone Star tick, a type of tick that’s known to cause some people it bites to develop an allergy to red meat, has reportedly been found in northern Wisconsin — a rare occurrence as these small arachnids aren’t typically found in the state. 

The tick was purportedly spotted near Eau Claire County, per local news Channel 3000. Lone Star ticks, which are not native to the state and are named for the white spot on the back of adult females, are sometimes reported in the southern half of Wisconsin, if at all, according to the Department of Entomology at the University of Wisconsin-Madison.

Susan Paskewitz, the chair of the Entomology Department at the university, told Channel 3000 the Lone Star tick reported likely found its way north by attaching itself to a bird or other animal that later made its way to the area.

Last summer, Scott Commins — an allergist and associate professor of medicine at University of North Carolina, Chapel Hill and one of the first physicians to discover the connection between Lone Star tick bites and the alpha-gal meat allergy —  told Fox News the allergy caused by a Lone Star tick bite is relatively rare. That said, the number of cases has sharply increased from the roughly two dozen he and his colleagues first studied in 2009.

LONE STAR TICK BITES TRIGGERING RED MEAT ALLERGIES IN MORE PEOPLE ACROSS US, PHYSICIAN SAYS

Commins offered a few different reasons for the increase.

First, doctors can now perform a blood test that detects the allergy, “which has made the diagnosis much easier,” he said.

A Lone Star tick. (iStock)

A Lone Star tick. (iStock)

Additionally, the “range of the Lone Star tick is increasing and expanding,” Commins said, which ultimately increases the chance of getting bitten. Higher costs of living could partly be to blame, causing more people in recent years to trade urban life for the suburbs. This movement results in closer contact with tick-carrying deer, which subsequently increases the chance for tick bites.

Commins also said a heightened awareness about the allergy has led those with symptoms to talk to their doctor and investigate if a Lone Star tick bite could be the cause.

Though it’s not totally clear how Lone Star tick bites sometimes result in the allergy, Commins said the tick’s saliva may be a factor.

“There’s a common pathogen in all of these ticks,” he said at the time.  “It could be a protein or enzyme in tick spit. We’re working on that in the lab at the moment.”

Not unlike the symptoms of a peanut, egg, tree nut or a shellfish allergy, many people who are allergic to red meat may experience hives, a skin rash or anaphylaxis.

Commins warned many also experience “severe GI [gastrointestinal] distress,” such as stomach pain, indigestion, vomiting and diarrhea. Some people have described their gastrointestinal symptoms as “stabbing pain or [being stuck with] a hot poker,” he added.

COLORADO GIRL, 7, DIAGNOSED WITH RARE TICK PARALYSIS AFTER OVERNIGHT CAMP

That said, the symptoms of a red meat allergy are not always immediate. In fact, Commins said, it usually takes hours after eating red meat for the symptoms to appear.

There is no cure for the allergy at this time; the most those with the allergy can do is to avoid red meat, which includes beef, lamb, pork, veal, and goat, among others.

But the news isn’t all bad.

“There is a bright spot in this; this is one of these food allergies that will resolve over time,” he said, though he noted additional tick bites may prolong the condition.

**Comment**
Another example of a tick in a place it’s not supposed to be.
BTW: this isn’t the first time it’s been found in Northern Wisconsin:  https://madisonarealymesupportgroup.com/2017/01/12/tick-related-red-meat-allergy-found-in-minnesota-wisconsin/  Excerpt:
According to Dr. Alaaddin Kandeel, an allergist at Essentia Health in Duluth, he’s diagnosed 18 patients with alpha-gal allergy – 10 from northeast Minnesota and 8 from northwest Wisconsin – hardly accepted Lone Star territory.  In the audio he states he diagnoses approximately 1 patient per month with Alpha-gal allergy and that the reactions can be severe, from passing out to life-threatening reactions.
One patient a month.  NOT RARE.

And while tick borne diseases are reportable by law, allergies like the alpha-gal allergy are not, so nobody truly knows prevalence.

Doctors should NEVER use a map to turn a patient away who is presenting with symptoms. If they do, turn them in to the authorities.
Many people do not know it isn’t just meat those with Alpha Gal have to avoid.
Anything derived from animals can cause the allergic symptoms including gelatin, daily vitamin supplements, shampoos & conditioners, lotions, & vaccines.
This woman limits her diet and uses vegan supplements, medications and personal care products:  https://madisonarealymesupportgroup.com/2018/05/04/arkansas-woman-develops-deadly-meat-allergy-after-tick-bite/
This is about the worst news possible for Wisconsinites whom can handle pain like nobody on the planet, and keep a stiff upper lip that many would collapse under, but take away our meat, cheese, and beer, and we are an absolute mess!
iu-19