In 2023, federal health authorities listed several hot spots where people were developing an allergy to red meat at alarming rates after having been bitten by ticks. Arkansas. Kentucky. Missouri. A county in Virginia.
Since then, most of those states have taken steps to monitor the prevalence of the potentially life-altering condition — known as alpha-gal syndrome — within their borders.
Arkansas, Kentucky and Virginia require laboratories or doctors to report every blood test that comes back positive for a marker of alpha-gal. In Missouri, state legislators are considering mandating the same.
But in New York, the state has done little to study the rising incidence of alpha-gal, despite evidence that Long Island is a hot spot. The state Health Department says it does not have data regarding the number of alpha-gal cases in New York.
“If Arkansas can track alpha-gal cases with nowhere near the resources, I think New York should be able to track cases,” said Sharon Forsyth, who leads an alpha-gal advocacy organization and has pushed for reporting requirements in a number of states.
Given the prevalence of the syndrome on Long Island, Ms. Forsyth said it was “completely outrageous” that the state was not tracking cases.
The state Health Department did not explain why it has declined to add alpha-gal syndrome to its list of reportable diseases. But a spokeswoman, Marissa Crary, said that the department was considering steps that would help estimate how many New Yorkers have alpha-gal syndrome. She also urged New Yorkers to take precautions to avoid tick bites by wearing long pants in wooded areas and performing frequent tick checks while outdoors.
The Centers for Disease Control and Prevention said that Suffolk County, which covers the eastern two-thirds of Long Island, appeared to have more cases than any other county in the United States, according to a study of blood tests from a commercial laboratory.
The C.D.C. study suggests that between 3,800 and 18,000 people in Suffolk County had alpha-gal from 2010 to 2022. That corresponds to as much as 1.2 percent of the population.
And the pace of new cases isn’t slowing. The New York Times recently interviewed three people who live on a single block in suburban Farmingville on Long Island who said they had developed alpha-gal syndrome in the past two years.
Alpha-gal syndrome was discovered about two decades ago. In the United States, most cases are believed to begin with a bite from the lone star tick.
The tick’s saliva contains a sugar molecule called alpha-gal. That same molecule is found in the meat of many mammals, including pigs and cows. The tick’s bite can trigger an overactive immune response, leading to allergic reactions when alpha-gal is encountered again. Some people develop hives, diarrhea or vomiting after eating a hamburger or bacon — or consuming dairy. The allergy has been linked to a few deaths, including that of a JetBlue pilot who died after eating a hamburger in 2024.
Tens of thousands of people each year are being tested for alpha-gal syndrome through a blood draw that looks for antibodies to alpha-gal. In more than 10 states, laboratories or doctors are required to notify state health authorities of each positive test, allowing for the collection and publication of data.
Not everyone who tests positive for alpha-gal antibodies will have an adverse reaction to red meat. In fact, most people who test positive may not actually have alpha-gal syndrome, experts say. Still, data on positive antibody tests can point to where the syndrome is becoming more or less prevalent — and whether hot spots are emerging.
The lone star tick was common across the eastern United States in centuries past. But deforestation and dwindling populations of a primary host, the white-tailed deer, reduced the tick’s range.
It had been found primarily in the Southeast for a time. But the resurgence of deer and other factors have led its range to rapidly expand north in recent decades.
Monitoring alpha-gal cases is a useful proxy for tracking the lone star tick’s expansion, said Ms. Forsyth, who is the executive director of the Alpha-gal Alliance Action Fund, a nonprofit organization.
Arkansas was the first state to make alpha-gal syndrome a reportable condition, in 2023. The state publishes a map that shows the incidence of suspected and confirmed cases by county.
More than 15 states track alpha-gal cases to some degree. Some have passed laws designating alpha-gal as a reportable condition. Elsewhere, state health departments simply declared it so.
A state assemblyman in Westchester County, Steven Otis, said that he had encouraged the Health Department to do the same in New York.
“Real-time reporting would have a tremendous benefit,” he said. “Without data, you really don’t have the tools to get people’s attention or to alert people when there is a growth in a particular area.”
He said that a team at the state Health Department is considering what to do, which Ms. Crary, the Health Department spokeswoman, confirmed.
“The department is currently exploring surveillance options that may help estimate the number of individuals with alpha-gal syndrome in New York State,” she said.
Although the state does not track alpha-gal cases, New York City does, even though the lone star tick isn’t prevalent in the city. Health officials said that 280 suspected cases of alpha-gal had been reported to the city’s Health Department since 2024.
When New York City’s Board of Health added alpha-gal to its list of reportable diseases in 2023, it said that receiving lab reports would “enable the department to better understand the burden of disease.”
Joseph Goldstein covers health care in New York for The Times, following years of criminal justice and police reporting.
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