Tick trouble: no cheese, no meat, just wine please

Ticks are found today at higher altitudes than in the past. Here at 900 m in the Valais Alps, they are at home in the high summer grass next to trails and pastures

It’s a hot July day and the climb from 400 metres, up through the woods to 1200 metres is a sweaty one on a sunny stretch of trail next to vineyards. I pause in light shade with tall grasses, next to an alpine meadow where horses and a few milk cows are quietly grazing, part of the Swiss caretakers of the land eco-system. While I’m taking a breather and admiring the peaceful scenery, a tick jumps off one of the tall grass stalks and finds a cozy spot near my armpit. It’s shortly after noon. Ticks have magical numbing properties and, unknown to me, the critter hangs on until the next morning, when I see it fall pm on the bathroom floor. The hike is 12 km long, parts of it strenuous although not difficult, but it’s 22:00, mid-July 2021, before I sit down to eat my supper of pan-fried veal steak and salad with a glass of cool white Swiss wine, Petite Arvine. I’m so tired I forget to check for ticks. I’m home alone, the result of widowhood, so there’s no fellow hiker to run a careful eye over hidden body parts.

I wake up at 4:00 the next morning, six hours after eating, to very painful stomach cramps that go on and on, a headache and dizziness — it resembles no sickness I can recall, not even food poisoning.

This was the end of most meat for me. The end of cheese. Butter, cream. Yogurt. It was also the end of wine and meat pairings as well as wine and cheese events. For a wine writer this is a health crisis but also a significant work problem.

It took nearly two years of several puzzling bouts of severe reactions after eating beef and pork and lamb and one scary case of going into shock, plus hours of research in French and English, an endoscopy and a colonoscopy before I could convince an allergist who had never heard of Alpha-Gal (most haven’t) to take blood samples and send them off to CHUV, the university hospitals in Lausanne.

Had I picked up this supposedly rare tick-borne allergy to mammalian meat and dairy products?

The tests done in February 2022 showed my digestive system to be in remarkably good shape. Therefore, I was told, I was probably suffering from stress (well yes: my husband had an accident and died, I had Covid, we were all isolated for weeks, my mentally handicapped daughter even longer, I researched and wrote and photographed a book on 50 hikes and 50 wines with a six-month deadline, and more).

I was pretty sure it wasn’t stress, although I couldn’t discount this.

The answer was yes: a clearcut case of an allergy to Alpha-Gal, which is a sugar molecule found in mammals. Ticks pick it up from the animals, dig into our skin and pass it to our bloodstream. Several but not all types of ticks transmit Alpha-Gal, but the carriers are less rare than was thought, and spreading, as climate change gives them a longer season and bigger breeding grounds.

An effective diagnostic blood test became available less than 10 years ago, and Alpha-Gal was first spotted only in the late 2000s. It is an “emergent” allergy, described by one of the companies that offers the test as “just plain weird. And the more we learn about it, the stranger it seems to get.” Expect to hear more, but in the meantime know it is probably under-diagnosed, including in emergency rooms — a severe reaction can include anaphylaxis, or going into shock, which can be life-threatening. The average time for a diagnosis, noted one research report, is seven long years.

I’m asked all the time if this is Lyme’s disease. No, and I’m grateful for that. The other very worrisome disease from ticks is encephalitis, for which a vaccination is available (not for Lyme’s). Alpha-Gal is “only” an allergy, but one to take seriously. Also worth noting: Alpha-Gal symptoms can be confused with IBS, Irritable Bowel Syndrome. Possibly vice versa.

Here are some basics.

• The tick’s hosts are non-primate mammals, in particular cows and cattle, horses, pigs and hogs, sheep, goats and game. Dog and cat dander is mostly not a problem, but can be. My bout of shock was triggered by being in a closed room with newborn lambs that were being nursed. The day before I had enjoyed truly splendid pork ribs in St. Louis, Missouri and then spent the night at a friend’s house writhing with pain. The farm visit was supposed to be a treat, but it was probably a case of Alpha-Gal overload. Some people go into shock from being too close to barbecue fumes.
• Ticks do not generally release Alpha-gal into a person’s bloodstream immediately, so it’s critical to check often and thoroughly for tick bites where ticks might be present. Crucial: dose yourself well with anti-tick spray and be sure to renew it every 2–4 hours, especially if you’re doing sports and sweating.
• Typical symptoms don’t occur until three to six hours after eating meat or dairy, part of the reason for delayed diagnoses, since patients and doctors don’t connect the dots. Symptoms vary hugely but often include severe cramps, diarrhoea, headaches, confusion.
• This is not the same as an allergy to red meat and if one or the other is suspected, get a blood test done.

There is no cure, only avoidance of mammalian meat, and for most people dairy products made with either. Think of banishing from your life butter, cream, yogurt, cheese and derivatives like gelatin for medications. The allergy diminishes for a small number of people after about five years. I find after two years that I can tolerate very small amounts of cheese, maybe a teaspoon of grated Parmesan on pasta) if they are spaced out, so maybe twice a month.

It’s possible to live without filet mignon. Here: pan-roasted vegetables tossed with olive oil, seasonings and fresh herbs.

Exercise, activity and alcohol tend to exacerbate symptoms. Since my diagnosis I’ve had to learn to eat very differently, re-jig my cooking and baking life, understand labels, and accept that most people have no idea if there is dairy or meat in much of what appears on a table. I’ve experimented with scores of food substitutes, mostly concluding that they are heavily processed, and I’m better off getting fresh foods.

I am now religious about tick sprays before and during hiking, and checking for ticks.

Bonus information: no, mayonnaise does not have cream in it and yes, classic green pesto sauce has cheese. And lactose-free milk is still milk, a taboo for no-dairy no-meat diets. Chicken and duck and fish and eggs and seafood are on the green light list, hooray!