Risk ratios (RRs), 95% CIs, and p –values were calculated to determine associations with positive test results. Means and SDs were calculated for continuous variables, and frequencies and percentages were calculated for categorical and ordinal variables. The date and location of residence at the time of the first positive test result (among persons with suspected AGS) or the first negative test result (among those who did not have AGS) were recorded. For persons who received multiple tests, a person who received at least one positive test result was suspected to have AGS, and a person who received all negative test results was considered to not have AGS. For persons who received one test, a person was suspected to have AGS if they received a positive test, and a person was considered to not have AGS if a negative test was received. An alpha-gal sIgE test result ≥0.1 kU/L was considered positive. Observations with invalid state entries or entries from outside the United States were excluded. No clinical data or travel histories of persons receiving testing were provided.
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These data highlight the evolving emergence of AGS and can be used to help state and local health agencies initiate surveillance and target public health outreach and health care provider education to high-risk localities.ĭeidentified data from sIgE tests § and panels ¶ submitted in the United States during January 1, 2017–December 31, 2022, were obtained from Eurofins Viracor, the clinical testing laboratory responsible for nearly all testing in the United States before 2022 ( ), and contained the following variables: patient identification number, age, sex (male, female, or unknown), date of testing, test result provided in kilounits of alpha-gal sIgE per liter (kU/L), and patient state of residence and zip code. Among 233,521 persons for whom geographic data were available, suspected cases predominantly occurred in counties within the southern, midwestern, and mid-Atlantic U.S. Overall, 90,018 (30.5%) persons received a positive test result in the study period, and the number of persons with positive test results increased from 13,371 in 2017 to 18,885 in 2021. During January 1, 2017–December 31, 2022, a total of 357,119 tests were submitted from residences in the United States, corresponding to 295,400 persons.
This study examined alpha-gal–specific IgE (sIgE) antibody testing results submitted to the commercial laboratory responsible for nearly all testing in the United States before 2022 to assess the geographic distribution and magnitude of this emerging condition. During 2010–2018, more than 34,000 suspected cases of AGS were identified in the United States, but current knowledge of where cases occur is limited. Specific symptoms and severity of AGS vary among persons, and no treatment or cure is currently available. Alpha-gal syndrome (AGS) is an emerging, tick bite–associated allergic condition characterized by a potentially life-threatening immunoglobulin E (IgE)–mediated hypersensitivity to galactose-alpha-1,3-galactose (alpha-gal), an oligosaccharide found in most nonprimate mammalian meat and products derived from these mammals.
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