Nebraska Declares Alpha-Gal Syndrome a Reportable Condition Amid Rising Cases

LINCOLN, Neb.– June 13, 2025 – The Nebraska Department of Health and Human Services (DHHS) has officially declared Alpha-Gal Syndrome (AGS), commonly known as the “red meat allergy,” a reportable condition in the state. This move aims to better understand the prevalence of the tick-induced allergy, which has seen 15 cases recorded in Nebraska so far in 2025, with 60% reporting serious anaphylactic reactions.

AGS is an allergy to a sugar molecule called alpha-gal, found in most mammals except humans and some primates. Symptoms can manifest after consuming or being exposed to mammalian products such as red meat, dairy, certain medications, and personal care items. Reactions can range from mild rashes and itching to severe, life-threatening anaphylaxis, with onset typically occurring 2 to 10 hours after exposure.

While the true burden of AGS in Nebraska remains unknown, a five-year analysis (2017-2022) of alpha-gal IgE testing on Nebraska residents showed that 19.3% of tests were positive. The highest incidence of positive tests was observed in the southern portion of the state, aligning with known populations of the Lone Star tick (Amblyomma americanum), the primary vector associated with AGS in the U.S. Other ticks, including the blacklegged tick and the recently introduced Asian longhorn tick, have also been implicated.

Risk factors for AGS include tick bites, with repeated bites increasing the likelihood of developing the condition. Most reported cases in the United States are concentrated in the South, East, and Central states where Lone Star tick populations are highest.

Currently, there is no cure for AGS. Management primarily involves strict avoidance of products containing alpha-gal. Immediate allergic reactions should be treated medically with antihistamines, epinephrine, and other appropriate medications. New tick bites may reactivate allergic reactions to alpha-gal.

The DHHS emphasizes the importance of preventing tick bites to reduce the risk of AGS and other tickborne illnesses. Recommendations include avoiding tick-prone areas, using EPA-registered insect repellents, treating clothing with permethrin, regularly checking for ticks, showering after outdoor activities, and promptly removing any attached ticks.

Healthcare providers, laboratories, and facilities are urged to report all suspected and confirmed cases of Alpha-Gal Syndrome to the Nebraska DHHS to aid in surveillance and public health efforts.