 tick-bite-induced meat allergies are really unlike any other food allergy we know. The most interesting feature of the reaction may be the first symptom can occur hours after eating meat. Normally you have an allergic reaction to a bee sting or something. It happens within minutes. But with this, you could eat a piece of bacon for breakfast and your throat doesn't start closing off until the afternoon, and so you blame lunch or doctors just call it spontaneous or idiopathic anaphylaxis. Idiopathic is just doctor speak for we have no idea what the cause is. The delay is because the alpha-gal is thought to be absorbed along with the fat in the meat, given that the allergic reaction occurs four to five hours after meat ingestion, corresponding to the peak absorption time of the fat from the digestive tract. What makes it even more difficult to diagnose is that the majority of victims experience only occasional overt reactions despite regular meat consumption. Fattier meats like pork rinds may provoke episodes more consistently and severely, but still it's not like it happens every time. And it's on the rise. Ten years ago, we didn't even know the thing existed, but now in tick-ridden states as many as 20% of the population have these anti-meat allergic antibodies, and more and more people are coming in affected. Though probably no more than 10% who test positive go on to experience hives or serious allergic reactions to meat. We're also seeing it more and more in kids. Researchers in Virginia are finding it not uncommonly, though identification of these cases may not be straightforward. Unlike in adults who frequently present with systemic reactions, the majority of children with this syndrome present with just skin manifestations such as hives. Doesn't mean it's not serious. In fact, nearly half the kids end up in the ER, and about one in 12 need to be hospitalized. Up to a quarter of the population breaks out in hives at some important point in their lives, but some children can be affected for weeks or months, and it can be triggered by infections, foods, drugs, parasites, autoimmune, but in a large subset of cases we don't know what the trigger is, and so we call it chronic idiopathic urticaria. It's a common thing pediatricians see, and the only cure is avoiding and eliminating whatever is triggering it, but in three quarters of the cases we have no clue. But now we know that many children who've been diagnosed with mysterious hives or allergic reactions and may have been specifically told that the reactions were not a result of food allergy, may have actually been suffering from anti-gal meat allergies. Given the serious nature of the reactions and the rising frequency of allergic swelling and hives across all age groups, this underscores the importance of identifying what's going on and clearly physicians should keep this new diagnosis in mind. Allergies to meat might be more common than previously thought. 2% would mean millions of people, but just to put it in context, Americans are much more likely to suffer an anaphylactic reaction due to seafood. Tick bite or not, no matter where they live. A national survey of emergency rooms found shellfish, who's by far the most frequently implicated food, and unlike many other allergies, kids don't tend to outgrow fish and shellfish allergies. And many fish allergens are actually allergies not to the fish, but to worms within the fish, like anisoccus. Exposure to these parasites living or dead in fish is a widespread problem. In fact, you can even have an allergic reaction to the parasitic fish worm eating chickens that were fed on fish meal. This is one of the ways someone who's allergic to fish could get triggered by just eating chicken. Reminds me of pork cat syndrome, where your mouth can get all itchy eating bacon in people with cat allergies, because of an allergic cross-reaction between cat skin and pig blood proteins. Anisoccus worms are found particularly in cod, anchovies in squid, and can also cause chronic hives and intractable chronic itching. Because of these worms, researchers recommend people stop eating all seafood sushi altogether, because besides inducing allergenic reactions, the worms may cause a leaky gut syndrome, which often is unrecognized and can predispose to other more important pathologies than just being itchy all over.