When Dana Neely moved back to her home state of Arkansas from Seattle, she had one thing on her mind: relaunching her barbecue restaurant. So, she got a smoker and set up shop in her backyard.
"My next-door neighbor saw my smoker and she was like, 'Are you going to be smoking outside?' And I was like, 'Well, yeah, it's a smoker.' And she's like, 'Well, I have Alpha-Gal.' And she's like, 'I'm fume reactive,'" Neely said. "And I talk to my friends, and they're like, 'Oh, yeah, we've been terrified of getting it. It's horrible here.' I'm like, 'OK, well, good to know.'"
Neely didn't think much of that conversation after starting her restaurant, Girls Gone BBQ, in 2022—but then just one year later she was craving a steak filet, cooked it up and then woke up and couldn't hear.
"And everything just starts itching everywhere," she said. "I look in the mirror, and my eyebrows were swollen and red. And I was red, and my nose was swollen and red, and my ears were swollen shut. That's why I couldn't hear."
Neely rushed to urgent care but says she already knew what the problem was.
"They have no clue what it is," she said. "Because I'm asking them to test me for it. And they're like, 'We don't even know what that is.'"
Suddenly, the 'pitmistress' could no longer eat or be around her barbecue. And discovering all the new things she was allergic to was overwhelming.
"If you go get a brown sugar, the molasses might be processed through bone char," Neely said. "Shopping bags, plastic shopping bags contain mammal. It's not just, you know, red meat or hoofed mammals. It's in so many things."
Alpha-Gal Syndrome, a tick-borne allergy to red meat, is on the rise. The Centers for Disease Control and Prevention reported a 41 percent increase in cases from 2017 to 2022. Heat maps from the CDC show some of the highest prevalence of cases are in Arkansas, Oklahoma and Missouri.
Joshua Kennedy is an allergist immunologist with the University of Arkansas for Medical Sciences based in Little Rock. He said he has definitely seen more cases of Alpha-Gal Syndrome popping up.
"So Arkansas is an epicenter," he said. "And I think it has to do with our love for the outdoors, being exposed to ticks. And potentially, that's kind of how all of this gets inside in our population. Tick bites are known to have Alpha-Gal in their saliva."
Alpha-Gal is a sugar molecule found in most mammals—but not in humans. Kennedy said because the molecule is foreign to our bodies, when it gets introduced, say through the saliva of a tick, it can result in serious allergic reactions to red meat and other mammal byproducts like milk or gelatin.
"So when a tick bites you, it injects saliva. Therefore, it's possible that's the route of first sensitization that's required for allergy," Kennedy said. "It is a vector-borne type of allergy that we didn't even know existed until 2007."
But how exactly does the illness manifest from the tick to human? Researchers aren't really sure.
"I wish we knew who would be at most risk, and that's another thing that needs to happen as far as the research goes," he said. "I've lived in Arkansas my whole life, and I can tell you I've had millions of tick bites, right? And I don't have Alpha-Gal. So why do my patients have it, when they get a tick bite? Is it the tick? Is it the person? What happens there?"
What they do know is the lone star tick is the species most associated with triggering the syndrome, and it is prevalent throughout the Ozarks and much of the southeastern United States. But that habitat is expanding, and that means more tick-borne illness.
"Ticks, I think, are sort of having their moment right now," Emily McDermott said. "Part of that is because we are recognizing this increase in tick-borne diseases."
She is a professor of medical and veterinary entomology at the University of Arkansas and is currently part of a team studying a new —to the U.S. at least—tick species called the Asian Longhorn, which can devastate cattle populations.
"They are known to transmit a number of different pathogens," she said. "Particularly a pathogen called Theileria orientalis Ikeda genotype that infects cattle."
McDermott says the Asian Longhorn tick is not likely to transfer a disease to humans, but their increased presence in our region indicates more tick resilience and spread.
"So as we see kind of milder winters, these ticks that may have been killed off by a good cold snap in the winter are surviving for longer," she said. "So their populations are able to increase more."
She said some of that increase is due to better case reporting and diagnosis. The annual number of cases for six different types of tick-borne illness has doubled since 2004, with Lyme disease leading that pack—according to the CDC. And Dr. Kennedy said the uptick, so to speak, means doctors are more likely to check for these types of diseases.
"We are one of the only states that you have to report Alpha-Gal to the Arkansas Department of Health," he said. "So I think we are doing a good job of education, which might increase our diagnostic rates and also therefore increase the prevalence."
While there's no cure for Alpha-Gal Syndrome, Kennedy said with no exposure to ticks he has seen some patients gradually reintroduce red meat into their diet with the help of an allergist. However, he explained that most people will likely need to eliminate red meat and mammal products from their diet entirely.
Back at her restaurant in Fayetteville, Dana Neely still serves up traditional BBQ, but says since her diagnosis Girls Gone BBQ has fundamentally changed.
"I had to figure out what to do," she said. "So we revised the whole menu. We have two prep tables in the back, and we made one of them just for chicken and veggies and then one of them for just beef, pork and cheese."
She now serves an Alpha-Gal friendly menu in addition to her old one—and while the change was hard, she said, giving up the business was never an option.
"It's so rewarding when you have somebody come in and be like, 'I haven't eaten out in two years,'" she said. "And they're so thankful, and people haven't had barbecue, especially, because I know I'm probably the only person doing it in a separate smoker. I have inclusive barbecue, and I want everybody to be able to enjoy it."
Ozarks at Large transcripts are created on a deadline. This text may not be in its final form and may be updated or revised in the future. The authoritative record of KUAF programming is the audio record.
