If you follow national news, you’d think that stepping outside on Martha’s Vineyard is a brush with death. The frenzy began last summer when the New York Times likened the impact of the lone star tick to the great white shark. Then the Boston Globe, NBC News, NPR, and CNN all descended on the Island to cover the “alpha-gal syndrome epidemic.” One bite, the headlines warned, and you may never eat a burger again. A man in New Jersey died. RFK Jr. invoked the Vineyard by name at a major press conference on AGS. Tick season, it seems, has become the new shark week.
You can understand why these stories get traction. They’re dramatic, and they contain a kernel of genuine public health importance. Though I’m not a doctor, a researcher, or an epidemiologist, after a year in the trenches at Martha’s Vineyard Medical, it’s clear to me that the fear these stories have generated is doing more harm than good, and that they are based on a sensationalized view of actual risk. The critical efforts of our local organizations and voices have positioned the VIneyard to lead the way in finding a solution to the tick issue. Unfortunately, much of the national press has oversimplified the nuances. What Islanders and visitors need is not more alarm but better information from the national press.
A tick bite is not a death sentence. A lone star tick bite can trigger the production of antibodies to a sugar molecule called alpha-gal, which is found in red meat and other mammalian products. Researchers estimate that in heavily tick-exposed populations, somewhere between 15 and 35 percent of people carry these antibodies. Martha’s Vineyard almost certainly sits at the high end of that range. But carrying the antibody is not the same as having AGS.
Several studies suggest that only 1 to 8 percent of individuals with alpha-gal antibodies develop clinical symptoms. Together with researchers from Yale and Harvard, we are preparing to study exactly this question on the Vineyard, and our hypothesis is that most people who have been bitten, even more than once, may never be affected.
Since 2020, Martha’s Vineyard Hospital has recorded a total of 1,516 positive alpha-gal tests. In a community that swells to 150,000 people each summer, that works out to 1 percent of our annual peak population. And yes, undoubtedly many people have been tested elsewhere. And yes, 1,516 positive tests does not mean 1,516 different people with AGS. A positive test is not the same as a diagnosis (the hospital has treated approximately 400 patients with AGS), and a diagnosis is not the same as a serious reaction. When you start to dig in, the real risk of a life-altering AGS reaction is far smaller than the headlines suggest.
Most AGS looks nothing like the headlines. The cases that make national news involve hives, throat swelling, and anaphylaxis. Those cases are real, and they are serious. On the Vineyard, we are prepared for the worst. Thanks to the efforts of Island advocate Megan Shai Brown, whose husband Michael died of anaphylactic shock after a wasp sting, Island first responders now carry EpiPens. But based on what we see in our patients, and in the published literature, cases involving anaphylaxis represent the minority. The more common presentations are quieter: abdominal pain after a steak dinner, recurring nausea, diarrhea that off-Island may get misdiagnosed as irritable bowel syndrome. It’s not that these symptoms aren’t awful, as anyone with AGS well knows. It’s that here, we know what to look for.
The ER is not where this story ends. The fear-driven narrative implies that an AGS reaction inevitably means a 911 call and an epinephrine injection. For a small number of patients, that is true, and those patients need to be identified, educated, and equipped. But most people with AGS manage their condition through dietary changes, watchful awareness, and the kind of coordinated care that a good primary care practice can provide.
The Island does not have an epidemic of tick-induced anaphylaxis. It has an epidemic of unasked and unanswered questions.
That realization is part of what led us to create the Tick Center this spring. Our goal is not to add to the alarm. It is to replace alarm with competence: rigorous diagnosis, and a care model that goes beyond “avoid red meat” to include nutrition guidance, medication safety review, acupuncture, mindfulness, and the kind of honest conversations patients often never get about what their test results actually mean for their lives.
Tick awareness matters. Wearing proper clothing, using repellent, checking for ticks after time outdoors, knowing the symptoms of AGS and Lyme: These are reasonable, proportionate precautions for anyone spending time on the Vineyard. They are not reasons to stay inside. This is why so many Island stakeholders (including Martha’s Vineyard Medical) are working collaboratively to get the word out and seek solutions.
Our Island is extraordinary. It’s my favorite place in the world. The outdoors — the trails, the beaches, the farms — is part of what makes it such a special place to live and visit. The ticks are real. The risk, for most people, is manageable. And the difference between fear and readiness is exactly what accurate information and good medicine are supposed to provide.
Jeff Levy is the owner of Martha’s Vineyard Medical, a primary care and urgent-care practice in Vineyard Haven, and the founder of the Tick Center, the Island’s first practice dedicated entirely to tick-borne illness and alpha-gal syndrome.