New England has long been an epicenter for tick-borne disease. Today, the region is also on the front lines of an emerging public health threat: expansion of the range of the lone star tick (Amblyomma americanum) and the disease it brings: alpha-gal syndrome (AGS).
AGS is a serious allergic reaction to the carbohydrate galactose-alpha-1,3-galactose (alpha-gal). AGS is spread through the saliva of the lone star tick, an invasive species now rapidly spreading across Massachusetts and the Northeast. Though once rare, both AGS and the lone star ticks are increasingly common in the region.
Martha’s Vineyard has the highest tick-borne disease rates in Massachusetts, and was among the first areas affected by lone star ticks. Yard surveys show their rapid spread, and related diseases have increased. In 2020, Martha’s Vineyard Hospital (MVH) ran nine alpha-gal tests; last year, that number jumped to 1,632, with 724 positives. This year, MVH’s allergist has already seen more than 400 patients with AGS, highlighting the rapid impact on the community.
The invasion of lone star ticks and the emergence of AGS have far-reaching consequences for the people of Massachusetts, as AGS is life-altering and difficult to recognize. Unlike most food allergies, reactions to red meat can occur hours after eating, often in the middle of the night, making the connection difficult to recognize. Symptoms range from hives and gastrointestinal distress to more serious, potentially life-threatening reactions such as anaphylaxis. A food that was once routine can suddenly become deadly, disrupting daily life in ways both unexpected and difficult to manage.
High disease rates can significantly impact Massachusetts’ economy and local communities. As tick season approaches, and with thousands of seasonal tourists expected throughout the state, awareness of tick risks is crucial. Our goal is not to discourage visitors looking for outdoor activities, but to provide information so people can stay safe.
While treatment and prevention of AGS is still being studied, individuals can reduce risk by using insect repellent, wearing protective clothing, checking for ticks after being outdoors, and removing ticks promptly. Raising awareness helps people take preventive steps and recognize symptoms. Public education is currently one of the most effective tools we have today.
Additionally, public health agencies, including the Massachusetts Department of Public Health, have raised awareness about lone star ticks and AGS, and medical providers play a critical role as well. At Martha’s Vineyard Hospital, we are collaborating with Mass General Brigham to improve recognition of AGS, support patients, and share emerging knowledge — including through a new research study on AGS. Our experience highlights how early awareness and coordinated action can make a meaningful difference as the science evolves.
Yet despite these efforts, prevention and awareness alone are unlikely to curb the rise of lone star tick–related disease, including AGS. Broader action is needed, including government measures to address ecological drivers such as growing deer populations. As AGS spreads, we must accelerate research and strengthen public health systems so clinicians can identify cases earlier, track prevalence more consistently, and advance prevention and treatment options.
With summer about to begin, people naturally wanting to spend more time outdoors, and Massachusetts welcoming visitors in the months ahead, we encourage everyone, residents and visitors alike, to take simple steps to protect themselves and to understand the risks associated with tick exposure.
At the same time, we urge public health leaders, healthcare systems, and researchers across Massachusetts — and New England — to recognize alpha-gal syndrome for what it is: an emerging public health challenge requiring urgent attention.
The opportunity to get ahead of this is still within reach, but the time to act is now.
Claire Seguin, DNP, is president and COO for Martha’s Vineyard Hospital. Jacob Lemieux, M.D., Ph.D., is an infectious diseases physician at Mass General Brigham.