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. Author manuscript; available in PMC: 2022 Feb 1.
Published in final edited form as: Emerg Med Clin North Am. 2021 Oct 29;40(1):1–17. doi: 10.1016/j.emc.2021.08.007

Fig. 4.

Fig. 4.

Summary of alpha-Gal sensitization leading to clinical symptoms of red meat allergy. The southeastern section of the United States is where most of the reactions to red meat have been reported. This region overlaps with the distribution of the lone star tick. The current hypothesis is that persons are bitten by lone star ticks carried by deer into rural and urban areas. After a period of time, IgE to alpha-Gal develops. Once IgE to alpha-Gal reaches sufficient levels, ingestion of red meat can trigger reactions. Several of the images used in this figure are licensed under a Creative Commons CC BY-NC 2.0 (Attribution-NonCommercial 2.0 Generic) license (Cow: https://flic.kr/p/adgjhp by user Plashing Vole; Deer: https://flic.kr/p/jeZwq7 by user Cherry Bream; Sheep: https://flic.kr/p/4WirD by user Lauren; Tick: https://flic.kr/p/cdnNaY by user Katja Schulz; Pig: https://flic.kr/p/N7gpc by user Anne). (From Steinke JW, Platts-Mills TA, Commins SP. The alpha-Gal story: lessons learned from connecting the dots. J Allergy Clin Immunol 2015;135(3):589–96; with permission.)