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Volume 31, Number 4—April 2025
Dispatch

Alpha-Gal Syndrome after Ixodes scapularis Tick Bite and Statewide Surveillance, Maine, USA, 2014–2023

Eleanor F. Saunders1, Haris Sohail1, Devin J. Myles, Dawn Charnetzky, Bryan N. Ayres, William L. Nicholson, Scott P. Commins, and Johanna S. SalzerComments to Author 
Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E.F. Saunders, B.N. Ayres, W.L. Nicholson, J.S. Salzer); University of North Carolina, Chapel Hill, North Carolina, USA (E.F. Saunders, S.P. Commins); Maine Center for Disease Control and Prevention, Augusta, Maine, USA (H. Sohail, D.J. Myles); MCD Global Health, Hallowell, Maine, USA (D.J. Myles); Maine Medical Center, Portland, Maine, USA (D. Charnetzky)

Main Article

Figure 1

Progression and persistence of bite site reaction in alpha-gal syndrome after Ixodes scapularis tick bite, Maine, USA, 2022. A) Day 1, attached Ixodes scapularis adult female; B) enlarged version of image in panel A; magnification ×2.1; C) day 3, growing erythema surrounding tick bite site accompanied by intense and increasing pruritus; D) day 5, bite site less inflamed and with scab; E) day 53, patient resumed photo documentation because of persistent pruritus and “flares” of lesion becoming intermittently raised; F) day 55, lesion improved; G) day 57, lesion slightly raised again, photo taken to document variation. After these photos, pruritus largely resolved. As of December 2024, the bite site remains identifiable as an asymptomatic papule.

Figure 1. Progression and persistence of bite site reaction in alpha-gal syndrome after Ixodes scapularis tick bite, Maine, USA, 2022. A) Day 1, attached Ixodes scapularis adult female; B) enlarged version of image in panel A; magnification ×2.1; C) day 3, growing erythema surrounding tick bite site accompanied by intense and increasing pruritus; D) day 5, bite site less inflamed and with scab; E) day 53, patient resumed photo documentation because of persistent pruritus and “flares” of lesion becoming intermittently raised; F) day 55, lesion improved; G) day 57, lesion slightly raised again, photo taken to document variation. After these photos, pruritus largely resolved. As of December 2024, the bite site remains identifiable as an asymptomatic papule.

Main Article

1These first authors contributed equally to this article.

Page created: February 04, 2025
Page updated: March 19, 2025
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