The research revealed that alpha-gal syndrome diagnosis time following symptom onset is much faster over time, down from a 5.3-year average during 2009 – 2011 to 28 days (2019).
In this cohort, the interval between onset of first symptoms and definitive [alpha-gal syndrome] diagnosis has decreased 70-fold over time," wrote researchers, headed by Caroline K. Maki, MPH, at the Rickettsial Zoonoses Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention (CDC) in Atlanta Georgia.
Alpha-gal syndrome is a developing tick-borne allergy to galactose-a-1,3 galactose (alpha-gal) carbohydrate, a molecule present in mammalian meat, mammal-derived foods and products, and some drugs. The prevalence of alpha-gal syndrome is patterned after the lone star tick, Amblyomma americanum. Symptoms of alpha-gal syndrome patients appear 2 to 8 hours after a product with alpha-gal intake, and such symptoms can be life-threatening.
About 450,000 people in the US have alpha-gal syndrome. However, according to a 2022 study, 42% of US healthcare providers have never heard of alpha-gal syndrome and 35% were not sure they could diagnose and treat the condition.
Earlier in the month, HCPLive interviewed one of the researchers on this study, Scott P. Commins, MD, PhD, from the department of medicine & pediatrics at the University of North Carolina, Chapel Hill, regarding how climate change has increased the incidence of alpha-gal syndrome.2
"We believe one of the largest is warmer winters have caused more deer migration," Commins said. "We see especially in the US white-tailed deer now have a growing geographic range. What that does is introduce ticks into communities where they might not have been before, and that exposes more people to alpha-gal syndrome."
This newly released report determined whether there are factors that likely affected the availability of timely and correct alpha-gal syndrome diagnoses in a patient.1 The data was retrieved from the case-control study coordinated by the Rickettsial Zoonoses Branch at the CDC and UNC Allergy & Immunology Clinic.
The authors examined a patient cohort (69% North Carolina residents, 88% White patients, and 55% females) with alpha-gal syndrome treated at an allergy clinic in North Carolina, the University of North Carolina at Chapel Hill (2019; n = 18)), and compared them to an earlier group (2009 – 2011; n = 18) treated within the same allergy clinic. By comparing the new vs old cohort, researchers aimed to reveal the alpha-gal syndrome diagnosis trends over time.
The research finally concluded that the duration from symptom onset to an alpha-gal syndrome diagnosis decreased from a mean of 5.3 years in 2009 – 2011 to 28 days in 2019, representing a 70-fold decrease. This result indicates an improvement in awareness and diagnostic capacity for alpha-gal syndrome since 2011.
The research highlighted a difference when it relates to the diagnosis of alpha-gal syndrome: patients who were less educated had reduced delays in diagnosis. On average, people with a high school degree had to wait 4.4 years for a diagnosis, while those with a graduate degree waited 1.4 years.
"The delayed diagnosis in the less educated points to a distinct gap in care access, even among this special group with ultimate access to a medical specialist and [alpha-gal syndrome] expert," researchers said.
Investigaters also reported a considerably better diagnosis time between 2015 and 2019, based on information from a study that analyzed the diagnosis time of 28 patients who were diagnosed with alpha-gal syndrome prior to late 2015. The analysis indicated that since 2015 there has been a remarkable enhancement in the number of patients diagnosed with alpha-gal syndrome within less than a year and a remarkable reduction in those diagnosed in > 5 years. Yet, the average diagnosis time of diagnoses > 1 year after symptom onset was still 7.5 years.
As we continue to learn about the increasing number of patients with [alpha-gal syndrome] in the US, the inequalities indicated by this study may become more evident," researchers said. "Health care providers should be fully aware of the factors that could affect patients' capacity to obtain timely [alpha-gal syndrome] diagnoses in order to provide the best level of care and prevent excessive physical, mental, and economic burden.
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