Purpose Alpha-gal syndrome (AGS) is an emerging health issue. This syndrome, caused by the bites of ticks, induces allergic reactions to the sugar molecule galactose-α-1,3-galactose after exposure to non-primate mammalian meat and other byproducts. Agricultural workers spend significant time outdoors placing them at an increased risk for tick bites and tick-borne diseases, like AGS. This study aimed to characterize farmers and ranchers’ prior knowledge, symptomology, and diagnostic experiences with AGS.

Methods We conducted a cross-sectional survey of more than 200 farmers and ranchers with a self-reported AGS diagnosis. The survey captured farmers and ranchers’ experiences related to prior knowledge and experience with tick bites and AGS, reported symptoms, and obtaining a diagnosis.

Findings A total of 201 respondents across 26 states participated in the survey, with the majority from Missouri and Oklahoma. We identified four distinct symptom clusters, with the most reported symptoms being abdominal cramping, diarrhea, itchy skin, and nausea. Women more often reported gastrointestinal discomfort, and men were more likely to be in the mild symptom category. On average, participants reported 2.98 medical provider visits before receiving a diagnosis, most being diagnosed by general practitioners and allergists.

Conclusions No previous studies have focused on the symptom and diagnostic experiences of farmers and ranchers with AGS. Capturing such data is essential as these workers may experience unique occupational challenges following AGS diagnosis. The diagnostic experience data support a continuing need to educate and empower AGS patients and providers, especially agricultural workers and providers serving rural communities.

The authors have declared no competing interest.

This work was supported by funding provided by the Central States Center for Agricultural Safety and Health (CS-CASH) through a National Institute of Occupational Safety and Health (NIOSH) Agriculture, Forestry and Fishing Grant (U54OH010162).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was deemed exempt by the University of Nebraska Medical Center Institutional Review Board (0562-25-EX).

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The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.