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Tick spreading to area tied to boy’s allergy
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About two months ago, after two years of tests, Paxton Matherly (left with his mother Kim Matherly) was diagnosed with alpha-gal allergy. Alpha-gal is a carbohydrate found in mammalian meat. The allergy is triggered in some people — but not all — by the bite of the lone star tick. (Bulletin photo)
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Monday, December 30, 2013

By BEN R. WILLIAMS - Bulletin Staff Writer

It took nearly two years to diagnose Paxton Matherly’s allergy.

Paxton, 4, is the son of Kimberly and Sammy Matherly of Bassett. Kimberly Matherly, who is a nurse with Lincare in Collinsville, remembers her son developing “the worst case of hives I’ve ever seen. He had no airway flow.”

“We took him to two different allergists who did normal allergy tests,” Matherly said, but no one was able to pinpoint what was wrong with Paxton.

“I knew something just wasn’t right,” Matherly said. “It had to be something he was ingesting” because Paxton was breaking out in full-body hives, not contact hives localized to a particular area of his body.

One night, Matherly said, her son not only broke out in hives, but his lips began to swell and he became lethargic. She rushed him to the emergency room where doctors were able to counter his reaction, but they still were unable to pinpoint what was causing it.

Roughly two months ago, Matherly took Paxton to the University of Virginia Medical Center where they met Dr. Julia Wisniewski, who specializes in pediatric allergy/immunology.

Wisniewski tested Paxton for alpha-gal allergy. The test came back positive.

Matherly said a tick bite was blamed for the allergy.

Alpha-gal is short for Galactose-alpha-1,3-galactose, according to Alpha-gal is a carbohydrate found in mammalian meat, including beef, pork, lamb, venison, goat and bison.

According to Matherly, alpha-gal allergy is a relatively new phenomenon that has been studied for only about four years. The allergy is triggered in some people — but not all — by the bite of the lone star tick.

According to Virginia Museum of Natural History Executive Director Joe Keiper, the lone star tick is small, roughly between the more common deer tick and dog tick in size, and the females have a white dot or star on their backs.

“When the tick bites you,” Keiper said, “it injects or stimulates an antibody that is reactive to this particular sugar (alpha-gal). It’s weird, because when you develop an allergy, the allergen tends to be a protein, and your body creates an antibody that will be specific for that protein. But this is a sugar.”

Matherly said that unlike many food allergies, the reaction to alpha-gal is delayed, meaning that symptoms may not appear until four to 10 hours after someone has eaten meat.

“If you eat beef or pork for supper,” she said, “it wakes you up in the middle of the night. A lot of people don’t correlate it with red meat.”

People with the alpha-gal allergy can eat chicken and fish, Matherly said, but the allergy still presents a host of problems. Some people are able to eat mammal by-products, such as milk, cheese or butter, but Paxton cannot.

Additionally, she said, her family can no longer eat at restaurants because cross-contamination is always an issue. If they were to order Paxton a chicken dish, for example, they would have no way of knowing if the cook had used the same knife to cut both steak and chicken, which would contaminate the chicken dish.

Even chicken nuggets present issues, Matherly said. Paxton can eat only grilled chicken nuggets, not battered, because many batters contain milk. It’s not even safe to order vegetables at a restaurant, she said, because it’s always possible that the vegetables were cooked in butter, lard or bacon grease.

As a result, the Matherlys never leave home without at least two EpiPens, or epinephrine autoinjectors, which are used to treat people who are having an allergic reaction and are experiencing anaphylaxis, which causes throat swelling and low blood pressure.

“My biggest breaking point was going to the grocery store for the first time” after the diagnosis, Matherly said.

She had to carefully examine every item to make sure it was safe for Paxton to eat or drink, and she was overwhelmed by the number of items that contain animal byproducts. Not even gummy snacks were safe, because gelatin is made from animal collagen.

Because the allergy has come into the spotlight only recently, there are a number of unanswered questions, Keiper said.

“I’ve read a few things from the CDC (Centers for Disease Control and Prevention), and it sounds like they’re still piecing it together,” he said. “It’s at one point fascinating, but on the other hand, it is a bit scary. Why has this suddenly changed?”

European Americans have lived in the range of the lone star tick for roughly 200 years, Keiper said, and Native Americans have lived in the tick’s range for far longer, yet it’s only recently that the alpha-gal allergy has come to prominence.

Although the lone star tick still is fairly uncommon in Martinsville/Henry County, Keiper said, its range has been steadily expanding.

“For 20 years at least, we’ve watched as the tick has spread,” he said. “There’s probably a lot of reasons for that. We and other animals like deer could be moving it. We’re very mobile in vehicles; we could get a lone star tick on us and have it drop off of us after feeding for a day, after we’ve driven 500 miles. The tick drops off and lays a thousand eggs in the leaf litter, so you’ve got a population present.”

Paxton’s condition has changed not only his life, but the lives of everyone in the Matherly household, including Matherly’s two older sons, Logan Fulcher, 15, and Austin McDaniel, 12.

“Our whole house is basically red-meat free,” Matherly said.

Paxton will be re-tested for the alpha-gal allergy when he’s a bit older, she said. Doctors hope that over time, the presence of the antibody in his immune system will decrease, causing his meat allergy to diminish.

In the meantime, Matherly is just grateful to have a diagnosis.

“I’m very thankful for U.Va.,” she said.


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