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Dispatches : Science

The Scariest Tick Disease You Haven't Heard Of

There are plenty of reasons to fear ticks—Lyme disease, Rocky Mountain Spotted Fever, general aversion to blood suckers. Here's another one to add to the list: severe and sudden allergies to red meat.

In September, Norman was camping with her husband in Falls Creek Falls Tennessee. At 3 a.m., she woke up with hives. She and her husband drove five miles to get cell service, and the 911 operator they called told them to stay put. "By the time the ambulance got there my throat was pretty closed up, and I had hives completely," Norman says. "They told me I would not have made it if we had driven."

The cause of the reaction? A tick that had bitten her six weeks earlier and a steak she'd eaten for dinner that night.

Across the American Southeast, and in parts of Europe and Australia, doctors are treating patients with sudden, potentially fatal allergies to red meat that researchers believe are caused by bites from specific types of ticks. In the U.S., it's the Lone Star Tick.

"These bites are really common, especially in places where there are tons of these ticks, in the Southeast particularly," says Dr. Robert Valet, an assistant professor of medicine at Vanderbilt University. "The vast majority of people don't get this. But it is on the list of things that can come from tick bites."

Here's how researchers believe it works: When a Lone Star tick bites a person, it introduces something called alpha-gal sugar into the bite. Some bitten patients become allergic to the sugar, which is also found in red meat. For those patients, eating alpha-gal can cause hives, lip or tongue swelling, or anaphylaxis, a potentially deadly allergic reaction that can cause the throat to close or blood pressure to drop.

Symptoms tend to appear four to six hours after eating red meat, and sometimes even dairy, and reactions tend to occur weeks or even months after a patient was bitten.

"Within the Southeast…it's up there with peanut allergies and shellfish allergies," Valet says. About one percent of the patients who visit the Vanderbilt Asthma, Sinus and Allergy Clinic are coming in with the allergy. Dr. Platts-Mills, who lead the UVA study and has the allergy himself, told NPR that this particular tick is "very aggressive. Its larval forms will bite humans, whereas none of the other American tick larvae will do that."

If you're wondering why you've never heard of it, researchers at the University of Virginia published the first study linking ticks to the allergy in 2009. "We've really only been testing for it in the last couple of years," Valet says.

It's also fairly rare in comparison to other tick-borne disease like Lyme disease, which reports about 25,000 new cases a year; so far, UVA has recorded only about 1000 cases of the tick-related allergy.

But that doesn't mean there's no reason to be careful, particularly if you live or hike in areas of Tennessee, Virginia, or North Carolina, though Lone Star Ticks can be found as far north as Maine and as far West as Nebraska—and bit-related allergies have been reported in states like New York and .

There's also no cure. Beyond carrying an Epipen and trying to avoid ticks to begin with, there's not a lot you can do. Though some allergies do go away on their own, it's a safe bet that most people who get it won't be eating red meat again, and some like Norman—about 30 percent of those with the allergy—are also allergic to dairy. In severe cases, it can also cause an allergy to gelatin.

But this isn't the kind of disease you need to get tested for. "It's kind of one of those things that will happen and it will be obvious," Valet says.

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Rethinking the Happy Pills

Researchers have thrown tons of time and money into studying whether exercise has an effect on depression, but far less research has gone into how exercise might affect antidepressants. If serious athletes are upping their training, it could change how the drugs are metabolized in the body, and how much medication they should take at a given time, an interaction scientists are only now beginning to investigate. 

For now, the research is thin. Though drug companies are required to submit data about the effects of drugs on pregnancy and other factors, they're not required to provide any data about physical exertion. "We know nothing about the majority of the drugs and their interaction with exercise," says Dr. Ira Jacobs, a professor and dean of the faculty of Kinesiology and Physical Education at the University of Toronto. With one in ten Americans taking antidepressants, and a constant effort to encourage patients to be more active, it's an important area of study—though only a handful of people are actively researching how they interact.

Jacobs spent 25 years of his career working for the Canadian Department of Defence researching topics like the effects of performance-enhancing drugs on special operations units. Anecdotally, he found that after troops deployed, they reported side effects from various medications that they had never experienced pre-deployment. It made him wonder how acute bouts of exercise might affect medication generally.

"People who are exerting themselves acutely all of a sudden are diverting blood flow to their muscles," he says. "Where it's coming from, among other organs, is the liver, one of primary organs where we metabolize drugs."

It's possible that as we exercise and move blood away from the liver, we metabolize our medication more slowly, meaning we may need less of it.

Last year, Ethan Ruderman, a then a graduate student under Jacobs' supervision, conducted a pilot study looking at the effects of one acute bout of cycling on sertraline, also known as Zoloft. He found that the drug was removed from the body slightly more slowly during exercise.

The study is very preliminary, and Ruderman cautions against making any conclusions based on the data—particularly for people who have a constant amount of daily exercise, as opposed to a single, intense bout—but it "does help to lay the groundwork for future studies in this area."

Though doctors still don't know a lot about how exercise affects antidepressants, Ruderman and Jacobs agree it's still worth discussing with your doctor. "If an athlete is getting an improper dose of anxiety/depression medication, this may impact their mood, ability and effort to train and practice, which will certainly impact their performance on game day," Ruderman says.

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Malaria Rising

For years, scientists and climatologists have expected to see climate change impact malaria's deadly reach, since the parasites that cause it (Plasmodium), and the mosquitoes (Anopheles) that spread it, grow and survive best in warm climates. Now a new study out of the University of Michigan confirms that the disease, and the bugs that bear it, are expanding into higher altitudes and previously unexposed communities.

The study, published in the journal Science, analyzed malaria records from highland regions of Ethiopia and Colombia, and then normalized them for influences such as malaria control programs or unusually high rainfall (control programs are reducing malaria rates, overall, and high rainfall boosts cases).

"We saw an upward expansion of malaria cases to higher altitudes in warmer years, which is a clear signal of a response by highland malaria to changes in climate," said the study's author, theoretical ecologist Mercedes Pascual.

The researchers examined malaria case records from the Antioquia region of western Colombia from 1990 to 2005, and from the Debre Zeit area of central Ethiopia from 1993 to 2005.

The report is especially troubling because the tropical highlands of Africa and South America contain very dense populations. The Debre Zeit region sits between roughly 5,000 and 8,000 feet above sea level and is home to 37 million people, or nearly half of Ethiopia's population. Many of these people live in rural areas where the insects could thrive.

"Because these populations lack protective immunity, they will be particularly vulnerable to severe morbidity and mortality," said co-author Menno Bouma, honorary senior clinical lecturer at the London School of Hygiene & Tropical Medicine, which contributed to the study.

In an earlier study, the same researchers estimated that without new control programs, just one degree (Celsius) increase in temperature could lead to an additional 3 million malaria cases annually in Ethiopian children.

"Historically, the highlands regions of those countries were considered havens from malaria, places where people could go to get away from the disease," says University of Michigan spokesman Jim Erickson.

For travelers, this trend should not immediately impact malaria rates for those who follow the Centers for Disease Control recommendations to take antimalarial drugs when visiting areas up to 8,200 ft in Ethiopia and up to 5,577 ft in Colombia (the Antioquia region sits just under 5,000 ft).

Still, it's important to consider that warming temperatures are already changing the footprint of at least one serious (yet preventable) disease. Plus, while the CDC rates the risk of contracting malaria in Ethiopia as "moderate," it notes that the Plasmodium parasite there is resistant to the common anti-malarial drug chloroquine.

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Down Is Becoming Too Expensive

Want proof that the world is flat? Consider this: how much you pay for your next jacket or sleeping bag could depend on whether 1.4 billion Chinese order Peking duck. China produces roughly 70 percent of the world's down, a by-product of the estimated three million tons of ducks and geese its population consumes each year. But China is ­rapidly urbanizing, and the burgeoning middle class is eating more beef and less fowl. Combine that with panic over recent bird-flu outbreaks and growing demand in the West for jackets, sleeping bags, and comforters, and the result is a massive spike in down prices. In 2009, a pound sold for $10; today it goes for $50.

In the U.S., higher materials costs are driving up prices on store shelves, where down jackets and sleeping bags now sell for about 30 percent more than they did five years ago. That has some manufacturers ramping up R&D to devise man-made fibers that can match down's exceptional warmth-to-weight ratio. Indeed, synthetics are undergoing a massive technological upgrade. "On a scale of one to ten, we're at five in terms of potential," says Joe Vernachio, vice president of global apparel and equipment at the North Face. "We'll be ­having sixes and sevens soon," he says. And a nine or ten? "It's out there," Vernachio says, "but we haven't seen it yet." Here's a rundown of the current crop of next-gen insulation.

Primaloft ThermoBall

What It Is: Clusters of tiny balls of synthetic fiber designed to mimic the loft and compressibility of feathers.

Who Has It: Thermo­Ball is currently exclu­sive to the North Face, but expect other brands to bring out products with it in 2015.

Warmth: One of the most insulating synthetic fibers we've ever tested.

Down Blends

What It Is: A fusion of natural and synthetic insulation.

Who Has It: This fall, Columbia will introduce TurboDown, which combines natural down with a proprietary insulation and the company's popular reflective technology, a metallic lining that bounces heat back to the body. Insulation maker PrimaLoft and major supplier Allied Feather and Down have plans to unveil down-poly blends within the year.

Warmth: Should be comparable to straight down, but it remains to be seen.

Polartec Alpha

What It Is: Developed for U.S. Special Forces, it's essentially a knit sheet of polyester that can be sandwiched between open-weave, breathable fabrics.

Who Has It: 66 North, Eddie Bauer, Marmot, and more than a dozen others.

Warmth: Not nearly as toasty as ­Thermo­Ball but lighter and much more breathable.

Infrared ­Insulation

What It Is: Synthetic fibers infused with ceramic or other materials that absorb body heat and, like a rock in the sun, slowly radiate it back to the wearer.

Who Has It: Ski-apparel maker Powderhorn has experimented with the technology; the North Face and Allied Feather and Down are both working on the idea.

Warmth: Mayo Clinic testing on ­female soccer players has proven disappointing. Says North Face's Vernachio: "We haven't been able to put it in a product yet that humans can detect."

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