First Documented Fatal Case of Tick-Induced Meat Allergy in Australia

A NSW coroner has ruled that the June 2022 death of 16-year-old Jeremy Webb was caused by an anaphylactic reaction to mammalian meat, which triggered a fatal asthma attack. This marks the first documented fatal case of tick-induced mammalian meat allergy in Australia.

Incident and Medical Findings

Jeremy Webb died on June 10, 2022, while camping at MacMasters Beach on the New South Wales Central Coast. After consuming beef sausages, he experienced vomiting, collapsed, and later died in hospital. Paramedics were unable to revive him.

An initial autopsy attributed his death to asthma. However, a coronial inquest prompted by his parents, Myfanwy and Johnathan Webb, led to a revised finding. Deputy NSW State Coroner Carmel Forbes ruled that the cause of death was anaphylaxis resulting from a mammalian meat allergy, which subsequently triggered a severe asthma attack. Magistrate Forbes stated that without the anaphylaxis, the asthma alone would not have been fatal.

"Without the anaphylaxis, the asthma alone would not have been fatal."

The Allergy: Alpha-Gal Syndrome

Clinical immunologist and allergist Professor Sheryl van Nunen posthumously diagnosed Jeremy Webb with mammalian meat allergy, also known as alpha-gal syndrome. The condition is a potentially life-threatening allergy to red meats such as beef, pork, and lamb, and can also be triggered by gelatin, fats, dairy products, and exotic meats like kangaroo.

The allergy is induced by tick bites. The allergen, alpha-gal, is a sugar molecule found in the saliva and gut of ticks. After two or more tick bites, approximately one in two individuals may develop antibodies to alpha-gal.

Unlike other food allergies, reactions typically appear three to six hours after consumption, as this is the time required for digestion and alpha-gal release. Symptoms can include:

• Gastrointestinal issues: Cramping, diarrhea, nausea, or irritable bowel-like symptoms
• Skin reactions: Welts, hives, or swelling around the eyes or lips
• Severe cases: Anaphylaxis leading to respiratory or cardiac compromise

Reactions can also be triggered by non-traditional mammalian products, such as gelatin in marshmallows, and by airborne meat particles. Higher concentrations of alpha-gal—such as in offal or sausages encased in mammalian intestines—may lead to more severe reactions.

Context and Prevalence

Professor van Nunen confirmed that Jeremy Webb's death is the first documented fatal case of mammalian meat allergy in Australia. The only other known fatal case globally occurred in 2024, involving a 47-year-old man from New Jersey, USA, who died after eating a hamburger.

While deaths directly from mammalian meat allergy are exceptionally rare, 14 recorded fatalities globally have been linked to medicines containing alpha-gal. According to CSIRO research, Pittwater in Sydney's northern beaches reported the highest prevalence of the condition globally in 2025, with 744 cases per 100,000 residents.

The Australian paralysis tick, a primary vector for the allergy, is prevalent along Australia's east coast, from Far North Queensland to Victoria. Cases of the condition, which experts say has historically been under-diagnosed, have increased by 40 percent annually over the past five years.

Missed Opportunities and Recommendations

Jeremy Webb had a history of repeated tick bites during his childhood while camping in NSW Central Coast bushland. His family noted that he began reacting to red meat around age 10, leading them to suspect a food intolerance rather than a potentially fatal allergy.

A year prior to his death, Webb was hospitalized for severe respiratory distress. The episode was diagnosed and treated as an asthma attack. Experts identified this hospital admission as a "missed opportunity" to identify the allergy's risks, citing the sudden onset, the need for multiple adrenaline doses, and the positive response to treatment as atypical for asthma alone.

"This hospital admission was a missed opportunity to identify the allergy's risks."

Magistrate Forbes recommended that Jeremy's death serve as a case study for the Central Coast Local Health District. She also recommended that the district update its allergy training for doctors to include the diagnostic signs of mammalian meat allergy.

Prevention and Management

Preventing Tick Bites

The most effective strategy is to avoid tick bites. Recommendations from Professor van Nunen and the Tick Induced Allergies Research and Awareness (Tiara) website include:

• Clothing: Wear long-sleeved shirts, long pants (tucked into socks), and a wide-brimmed hat in tick-prone areas
• Repellent: Use insect repellent
• Visibility: Wear light-colored clothing to easily spot ticks
• Post-Outdoor Care: Check the body for ticks after being outdoors. Place outdoor clothing in a hot dryer for 20 minutes to kill any ticks

Proper Tick Removal

The recommended approach is "freeze, don't squeeze." This involves killing the tick on the skin using an ether-containing spray and then waiting for it to detach naturally or seeking medical assistance for its removal. Squeezing a tick can inject its saliva, which contains alpha-gal, into the body, increasing the risk of allergy.

Diagnosis and Emergency Preparedness

Diagnosis can be complex due to the delayed onset of symptoms. While specific skin or blood tests for a general "tick allergy" are not available, tests for alpha-gal antibodies can identify mammalian meat allergy. Blood tests for mast cell tryptase levels can help assess the risk of severe reactions and differentiate between asthma and anaphylaxis.

Anaphylaxis and asthma can co-occur, making differentiation challenging. Professor van Nunen states that the majority of food allergy deaths (85 percent) are caused by anaphylaxis triggering asthma. Individuals experiencing sudden severe asthma should consider anaphylaxis as a potential cause.

"85 percent of food allergy deaths are caused by anaphylaxis triggering asthma."

Myfanwy Webb advises individuals concerned about or diagnosed with this allergy to advocate for immunology testing and to request an adrenaline auto-injector (EpiPen) for emergency use in case of anaphylaxis, even before a formal diagnosis is confirmed. She suggests referencing the coronial report on Jeremy's death to inform healthcare professionals about mammalian meat allergy.