Roy Suryo
Diagnosed MMA cases have seen a steady increase since 2007, when an Australian doctor first identified the link between the allergy and tick bites. Now, scientists and advocates are issuing urgent warnings: this preventable condition can be triggered unexpectedly, posing a potentially lethal threat. Webb had long harbored suspicions about her son’s meat allergy, but it remained undiagnosed and the family was unaware of its potentially fatal nature. "When I looked up the research about it, there wasn’t at that time anything to suggest it was more than a food intolerance," she explained. Looking back, she describes it as "like a ticking time bomb." MMA symptoms can range from mild to severe, encompassing skin rashes, swelling, stomach cramps, vomiting, and life-threatening anaphylaxis. From around the age of ten, Jeremy experienced nausea after eating meat, and sometimes even from inhaling the fumes of roasted meat, which Webb now believes may have contributed to the episode after her birthday party. On another occasion, he was hospitalized after consuming marshmallows, which often contain gelatin derived from animal products.
Professor Sheryl van Nunen, a pioneer in the field, discovered the link between MMA and ticks nearly two decades ago, observing a pattern in patients at her Sydney allergy clinic. Working on Australia’s east coast, she inadvertently found herself in one of the world’s two primary MMA hotspots; the other is in the United States, though cases have since been reported on all six continents where ticks are present. In Australia, the eastern paralysis tick is the primary culprit behind MMA. Professor van Nunen explains that after just two tick bites, 50% of individuals develop antibodies to alpha-gal, a sugar molecule present in tick saliva. Subsequently, there’s a 15 to 20% chance they will become allergic to meat. "If only people knew what a tick could do," she states with concern. Jeremy, who grew up surrounded by dense bushland north of Sydney, had a history of tick bites from childhood.
The precise reasons for the east coast, particularly areas north of Sydney, being an MMA hotspot remain unclear, with some regions reporting over 700 sufferers per 100,000 people. However, Dr. Alex Gofton, a tick expert who led a recent study on the allergy, offers several hypotheses. One significant factor is increased human-tick contact. "The population in those tick endemic areas over the last 20, 30 years has increased dramatically," Dr. Gofton notes. Furthermore, the La Niña years between 2020 and 2023 created ideal conditions for ticks to thrive, coinciding with the COVID-19 pandemic, which prompted more people to move from urban centers into bushland. Dr. Gofton also suggests that the high diagnostic rate, with a 22% annual increase in cases since 2020, may be driven by heightened awareness and improved testing protocols. Analyzing laboratory data, he estimates over 5,000 suspected MMA cases in Australia, though he acknowledges this likely underestimates the true figures.
Despite growing awareness, diagnosing MMA can be challenging. Symptoms often manifest hours after consuming a meal, typically at night, leading to confusion with asthma, especially in individuals with pre-existing respiratory conditions. Professor van Nunen describes it as an "anytime but not an every time allergy." Symptoms may not always appear, or they can be exacerbated by various factors, including the type of meat, its preparation method, spice levels, alcohol consumption, post-meal exercise, and sleep deprivation. For those highly sensitive, mammalian products such as milk and any derivative of mammal meat can also act as triggers. This includes beauty products and laundry softeners containing lanolin, and even supermarket plastic bags containing stearic acid. Fumes from barbecues or even petting a cat or dog can also provoke an allergic reaction.
Elizabeth Rowley, a mother of three residing in Hannam Vale, New South Wales, endured years of doctor visits and consultations with allergy specialists in pursuit of a diagnosis for her mysterious illness, which began in 2006. Her symptoms were varied and debilitating, ranging from memory loss and brain fog to chest pain, numbness in her arms, generalized body aches, and breathing difficulties that frequently led to her passing out. "They said, ‘you’re turning into a bit of a hypochondriac – it’s not anaphylaxis – get over it’," she recalls being told. Rowley has since established a Facebook group to support others experiencing similar challenges. "It’s just mentally horrendous more than anything, just trying to find out what it was," she confides. "I thought I was going crazy." Remy Williams, a 23-year-old psychology student living in Sydney’s Northern Beaches, was diagnosed with the allergy as a child. The constant vigilance required to manage her diet eventually led to an eating disorder. However, the most profound impact, she states, was witnessing her mother’s struggle with the same allergy, which resulted in two severe anaphylactic attacks on airplanes. "It was incredibly scary," Remy recounts, adding, "She literally almost died in front of me."
Navigating everyday life becomes a complex undertaking with such a wide array of potential triggers. Rowley faced significant obstacles in finding employment as a bookkeeper, as many workplaces posed an allergy risk. Jobs in shopping centers were out of the question due to restaurant fumes, and even in smaller environments, colleagues’ eating habits could impact her. She recounts how her boss’s morning toast habit became a daily ordeal. "As soon as the butter hits it, I just go…" she groans, explaining the immediate reaction. "But you can’t keep walking in and saying to the bosses, ‘Sorry, you can’t eat that’." Socializing also presents difficulties, as many events and gatherings are food-centric. "You can’t do barbecues," Rowley states. "Can’t do some restaurants either, or most restaurants."
Professor van Nunen’s most significant concern is the 85% of individuals who have MMA antibodies but do not currently exhibit symptoms after eating meat. These individuals, she warns, remain at risk of reacting unexpectedly to medical treatments. Many medications, including vaccines containing gelatin, are derived from animal products. At least one person is known to have died from anaphylaxis after receiving the colon cancer drug cetuximab. Another fatality occurred following a blood transfusion. Professor van Nunen asserts that it is "well known" there have been more MMA-related deaths, though the most extensively documented cases are an American airline pilot who died in 2024 after eating a hamburger, and Jeremy’s. A critical takeaway from Jeremy’s tragic death, according to Professor van Nunen, is that a staggering 94.8% of fatalities from food allergy anaphylaxis are linked to the condition triggering pre-existing asthma.
"They go straight into status asthmaticus and… unless you intubate them within a certain time, if they have a respiratory arrest, you have four minutes, otherwise they’re brain dead," she explains, highlighting the critical time window for intervention. Myfanwy Webb has found strength in recalling Jeremy’s positive outlook on life. "He fitted everything into it, wouldn’t waste a minute," she shares. This resilience fuels her determination to raise awareness of the allergy that claimed her son’s life and to advocate for improved treatment protocols, preventing other families from enduring similar heartbreak. In addition to speaking publicly about Jeremy’s death, Webb has collaborated with the hospital where he was treated to develop training on MMA. She is also working on a research paper with Professor van Nunen, slated for presentation at a conference later this year. "Now [Jeremy’s] positive spin is actually helping people, even though he’s passed," she says, believing her son would be proud of their efforts.
How to avoid tick bites:
- Wear long clothing, tucking trousers into socks.
- Use insect repellent containing DEET or picaridin.
- Stick to marked paths when walking in tick-prone areas.
- Check yourself, children, and pets thoroughly for ticks after spending time outdoors.
- Remove ticks promptly and correctly using fine-tipped tweezers.
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