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Dark woods and white linens You are in your favorite steak house. Shrimp cocktail, green salad, red wine, the ten ounce filet, creamed spinach. Ten minutes later swollen iips tight throat coughing, 911 the emergency room. Was it the bill, the shrimp cocktail? No it was a tiny tick bite from a lone star tick you got six months ago walking in the woods and forgot about You have developed a potentially life threatening allergic reaction called Alpha Gal or red meat tick bite syndrome. What? Yup, the tick put a special sugar in your body called galactose alpha, 1,3 galactose. You developed antibody to it which reacted with the galactose in the steak which nearly killed you. The sugar is also found in pork, lamb, venison, and other mammals so avoid eating them . The best way to avoid alpha gal is to avoid ticks. Avoid grassy brushy and wooded areas. Walk in the center of trails and coat your clothes with tick repellant like off or permethrin. After a walk, check for ticks on your skin clothes and pets, shower and remove any ticks. If you have trouble with meat, see an allergist. A physical exam, history and blood test for the antibody can diagnose alpha gal. Avoid eating meat and keep emergency medicines like adrenaline, steroids, and antihistamines with you. Your local fish restaurant has dark woods and white linens and more omega threes than your favorite steak house. So seafood it is.