A mysterious red meat allergy stalks meat-loving Arkansans, but an alternative protein movement is sprouting up to offer the afflicted a new, and perhaps healthier, path forward.
The red meat allergy called alpha-gal syndrome has become infamous around Southern communities in the last few years, as more and more people are reporting surprise allergic reactions hours after eating beef, pork, lamb, dairy or other mammals. Many of the individuals recently diagnosed with alpha-gal had not previously experienced an allergic reaction to meat, including Amy Hall, whose diagnosis led her to become an emu farmer in Paris (Logan County).
When the problem started for Hall, she was working as an international commercial pilot. Every so often, when she'd be in a hotel somewhere overseas, she'd start to break out in hives and feel her chest tighten up. Her first reaction, when she was in her 40s, was at a Sheraton hotel in Ethiopia, which left her shaking and covered in a rash from head to toe.
Eventually, after an allergic reaction so extreme she ended up going into anaphylactic shock and being hospitalized, Hall's health troubles began to interfere with her work.
"I had never had food allergies in my entire life, I didn't know what the heck was going on. And of course the FAA [Federal Aviation Administration] was like, 'What's going on with you? You need to go through tests, and you're grounded,'" Hall said. "When you have a problem like that and you can't tell the FAA why, they are like 'nope,' and that's understandable."
Even Hall's allergist was stumped.
"Back then, people had no idea about alpha-gal, and I was going to this allergist who had me on all kinds of antihistamines," Hall said. "And I thought, 'This isn't something sustainable, right?'"
Around two years after Hall's first reaction in Ethiopia, her allergist returned from a symposium at the University of Virginia and said he finally knew what was wrong with her. The University of Virginia is where Dr. Thomas Platts-Mills, an allergist and immunologist, discovered the alpha-gal syndrome through various studies in the 2000s.
Platts-Mills had heard from patients that they developed a red meat allergy in the middle of their lives, but he initially didn't believe it was possible. Later, while conducting trials for a new cancer drug, Platts-Mills and other researchers found that more than 20% of the patients in the trial would mysteriously break out into anaphylactic shock after being given the drug.
The researchers then determined that a mammal-based sugar called alpha-gal was present in the drug and that all the patients who experienced an allergic reaction had antibodies for alpha-gal before the treatment. Platts-Mills began making connections between the allergic reactions during the cancer drug tests and the reactions many of his patients had complained about after eating red meat.
Despite the fact that humans do not naturally produce the alpha-gal sugar, some humans primarily in the South were being exposed to it and having allergic reactions to meat they'd eaten all of their lives without trouble. And Platts-Mills didn't know why.
Dr. Joshua Kennedy, an allergist at UAMS, was completing a fellowship at the University of Virginia in 2007 when Platts-Mills' team finally connected the dots between how some people were mysteriously coming to possess the alpha-gal antibodies: the lone star tick, named for the white, star-shaped spot on its back.
Kennedy explained that the tick is prevalent in the South, where alpha-gal syndrome has mostly been found, and that researchers have found it can produce alpha-gal sugar in its saliva. Moreover, as the tick habitat has expanded northward, so have diagnoses of alpha-gal syndrome. But Kennedy said there are still so many questions around the allergy, as many people who have been bitten by the tick never develop the allergy. In other words, the actual means by which a bite turns into an allergy is still unknown.
Furthermore, many people with alpha-gal will see their symptoms decline or even disappear with time, and not all kinds of red meat products make everyone with the syndrome have an allergic reaction. Before Hall was diagnosed, she ate pork knuckle in Germany without a reaction.
Now, alpha-gal syndrome is recognized by the Centers for Disease Control and Prevention as an emerging tick-borne illness, and the organization estimates as of 2023 that as many as 450,000 people may have been affected.
Arkansas has proven to be the heart of the tick-driven public health challenge. A 2024 Army Medical Department study of military personnel found Arkansas had the highest prevalence of the syndrome, and a 2023 CDC study found that over half of Arkansas counties -- especially in the Ozarks -- had some of the highest rates of cases.
"We are absolutely seeing an increased number of positive tests in our state, and our state is one of five or six current states that actually has a mandatory report for alpha-gal. Our Department of Health is actively evaluating cases for our state to determine whether or not they fit certain diagnostic criteria and determining whether a patient is actually having an alpha-gal reaction," Kennedy said. "It's become a hotbed."
Whether the surge in diagnoses is because testing is more widespread or more ticks are spreading the allergy is also up for debate, Kennedy said, with much more research and studies needed to find conclusive answers. But regardless of how exactly the allergy develops, alpha-gal syndrome diagnoses have disrupted thousands of people's lives.
For Hall, the disruption was so significant that it resulted in her becoming one of the largest emu farmers in the United States.
After being officially diagnosed with alpha-gal syndrome in 2013, Hall adopted a plant-based diet to prevent further reactions. But soon she was running into another problem: vitamin B-12 deficiency, which can be caused by not eating enough red meat. After some searching, she found that a couple of exotic birds could be a good substitute. Despite containing high amounts of B-12 and protein, emu and ostrich meat don't cause allergic reactions for people with alpha-gal syndrome.
So Hall retired and began building a house on a piece of land near Paris that she had purchased when her parents relocated to Arkansas from her hometown of Cleveland. She bought a few emus to raise on her land for her own consumption after she struggled to find emu farms that would sell her the meat not mixed with pork fat.
After a few years, her operation slowly expanded and she began selling emu to local restaurants and markets, and to customers online. In 2019, she opened Gum Creek Emus, building a second career in the remote Ozark Mountains. Now, at 58 years old, she has hundreds of emus on her 20 acres of farmland, and expects dozens more as the birds head into mating season.
Part of the reason she was drawn to farming as a second career was because she grew up on a farm.
"Everyone is different with alpha-gal, you know? Some people just get a little rash, but I would break out into full hives everywhere and go into shock," Hall said. "My parents had a farm for a long time, and they had horses. I think that's where I picked up alpha-gal, going on horse rides through the woods. And we'd get off and go pee in the woods and spend every night picking off ticks."
The transition away from meat-eating was difficult for Hall, but with the growth of her farm, she's found a lot of community with people in similar situations. She said most of her sales are to people struggling with alpha-gal who, like her, turned to emu meat to supplement their diets. Her favorite part of the emu? The flat filet.
"The necks are like oxtail and have quite a bit of meat on them. They're great for broth. Then there's the flat filet, which can make great fajitas. I love fajitas," Hall said. She also extracts and sells "emu oil" from the birds, which is used as a cosmetic ingredient similar to mineral oils.
Around the same time Hall was being officially diagnosed with alpha-gal syndrome in 2013, Karen Ballard was in eastern Arkansas working as a program evaluation professor for the University of Arkansas Division of Agriculture. Like Hall, Ballard began to experience unexpected allergic reactions after eating meat and dairy.
Ballard and her husband grew up in Delta row crop country, among huge soybean fields where the yields were destined for export. But she never ate much soy, even while she was working on nutrition research with the university to expand access to it.
After a particularly bad allergic reaction in 2019, Ballard even lost her vision in the car while her daughter was driving her to the hospital. Then, in her mid-60s, a doctor diagnosed her with alpha-gal.
"One of the hardest things about alpha-gal -- I mean it's hard enough that you can't eat meat in a meat-dominant society -- is in the South we wrap everything in bacon, or at least I did," Ballard said. "I don't think there was a vegetable I cooked that didn't have bacon. I mean I was your classic Southern cook. It's in gelatin, and in some pharmaceuticals ... How do you know what is safe and what isn't safe?"
With her diagnosis of alpha-gal, Ballard turned to a food grown in massive quantities in the Delta but rarely eaten there: soybeans. Ballard and her husband also took over his family's farm in rural Jackson County, and she began growing edamame and dried soybeans to sell locally around Arkansas.
"The most people think about soy, if they think about it at all, is that it's the gold standard of plant protein, but they don't think about the fact that it's high in fiber and there are all these things it brings to the table," Ballard said. She emphasized that soy is truly a superfood, packed with protein, fiber, calcium and vitamins. After adopting soy into her diet daily, Ballard said, she lost weight, had lower cholesterol and was surprised by how much more healthy she felt.
Their farm, called B&B Legacy Farms, was designed in part to make locally grown, quality soy products available in Arkansas. While also growing and promoting soy, Ballard also applied for grants from the Mid-South Soybean Board to study how to expand access and demand for soy products in The Natural State.
"Most people had never eaten soy beyond edamame and then only occasionally, and most people -- around 97% -- had never eaten a cooked, dried soybean. In a state where we grow 3 million acres of it and it's the top production crop in the state," Ballard said. "But we don't eat it. And it's phenomenal! Why? What were the barriers? And I found that it was multitiered."
In particular, Ballard found that many Americans hold strong biases against soy foods, and that when tofu or other soy products are cooked to fit American recipes, more people tend to like it. She conducted hundreds of trials with customers, testing various recipes and consumer responses to see how Americans would ideally like to consume soy.
Now, Ballard has retired from both the university and from selling soy products direct to consumers from her farm, but other researchers at the Division of Agriculture will continue her efforts. A large part of her research was developing recipes that incorporate soy in American cuisine, such as "Soylicious Banana Pudding" and "Chipotle Soylicious Bean Dip."
Though Hall's farm was successful among the alpha-gal community, Ballard found much more success with vegans and vegetarians. She does think there is an opportunity for more soy adoption in the alpha-gal community, but said that because people with the allergy don't choose to stop eating animals, they're usually looking for animal-based alternatives to the foods they can't eat anymore.
While their diagnosis of alpha-gal may have upended their lives for some time, both Hall and Ballard believe they've ended up in better places years after their diagnosis despite the challenges.
"I don't have any doubt that it has increased my quality of life and it has increased my longevity because of the health side effects of not eating so much saturated fat. I had a cholesterol level at 25 of like 250 and everyone in my family practically has heart disease. I have the genes for that," Ballard said. "Nutrition was never part of that discussion, so [alpha-gal syndrome] caused me to learn about nutrition and learn about how much power we have over the quality of our years and the length of them. I had never previously connected the dots on how what I ate could change all my health numbers."
For Hall, she loves being out on her land with the birds, and providing a service to so many people struggling to adapt their diets like she did years ago. There aren't many emu farmers in the country, but she thinks emu farming will become more popular as time goes on and more people are diagnosed.
"The thing about emus is you can grow a lot of them on a smaller footprint," she said. "You don't need 100 acres, you can raise a pretty appreciable mob on five acres. They need space to thrive, but they also don't eat a lot of grass."