Alpha-Gal on the Rise: The Alarming Growth of Alpha-Gal Syndrome in High-Risk Regions.

Background Mammalian meat allergy (MMA), increasingly linked to delayed hypersensitivity reactions such as alpha-gal syndrome, is a growing public health concern. This study evaluates the incidence, prevalence, and incidence rate of MMA in a large, diverse population of over 114 million individuals across two time periods (2015-2020 and 2021-2025), with stratification by age, sex, race, and ethnicity. Methods Using longitudinal electronic health record data, we calculated incidence proportion, prevalence, and incidence rate (cases per person-day) for MMA diagnoses. Analyses were stratified by demographic factors and compared across time windows. Predictive modeling was used to estimate future trends in high-risk populations. Results MMA increased dramatically across all demographics. Overall incidence proportion rose by over 5,500%, with the most substantial increases observed in individuals over 40 years old. Age-stratified analysis within racial groups revealed particularly sharp increases among Black (9,530%) and Hispanic (7,678%) adults over 40. Females experienced a steeper rise in incidence rate (11,169%) than males (7,426%). Predictive modeling projects continued growth through 2030, with incidence proportions in Black and Hispanic populations expected to increase by 57% and 72%, respectively. Conclusion MMA is emerging as a rapidly increasing diagnosis, particularly among middle-aged and older adults in racially diverse populations. These findings highlight the need for targeted public health efforts, including clinician education, adult-focused screening, and prevention strategies - especially in communities with rising allergy rates. Enhanced awareness and early identification are critical to mitigating the rising burden of this potentially life-threatening allergic condition.