5 Questions with Dr. Paulina Maldonado-Ruiz

Dr. Paulina Maldonado-Ruiz

This month, we check in with Dr. Paulina Maldonado-Ruiz, who recently accepted the position of assistant professor in medical entomology at the University of Arizona in Tucson, Ariz., where she plans to continue her research on tickborne disease. She posts updates of her research online at PaulinaMaldonadoRuiz.com.

1. Most pest management professionals (PMPs) are aware that a potentially deadly allergy to red meat can develop because of a bite from a lone star tick (Amblyomma americanum), but you could please expand a little on why it can happen?

Certainly. Alpha-gal syndrome (AGS) occurs when a lone star tick bite introduces alpha-gal-containing saliva. Alpha-gal (galactose-alpha-1, 3-galactose) is a carbohydrate, a molecule, and while this illness is not caused by a pathogen like most tickborne diseases, we can use the same principles to prevent it.

2. How can PMPs better communicate this risk to their customers in laymen’s terms?

There is still a lot that we do not know about AGS; however, I believe the best way to explain the risk to customers is like we do for any other tick-borne disease. They need to prevent tick bites by checking for ticks in their clothes and on their pets, and prevent disease by early tick removal. If you reside in an area where the lone star tick is prevalent, and you are exposed to tick bites, then you are at risk. Its geographical distribution includes the South, East, and Central United States, and it’s steadily expanding to new areas.

3. Are certain populations, such as children and the elderly, more susceptible than others? Or is the risk the same for everyone?

Great question! There is no evidence yet supporting that certain populations are at higher risk than others, but it’s something we’re looking into. What we can say is that anyone exposed to a lone star tick bite is at risk of developing AGS. Another important point is that while lone star ticks have been the only tick species associated with AGS, not everyone exposed to lone star tick bites develops the allergy. The causes for variation in human response are still unknown.

4. What precautions can PMPs and their customers take to avoid a bite?

As with any other tick-transmitted disease, there are several precautions everyone should take. Avoid grassy, wooded areas by staying on walking trails. You also can treat your gear and clothing with insect repellents and wear your socks over your pants if possible.

After potential outdoor exposure, conduct a thorough tick check immediately, making sure you check yourself, your clothes, and your pets. Taking a shower is ideal. If there are any attached ticks, they should be removed immediately. Our research suggests that early tick removal may help prevent AGS, as shown with other pathogen-associated tickborne illnesses such as Lyme disease, which is transmitted by deer ticks (Ixodes scapularis).

5. Now that you’re settling into your new role at the University of Arizona, what’s next in your tick research?

In previous research, we showed a large variation in alpha-gal levels in ticks during blood feeding on the same host, and a large variation in alpha-gal levels in ticks fed on different host blood (different human donors and different animals). Our findings suggest tick and host individual variation may be the key to uncovering specific factors in AGS risk and prevention assessment.

As a result, I’m currently focused on uncovering the genetic and molecular tick causal factors contributing to AGS in different tick species, and the specific host factors that may be associated with the development of AGS. This way, we could potentially identify who is most at risk and what we can do to minimize it. We also are looking at new strategies for tick management by better understanding the tick gut-microbe interphase.