Fork That Tick home

Take the allergy abroad.

The tick took the bratwurst. It doesn't get the whole trip. See the world, just with more questions for your waiter than the average tourist.

Start with your allergist. Ask what you should carry, what you can tolerate and what to do if you react far from home. Your plan beats anything on this page.

Before you go

  • Pack more medicine than you need. Bring enough for the whole trip plus extra for delays. If epinephrine is prescribed for you, FARE says to carry two doses at all times.
  • Keep the original labels. The CDC says officials at the border may ask to see medications in their original prescription containers.
  • Get a doctor's letter. Ask for one on letterhead listing each medication by generic name, its dose and why you need it. The CDC says a translation can help.
  • Check the rules for your destination. Medication rules vary, so check with that country's embassy before you leave.
  • Be careful about buying medicine there. Ingredients can differ between brands and countries, and medicines can contain alpha-gal ingredients. Ask your doctor what to do if you run out.
  • Know how to get help. Look up the local emergency number and the nearest hospital for each stop. Show travel companions where your medicine is and how to use it.
  • Read your insurance policy. Ask whether it covers care abroad, pre-existing conditions and medical evacuation.

Flying

  • Keep epinephrine on you. TSA allows it, and FARE says not to put it in checked luggage or the overhead bin. Have the prescription label handy.
  • Tell the airline early, then tell them again. Let them know when you book, then remind the gate agents and flight crew.
  • Don't count on the meal. Requesting a vegetarian or vegan meal doesn't guarantee it fits your needs, so read the label or bring your own.
  • Pack food that's ready to eat. Airlines may not heat or chill it. Virgin Atlantic, for one, can't do either.
  • Check customs before you pack snacks. Food you bring has to meet security rules and the customs rules of your destination.
  • Ask about boarding early. Pre-boarding policies for food allergies vary by airline, so ask before you fly.

Ordering food

"Vegetarian" doesn't mean what you need it to mean. It may still include dairy, gelatin or meat stock, and some kitchens think a dish without visible meat counts. Even vegan dishes may be cooked in a shared kitchen.

  • Ask about the cooking, not just the dish. Ask what fat it's cooked in, what the broth is made from and whether it shares a grill or fryer with meat.
  • Say it's an allergy. A preference gets a shrug. A medical problem gets a conversation with the kitchen.
  • Call ahead. Contact hotels and restaurants before you arrive, while there's still time to make a plan.
  • Choose lodging with a kitchen. One safe meal a day makes the rest of the trip far less stressful.
  • Walk away when the answers are vague. "A little" meat stock is still meat stock. Hunger is annoying, and a reaction in a strange city is worse.

Your allergy card

Most servers abroad will never have heard of alpha-gal, so spell out the foods instead. Adjust this card with your allergist, then print it or keep a photo on your phone.

I have a serious food allergy

I am allergic to all mammal products (alpha-gal syndrome). A reaction can be life-threatening.

I cannot eat: beef, pork, ham, bacon, lamb, goat, venison, rabbit, organ meats, lard, animal fat, meat broth or stock, gravy and gelatin. [Add milk, butter, cream and cheese if dairy affects you.]

I can eat: chicken, turkey, duck, fish, seafood, eggs, vegetables and fruit.

Please do not cook my food in animal fat or meat broth, or on a surface or in oil used for meat.

Can you make a meal for me? Thank you.

Get the translation checked. Don't rely on a translation app for this. Words like "stock," "gelatin" and "animal fat" need to come through exactly, so have a professional translator or trusted native speaker review it.

Food by destination

These are examples to ask about, not rules for a whole country. They come mostly from travel writers, so treat them as a starting point. Recipes vary from kitchen to kitchen.

  • Spain

    Ham can season vegetable dishes and ham stock can turn up in croquettes. Beans may be cooked with chorizo.

  • Italy and Portugal

    Vegetable soup isn't automatically vegetable-only. Ask about meat stock in minestrone, and about "just a little" stock in Portuguese soups.

  • Central Europe and the Balkans

    Lard can show up in pastries and dough, including in Prague, Croatia and Slovenia. In Germany and Austria, check candy and fruit yogurt for gelatin.

  • Malaysia and Taiwan

    Lard is a common cooking fat at some Chinese stalls in Kuala Lumpur, and broths are often pork-based. Taiwanese guides warn that vegetables may be blanched in meat broth. Dedicated vegetarian stalls can be easier, but still ask about dairy.

  • Japan

    Ramen broth is often pork-based. Dashi, the common soup stock, is usually made with fish and kelp, but ask what's in your particular bowl.

  • Mexico

    Beans may be cooked with lard, so ask before you order them, even when they sound like the safe choice.

  • Morocco and Georgia

    Couscous broth can be meat-based in Morocco, and beans and soups can contain meat stock in Georgia.

Ticks abroad

The lone star tick isn't the only culprit. Alpha-gal has been linked to different ticks around the world, and the evidence is stronger for some than for others. Another bite can raise your alpha-gal antibody levels, so pack tick protection for hikes, gardens and tall grass.

  • Europe

    The castor bean tick is thought to be the main species.

  • Australia

    The Australian paralysis tick has been linked to alpha-gal.

  • Japan and Korea

    The Asian longhorned tick and others have been linked to it in Japan. One species is a possible link in Japan and Korea.

  • Central America

    The Cayenne tick group has been linked to cases in Panama.

  • Brazil, Ivory Coast and South Africa

    These are possible links only, with less evidence so far.

Pack for the trip

We keep travel-friendly food, medicine cases and tick protection in one place.

See travel gear

Rules change. This page is general information, not medical or legal advice. Confirm the details with your doctor, airline and destination's embassy before you travel.

Sources