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On a June night in 2022, 16-year-old Jeremy Webb was camping with friends on the New South Wales Central Coast, north of Sydney, when he vomited and began having difficulty breathing after eating beef sausages.

He ran from the campground to knock on the window of a nearby camper van, and asked the occupants to call an ambulance. Then he collapsed.

His friends administered CPR until the ambulance officers arrived at 11:26pm, but to no avail. He was declared dead at hospital just over an hour later. .

Webb’s death was originally attributed to asthma. But a coronial inquest has now found an allergic reaction to meat – triggered by a tick bite – caused the acute asthma attack.

It is the first documented fatal case of mammalian meat allergy in Australia.

Prof Sheryl van Nunen, a clinical immunologist and allergist at the National Allergy Centre of Excellence, is only aware of one other case in the world: that of a 47-year-old pilot in New Jersey, who died in 2024.

“Jeremy was the first worldwide,” Van Nunen told Guardian Australia.

The inquest followed extensive advocating from Jeremy’s parents, who wanted to improve public awareness about the issue. In findings handed down on Thursday, the deputy NSW state coroner Carmel Forbes, said that “Jeremy died as a result of anaphylaxis due to mammalian meat allergy after tick bite, causing an acute exacerbation of asthma”.

Mammalian meat allergy after a tick bite is known as alpha-gal syndrome in the US but was first described by allergy specialists in Australia.

The association has since been confirmed by researchers on all six continents where tick bites occur, according to the Australasian Society of Clinical Immunology and Allergy (Ascia).

The allergen associated with reactions, alpha-gal, is a sugar molecule present in the saliva and gut of ticks, as well as many mammals, including beef, lamb, pork, goat, kangaroo, and venison.

The allergic response to meat can present any time after a tick bite, even months or years after the initial bite, according to Ascia. Blood tests may assist in confirming a diagnosis.

The symptoms occur three to six hours after eating meat, because that is the time it takes to digest the food and for the alpha-gal to be released, Van Nunen said. Symptoms can range from gastrointestinal symptoms to welts and swellings and anaphylaxis.

Irritable bowel-like symptoms are the most common, and Acasia recommends people living in tick-infested areas who experience regular gut discomfort should be screened for the alpha-gal allergy. The allergy can also be triggered by mammalian products including milk and gelatin.

Preventing a tick bite from occurring is the most important strategy, Van Nunen said. If a bite does occur, she recommended people make sure the tick is removed correctly and check the Tick Anaphylaxis and Mammalian Meat Allergy Resources (Tiara) website.