We describe a case of alpha-gal syndrome (AGS) in a resident of Washington, USA, after local Ixodes pacificus tick bites, which were associated with IgE increases after diagnosis. AGS should be considered a potential cause of anaphylactic and allergic reactions in persons with tick exposures, regardless of geographic residence.
Keywords: Ixodes pacificus; United States; Washington; alpha-gal syndrome; anaphylaxis; parasites; surveillance; tick bite; vector-borne infections; zoonoses.