Kentucky's application in response to Increasing awareness and knowledge of Alpha-gal Syndrome in the United States RFA-CDC CK-26-0193 - Kentucky Alpha-gal Learning, Education, Response & Tracking (KY-ALERT) is a statewide initiative led by the Kentucky Department for Public Health (KDPH) in partnership with the University of Kentucky (UK) to strengthen Alpha-gal Syndrome (AGS) surveillance, education, and response through integrated innovation, cross-sector collaboration, and targeted outreach to high-risk occupational populations. AGS is an emerging tickassociated allergic condition with growing national burden. Kentucky is consistently identified among the highest-incidence states in the U.S. due to widespread lone star tick exposure, rural geography, and high levels of outdoor occupational and recreational activity. Kentucky represents a uniquely high-risk environment for AGS due to its strong agricultural economy, extensive forestry and natural resource sectors, and widespread outdoor workforces. Agricultural producers, including family-based cattle operations, forestry workers, utilities personnel, construction workers, and outdoor recreation and tourism sectors experience sustained tick exposure, placing these populations at elevated risk for AGS. Kentucky’s agricultural identity and outdoor culture further increase both exposure risk and potential socioeconomic impact, making targeted surveillance and intervention essential for protecting both health and livelihoods. KY-ALERT is uniquely positioned to directly address these challenges and scale AGS response through a coordinated, multi-sector partnership. This infrastructure is complemented by longstanding partnerships with healthcare systems, local health departments, Extension agents, agricultural organizations, and industry stakeholders. The initiative will be guided by the Kentucky AGS Leadership Council, which brings together representatives from public health, healthcare, agriculture, veterinary medicine, academia, industry, community organizations, and individuals with lived experience. Letters of support from agricultural and industry partners further demonstrate broad partnership commitment and alignment. KY-ALERT also introduces an innovative electronic surveillance and engagement platform that integrates secure, automated text messaging with Kentucky’s National Electronic Disease Surveillance System (NEDSS). This system enables rapid patient outreach, allowing individuals to complete secure electronic questionnaires via mobile devices. Responses are automatically transmitted into surveillance systems using interoperable data standards, reducing manual data entry, improving timeliness, and increasing completeness of epidemiologic data. This approach modernizes AGS surveillance while reducing burden on local health departments and improving response rates among affected individuals statewide. In parallel, KY-ALERT will expand provider education, occupational risk communication, and public-facing resources tailored to highrisk populations. UK Cooperative Extension and KDPH communication systems will ensure dissemination to agricultural producers, outdoor workers, rural communities, and clinical providers, while leveraging trusted community-based networks to maximize reach and impact. By integrating innovative surveillance technology, occupationally focused outreach, and a deeply embedded statewide One Health partnership, KY-ALERT provides a scalable and sustainable model for AGS response. This initiative aligns with CDC priorities to Share, Educate, and Track, and establishes Kentucky as a national leader in addressing this emerging vector-borne allergy through coordinated surveillance, workforce engagement, and cross-sector collaboration
