To the Editor: A 40-year-old man working in the meat industry reported that he had experienced rhinorrhea, sneezing, lacrimation, and ocular itching immediately after handling minced beef in the preparation of ham burgers. During this activity, he had added a commercial flavoring (SHTC) to the minced meat (40 g of flavoring per kilogram of meat). The label of the commercial flavoring listed the following ingredi ents: salt, starch, spices, E-22l (sodium sulfite), E-224 (potassium metabisulfite), E-301 (sodium ascorbate), E-33l (citrate), and E-120 (cochineal). The patient eats beef with no adverse symptoms. After obtaining informed consent, we investigated the patient and 3 healthy control subjects. We conducted skin prick testing with the commercial flavoring by the prick-prick method. I A lO-mm wheal and a 19-mm flare were observed in the patient IS minutes after testing. Results of skin prick testing with starch, cochineal, and raw beef were negative. When questioned, the manufacturer revealed that the spices included in the commercial flavoring were ginger, black pepper, and nutmeg. Skin prick test results were posi tive only with a ginger extract (I mglmL; wheal diameter, 12 mm; flare diameter, 30 mm) and fresh ginger (wheal diameter, 25 mm; flare diameter, 40 mm); they were negative with black pepper and nutmeg extracts. The 3 control subjects showed no response to any of the agents tested. Ginger-specific IgE levels (CAP-RAST Sys tem, Pharmacia Diagnostic) were above 100 kUA/L. No specific IgE was detected with black pepper or nutmeg extracts. By CAP RAST inhibition assays, the patient's IgE antibody was found to be inhibited by ginger extract but not by the other spices included in the commercial flavoring. SDS-PAGEI immunoblotting studies of ginger extract showed an IgE-binding component with a molecular