Abstract
Although residents of Lyme disease-endemic regions describe frequent exposure to ticks, Lyme disease develops in relatively few. To determine whether people who experience cutaneous hypersensitivity against tick bite have fewer episodes of Lyme disease than those who do not, we examined several factors that might restrict the incidence of Lyme disease among residents of Block Island, Rhode Island. Of 1,498 study participants, 27% (95% confidence interval [CI] 23%-31%) reported > or = 1 tick bites, and 17% (95% CI 13%-21%) reported itch associated with tick bite in the previous year. Borrelia burgdorferi infected 23% (95% CI 20%-26%) of 135 nymphal Ixodes scapularis (I. dammini) ticks. The likelihood of Lyme disease infection decreased with >3 reports of tick-associated itch (odds ratio 0.14, 95% CI 0.94-0.03, p = 0.01). Prior exposure to uninfected vector ticks protects residents of disease-endemic sites from Lyme disease.
Highlights
Most of Centers for Disease Control and Prevention (CDC)’s surveillance systems are passive, which means they rely on physicians, laboratory and hospital staff, and others to take the initiative in reporting data to health departments
In 1996, public health officials used surveillance data to detect an outbreak associated with Escherichia coli (E. coli) O157:H7, which made 66 people ill and killed 1 after they drank unpasteurized apple juice
Surveillance systems can detect only a fraction of disease cases because not all people who contract foodborne diseases seek treatment, are properly diagnosed, have their diagnoses confirmed through laboratory analysis, and have their cases reported through the surveillance systems
Summary
These officials rely on surveillance data to focus their staff and financial resources on preventing and controlling the foodborne diseases that most threaten public health. Most of CDC’s surveillance systems are passive, which means they rely on physicians, laboratory and hospital staff, and others to take the initiative in reporting data to health departments.
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