Effectiveness of Personal Protective Measures to Prevent Lyme Disease

Marietta Vázquez,Catherine Muehlenbein,Matthew Cartter,Eugene D Shapiro,Starr Ertel,Edward B Hayes

doi:10.3201/eid1402.070725

Abstract

After the manufacture of Lyme vaccine was discontinued in 2002, strategies to prevent Lyme disease (LD) have focused on personal protective measures. Effectiveness of these measures has not been conclusively demonstrated. The aim of our case-control study was to assess the effectiveness of personal preventive measures in a highly disease-endemic area. Case-patients were persons with LD reported to Connecticut's Department of Public Health and classified as having definite, possible, or unlikely LD. Age-matched controls without LD were identified. Study participants were interviewed to assess the practice of preventive measures and to obtain information on occupational and recreational risk factors. Use of protective clothing was 40% effective; routine use of tick repellents on skin or clothing was 20% effective. Checking one's body for ticks and spraying property with acaricides were not effective. We concluded that use of protective clothing and of tick repellents (on skin or clothing) are effective in preventing LD.

Highlights

After the manufacture of Lyme vaccine was discontinued in 2002, strategies to prevent Lyme disease (LD) have focused on personal protective measures
In 2001, Phillips et al found that 80% of the surveyed residents of Nantucket reported checking their bodies for ticks after potential tick exposures, 53% used protective clothing, 34% reported routinely avoiding tick infested areas, and 11% reported routine use of tick repellents (7)
We found controls were more likely to be female; this difference could be explained by our method of identification and enrollment of controls, if women were more likely to be at home at the time of our call

Summary

Introduction

After the manufacture of Lyme vaccine was discontinued in 2002, strategies to prevent Lyme disease (LD) have focused on personal protective measures. In 2001, Phillips et al found that 80% of the surveyed residents of Nantucket reported checking their bodies for ticks after potential tick exposures, 53% used protective clothing (such as wearing long pants and long-sleeved shirts), 34% reported routinely avoiding tick infested areas, and 11% reported routine use of tick repellents (7). These researchers did not find a difference in reported frequency of LD among those who did and those who did not report preventive behavior. A study conducted in California by Lane et al found that outdoor occupations such as woodcutting were associated with an increased risk for LD (10)

Methods

Results

Conclusion