Advertisement

Risk perceptions regarding ticks and Lyme disease

a national survey
  • James E Herrington Jr
    Correspondence
    Address correspondence to: James E. Herrington, Jr., PhD, MPH, Office of Global Health, MS D-69, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta GA 30333, USA.
    Affiliations
    Office of Global Health, Centers of Disease Control and Prevention, Atlanta, Georgia, USA
    Search for articles by this author

      Abstract

      Background

      Lyme disease (LD) is caused by the tickborne bacterium Borrelia burgdorferi and, in 2000, accounted for >90% of all reported cases of vectorborne illness in the United States. Aside from anecdotal and indirect evidence, little empirical evidence exists regarding what the U.S. public knows, says, or does about preventing LD.

      Objectives

      To examine knowledge, perceptions, and practices regarding prevention of tick bites and LD.

      Methods

      In 1998, a random-digit-dial frame was used to collect a cross-sectional sample (n =1500) from the 48 coterminous states plus the District of Columbia, and an over-sample (n =250) from six states with the highest incidence of LD.

      Results

      Forty percent of respondents reported doing something to avoid being bitten by ticks. Less than half (41%) used insect repellent. Ninety-two percent of those who had heard about LD stated their likelihood of ever getting the disease was ≤50 on a 100-point scale (mean=29; standard deviation, 23.5). Being somewhat to very concerned about being bitten by ticks was strongly associated with taking preventive measures (odds ratio, 8.34; 95% confidence interval, 6.29–11.06).

      Conclusions

      Having seen ticks, being concerned about being bitten, perceiving insect repellent to be effective, having heard about LD, and knowing someone who had LD are the factors most predictive of specific tick-bite preventive behaviors (p <0.001). However, greater efforts are needed in promoting the effectiveness and safety of DEET-containing insect repellents.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Centers for Disease Control and Prevention
        Lyme disease—United States, 2000.
        MMWR Morb Mortal Wkly Rep. 2002; 51: 29-31
        • Wharton M.
        • Chorba T.L.
        • Vogt R.L.
        • Morse D.L.
        • Buehler J.W.
        Case definitions for public health surveillance.
        MMWR Morb Mortal Wkly Rep. 1990; 39: 19-21
        • Centers for Disease Control and Prevention
        Surveillance for Lyme disease—United States, 1992–1998.
        MMWR Morb Mortal Wkly Rep. 2000; 49: 1-11
        • Centers for Disease Control and Prevention
        Human granulocytic ehrlichiosis—New York, 1995.
        MMWR Morb Mortal Wkly Rep. 1995; 44: 593-595
      1. Fishbein DB, Dawson JE, Robinson LE.
        Human ehrlichiosis in the United States, 1985–1990. 1994; 120: 736-743
        • Centers for Disease Control and Prevention
        Epidemiologic notes and reports.
        MMWR Morb Mortal Wkly Rep. 1989; 38: 649-650
        • Varde S.
        • Beckley J.
        • Schwartz I.
        Prevalence of tick-borne pathogens in Ixodes scapularis in a rural New Jersey county.
        Emerg Infect Dis. 1998; 4: 97-99
        • Abramson J.S.
        • Givner L.B.
        Rocky Mountain spotted fever.
        Pediatr Infect Dis J. 1999; 18: 539-540
        • Paddock C.D.
        • Greer P.W.
        • Ferebee T.L.
        • et al.
        Hidden mortality attributable to Rocky Mountain spotted fever.
        J Infect Dis. 1999; 179: 1469-1476
        • Dennis D.T.
        Epidemiology, ecology, and prevention of Lyme disease.
        in: Rahn D.W. Evans J. Lyme disease. American College of Physicians, Philadelphia, PA1998: 7-34
        • Rahn D.W.
        • Evans J.
        Lyme disease.
        American College of Physicians, Philadelphia, PA1998
        • Hallman W.
        • Weinstein N.D.
        • Kadakia S.
        • Chess C.
        Precautions taken against Lyme disease at three recreational parks in endemic areas of New Jersey.
        Environ Behav. 1995; 27: 437-453
      2. Herrington JE. A national survey of risk perceptions and practices to prevent tick-borne Lyme disease and mosquito-borne viral encephalitis. PhD diss. Colorado State University, 2002

        • Schwartz B.S.
        • Goldstein M.D.
        Lyme disease in outdoor workers.
        Am J Epidemiol. 1990; 131: 877-885
        • Brown S.W.
        • Cartter M.L.
        • Hadler J.L.
        • Hooper P.F.
        Effectiveness in disease and injury prevention.
        Arch Dermatol. 1992; 128: 1171-1172
        • Cartter M.L.
        • Farley T.A.
        • Ardito H.A.
        • Hadler J.L.
        Lyme disease prevention.
        Conn Med. 1989; 53: 354-366
        • Shadick N.A.
        • Daltroy L.H.
        • Phillips C.B.
        • Liang U.S.
        • Liang M.H.
        Determinants of tick-avoidance behaviors in an endemic area for Lyme disease.
        Am J Prev Med. 1997; 13: 265-270
      3. Survey Research Center. Survey methods report, practicuum project 1334. College Park MD: University of Maryland, 1998

        • Glanz K.
        • Rimer B.K.
        • Lewis F.M.
        Health behavior and health education.
        3rd ed. John Wiley & Sons, San Francisco CA2002
      4. U.S. Census Bureau. Estimates of the population of states by age, sex, race and Hispanic origin. Washington DC: Government Printing Office, 1997

      5. U.S. Census Bureau. Educational attainment in the United States: March 1996 (update). Washington DC: Government Printing Office, 1997

        • Herrington J.E.
        • Campbell G.L.
        • Bailey R.E.
        • et al.
        Predisposing factors for individuals' Lyme disease prevention practices.
        Am J Public Health. 1997; 87: 2035-2038
        • Fradin M.S.
        Mosquitoes and mosquito repellents.
        Ann Intern Med. 1998; 128: 931-940
        • Fradin M.S.
        • Day J.F.
        Comparative efficacy of insect repellents against mosquito bites.
        N Engl J Med. 2002; 247: 13-18
        • Slovic P.
        Perception of risk.
        Science. 1987; 236: 280-285
        • Fischhoff B.
        Risk perception and communication unplugged.
        Risk Anal. 1995; 15: 137-145
        • Slovic P.
        • Kraus N.
        • Covello V.T.
        Comment.
        Risk Anal. 1990; 10: 389-392
        • Brick J.M.
        • Waksberg D.K.
        • Starer A.
        Bias in list-assisted telephone samples.
        Public Opin Q. 1995; 59: 218-235
        • Kristal A.
        • White E.
        • Davis J.
        • et al.
        Effects of enhanced calling efforts on response rates, estimates of health behavior, and costs in telephone health surveys using random-digit dialing.
        Public Health Rep. 1993; 108: 372-379
      6. U.S. Department of Commerce. Falling through the Net: defining the digital divide. A report on the telecommunications and information technology gap in America. Washington DC: National Telecommunications and Information Administration, 1999

        • Grimes D.A.
        • Schultz K.F.
        Descriptive studies.
        Lancet. 2002; 359: 145-149