Lyme disease and preventive behaviors in residents of Nantucket Island, Massachusetts.
BACKGROUND
To determine the age-specific prevalence of Lyme disease and whether preventive behaviors on Nantucket Island correlate with Lyme disease, we surveyed island residents.


METHODS
A survey with questions on Lyme disease symptoms, history, and preventive behaviors was mailed to all residents. Respondents were stratified by likelihood of having had Lyme disease. A subsample was selected for examination, and then classified according to the Lyme disease national surveillance case definition.


RESULTS
The overall lifetime prevalence of Lyme disease for Nantucket residents was 15% (CI, 10%-19.8%): 19% among females, and 11% among males. The prevalence was highest among age groups 0-16 and 30-49 years. Overall, 86% of the population practiced at least one behavior. The most frequently reported preventive behavior was checking oneself for ticks (80%), followed by wearing protective clothing (53%), avoiding tick areas (34%), and using tick repellent (11%). Younger individuals practiced fewer preventive behaviors than older individuals (p=0.001). Although males reported greater tick exposure than females, females uniformly practiced preventive behaviors more frequently (p=0.001). The practice of preventive behaviors was not associated with a history of Lyme disease, but finding more than 5 ticks per year on oneself was (p=0.001).


CONCLUSIONS
Lyme disease is highly prevalent on Nantucket Island. Young people are particularly at risk and health education should emphasize preventive behaviors less frequently practiced: using tick repellent, avoiding tick areas, and wearing protective clothing.
Division of Rheumatology, Immunology and Allergy, Robert B. Brigham Multipurpose Arthritis and Musculoskeletal Diseases Center, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. cphillips@rics.bwh.harvard.edu
C B
CB
Phillips
M H
MH
Liang
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O
Sangha
E A
EA
Wright
A H
AH
Fossel
R A
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Lew
K K
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Fossel
N A
NA
Shadick
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D008193:Lyme Disease / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D012737:Sex Factors