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.
Phillips
C B
CB
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
Liang
M H
MH
Sangha
O
O
Wright
E A
EA
Fossel
A H
AH
Lew
R A
RA
Fossel
K K
KK
Shadick
N A
NA
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