title: Lyme disease knowledge, beliefs, and practices of New Hampshire primary care physicians.
abstract: BACKGROUND
  Lyme disease is the most commonly reported vectorborne illness in the United States and is endemic in many counties in the Northeast, including counties in New Hampshire. Previous studies conducted elsewhere on Lyme disease have indicated substantial differences between physician practices and published consensus guidelines for diagnosis and treatment.
  
  
  METHODS
  During 1999, we mailed a 21-item questionnaire to 600 randomly selected family practice physicians, internists, and pediatricians in New Hampshire.
  
  
  RESULTS
  Respondents answered a median of 10 (76.9%) of 13 knowledge items correctly. Most physicians (73.6%) underestimated the incidence of erythema migrans among Lyme disease patients, and 41.2% would either test or offer treatment to an asymptomatic patient with deer-tick bite. When surveyed, most respondents (72.4%) planned to recommend Lyme disease vaccine to high-risk persons. Approximately one half (44.8%) reported giving empiric antibiotic treatment of Lyme disease solely because of patient concern.
  
  
  CONCLUSIONS
  New Hampshire primary care physicians indicated good knowledge about Lyme disease. Lack of awareness about Lyme disease diagnostic criteria, however, could contribute to misdiagnosis through overreliance on laboratory testing. Lyme disease vaccine appeared to be well accepted by physicians, although the vaccine has since been withdrawn from the US market. Both inappropriate management of tick bite and empiric treatment of unsubstantiated Lyme disease diagnoses were common.
authors.affiliation: Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Magri
authors.forename: Melissa T
authors.initials: MT
authors.lastname: Johnson
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Herring
authors.forename: Jesse F
authors.initials: JF
authors.lastname: Greenblatt
mesh_terms: D000954:Antigens, Surface / Q000008:administration & dosage; D001425:Bacterial Outer Membrane Proteins / Q000008:administration & dosage; D001428:Bacterial Vaccines; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D015994:Incidence; D008074:Lipoproteins; D008193:Lyme Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D009513:New Hampshire / Q000453:epidemiology; D010821:Physicians, Family / Q000523:psychology* / Q000592:standards; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000954:Antigens, Surface; D001425:Bacterial Outer Membrane Proteins; D001428:Bacterial Vaccines; D008074:Lipoproteins; C072045:OspA protein