title: Tick exposure and Lyme disease at a summer camp in Maryland.
abstract: After investigating an outbreak of Lyme Disease among counselors at a summer camp in Kent County, Maryland in 1994, we wanted to determine the incidence of Lyme Disease (LD) at the camp the following summer and identify risk factors for tick exposure. Any ticks that were detected on campers' skin or clothing were collected by the camp nurse and we studied them for infection with Borrelia burgdorferi. In addition, we sent detailed questionnaires home with the 1,623 campers. A total of 537 campers returned the questionnaire and 200 had found ticks on their skin or clothing while at camp. Risks were analyzed using logistic regression models. Participation in the ropes-course, night-trip and camp-out events significantly increased the risk of tick exposure (OR 1.6 to 2.3). Six cases of LD were identified among campers, which was an estimated incidence of 3.3 per 1,000 campers/10-14 day camp session, and two counselors had LD. Of the 238 ticks collected mainly in June-July 1995, 19% were identified as Ixodes scapularis larvae and nymphs; 11% of the latter were infected with B. burgdorferi. The risk for LD in campers and staff was much higher than that of the general population despite the use of tick-exposure precautions. Focused interventions need to be put in place in summer camps to prevent transmission of LD.
authors.affiliation: Dept. of Medicine, West Virginia University School of Medicine, Morgantown, USA.
authors.forename: Arif R
authors.initials: AR
authors.lastname: Sarwari
authors.forename: Thomas
authors.initials: T
authors.lastname: Strickland
authors.forename: Cesar
authors.initials: C
authors.lastname: Pena
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Burkot
mesh_terms: D000293:Adolescent; D000818:Animals; D025065:Borrelia burgdorferi / Q000302:isolation & purification*; D002165:Camping; D002648:Child; D003625:Data Collection; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000453:epidemiology*; D008297:Male; D008396:Maryland / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons; D011795:Surveys and Questionnaires; D013987:Ticks / Q000382:microbiology; D013997:Time Factors