title: Effectiveness of Residential Acaricides to Prevent Lyme and Other Tick-borne Diseases in Humans.
abstract: In the northeastern United States, tick-borne diseases are a major public health concern. In controlled studies, a single springtime application of acaricide has been shown to kill 68%-100% of ticks. Although public health authorities recommend use of acaricides to control tick populations in yards, the effectiveness of these pesticides to prevent tick bites or human tick-borne diseases is unknown.
  
  
  
  We conducted a 2-year, randomized, double-blinded, placebo-controlled trial among 2727 households in 3 northeastern states. Households received a single springtime barrier application of bifenthrin or water according to recommended practices. Tick drags were conducted 3-4 weeks after treatment on 10% of properties. Information on human-tick encounters and tick-borne diseases was collected through monthly surveys; reports of illness were validated by medical record review.
  
  
  
  Although the abundance of questing ticks was significantly lower (63%) on acaricide-treated properties, there was no difference between treatment groups in human-tick encounters, self-reported tick-borne diseases, or medical-record-validated tick-borne diseases.
  
  
  
  Used as recommended, acaricide barrier sprays do not significantly reduce the household risk of tick exposure or incidence of tick-borne disease. Measures for preventing tick-borne diseases should be evaluated against human outcomes to confirm effectiveness.
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado.
authors.forename: Alison F
authors.initials: AF
authors.lastname: Hinckley
authors.affiliation: Connecticut Emerging Infections Program, Yale School of Public Health, New Haven.
authors.forename: James I
authors.initials: JI
authors.lastname: Meek
authors.affiliation: Connecticut Emerging Infections Program, Yale School of Public Health, New Haven.
authors.forename: Julie A E
authors.initials: JA
authors.lastname: Ray
authors.affiliation: Connecticut Emerging Infections Program, Yale School of Public Health, New Haven.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Niesobecki
authors.affiliation: Western Connecticut State University, Danbury.
authors.forename: Neeta P
authors.initials: NP
authors.lastname: Connally
authors.affiliation: Maryland Department of Health and Mental Hygiene, Baltimore.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Feldman
authors.affiliation: Maryland Department of Health and Mental Hygiene, Baltimore.
authors.forename: Erin H
authors.initials: EH
authors.lastname: Jones
authors.affiliation: New York State Department of Health, Albany.
authors.forename: P Bryon
authors.initials: PB
authors.lastname: Backenson
authors.affiliation: New York State Department of Health, Albany.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: White
authors.affiliation: New York State Department of Health, Albany.
authors.forename: Gary
authors.initials: G
authors.lastname: Lukacik
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado.
authors.forename: Ashley B
authors.initials: AB
authors.lastname: Kay
authors.affiliation: New York State Department of Health, Albany.
authors.forename: Wilson P
authors.initials: WP
authors.lastname: Miranda
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Mead
mesh_terms: D056810:Acaricides / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009511:New England; D010919:Placebos / Q000008:administration & dosage; D011722:Pyrethrins / Q000008:administration & dosage; D064927:Tick Bites / Q000453:epidemiology / Q000517:prevention & control*; D017282:Tick-Borne Diseases / Q000453:epidemiology / Q000517:prevention & control*; D013987:Ticks / Q000187:drug effects* / Q000254:growth & development*; D055815:Young Adult
chemical_list: D056810:Acaricides; D010919:Placebos; D011722:Pyrethrins; C099952:bifenthrin
keywords: Lyme disease; acaricide; humans; pesticide; prevention; tick-borne diseases; ticks