U.S. public's experience with ticks and tick-borne diseases: Results from national HealthStyles surveys

Abstract

Surveillance data indicate that tick-borne diseases (TBDs) are a substantial public health problem in the United States, yet information on the frequency of tick exposure and TBD awareness and prevention practices among the general population is limited. The objective of this study was to gain a more complete understanding of the U.S. public's experience with TBDs using data from annual, nationally representative HealthStyles surveys. There were 4728 respondents in 2009, 4050 in 2011, and 3503 in 2012. Twenty-one percent of respondents reported that a household member found a tick on his or her body during the previous year; of these, 10.1% reported consultation with a health care provider as a result. Overall, 63.7% of respondents reported that Lyme disease (LD) occurs in the area where they live, including 49.4% of respondents from the West South Central and 51.1% from the Mountain regions where LD does not occur. Conversely, in the New England and Mid-Atlantic regions where LD, anaplasmosis, and babesiosis are common, 13.9% and 20.8% of respondents, respectively, reported either that no TBDs occur in their area or that they had not heard of any of these diseases. The majority of respondents (51.2%) reported that they did not routinely take any personal prevention steps against tick bites during warm weather. Results from these surveys indicate that exposure to ticks is common and awareness of LD is widespread. Nevertheless, use of TBD prevention measures is relatively infrequent among the U.S. public, highlighting the need to better understand barriers to use of prevention measures.

Methods to Prevent Tick Bites and Lyme Disease

“…60 There are a myriad of explanations for poor adherence, ranging from inconvenience, to concern about product safety, to perceptions and beliefs about the threat of Lyme disease. Unfortunately, there are no clear solutions to this problem.…”

Relative Risk for Ehrlichiosis and Lyme Disease in an Area Where Vectors for Both Are Sympatric, New Jersey, USA

“…The infection tends to manifest as a general influenza-like illness, and onset of a rash is rare (12), so persons may be less likely to visit a doctor unless more severe symptoms emerge or they are aware of a recent tick bite and the presence of tickborne diseases in the area. Awareness of nonLyme disease tickborne illnesses is startlingly low, even in parts of the country where ehrlichiosis cases outnumber Lyme disease cases (33)(34)(35). One study found that >50% of respondents in the United States had heard of Lyme disease, whereas only 1.4% had heard of ehrlichiosis (35).…”

“…Awareness of nonLyme disease tickborne illnesses is startlingly low, even in parts of the country where ehrlichiosis cases outnumber Lyme disease cases (33)(34)(35). One study found that >50% of respondents in the United States had heard of Lyme disease, whereas only 1.4% had heard of ehrlichiosis (35). As a consequence of these factors, when active screening for ehrlichial infections is performed, the resulting case rates are often much higher than those reported to governmental agencies (3,36,37).…”

Molecular screening of ticks for the presence of Rickettsia species: A public health concern

“…Consequent upon this variation in the global distribution, availability and density in population of the tick vectors and reservoir hosts, the prevalence of tick-borne rickettsial pathogens varies from one ecological site to the other [8][9][10][11]. Across the globe, there are many studies that are currently being carried out with the sole aim of determining the significance for human health of tickborne diseases.…”