STUDY: Many people do not routinely protect themselves against bites from disease-carrying ticks.

JOURNAL: American Journal of Preventive Medicine 2002;29

AUTHORS: Dr. Timothy F. Jones

ABSTRACT: Many people do not routinely protect themselves against bites from disease-carrying ticks, according to the results of a new US study.

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COMMENTARY: What is most surprising, or disheartening, is that people don't adhere very well to pretty basic preventive recommendations," said study lead author Dr. Timothy F. Jones from the Tennessee Department of Health in Nashville.

Jones and his colleagues focused on the use of insect repellent by 1,820 Tennessee residents included in a nine-state telephone survey conducted by the Centers for Disease Control and Prevention (CDC) in Atlanta between February 2000 and February 2001. Although people of all ages were included, more than two thirds of the respondents were between 16 and 60. Almost 40% were male, and nearly 80% were white.

In the July issue of the American Journal of Preventive Medicine, the authors report that only one quarter of those surveyed said they used insect repellent before entering a tick-infested area and also checked their bodies for ticks after leaving. Over 60% said they ever used repellent in such situations, while 29% said they always did. Women and whites generally used repellent more often than men and blacks, respectively.

One in six respondents said a tick had bitten them in the past year. Multiple bites, however, did not seem to drive preventive messages home, the researchers found. Although 12% of those surveyed said they had been bitten at least twice in the past year, less than half of this group said they usually put on repellent in appropriate situations.

Among the more than 40% of those surveyed who owned dogs, about one-quarter said they had picked ticks off their pets using their bare hands--despite public health advisories to avoid such contact. Dog owners were much more likely to report at least one tick bite in the past year than non-owners.

Vulnerability to tick bites appeared to be related to location, the investigators found--with more than one third of rural residents reporting tick bites, compared with about 10% of urban residents and about 18% of suburban residents. Rural residents were, however, less likely than non-rural residents to use insect repellent.

Jones and his team note that in the absence of vaccines for any tick-borne illness other than Lyme disease (which is now being withdrawn from the market), education efforts must be ratcheted up to better promote effective and easy-to-follow bite prevention measures.

If there are easy steps you can take to protect yourself from some pretty severe diseases--even if they're relatively rare--then it's certainly worth doing. "It's kind of like putting on your seatbelt. After you've done it for a while you don't even think about it."

In 1999, there were over 16,000 cases of Lyme disease, 579 cases of Rocky Mountain spotted fever, and 302 cases of ehrlichiosis diagnosed in the US. Tennessee is one of three states that account for nearly half of US Rocky Mountain spotted fever cases.

Remember that an ounce of prevention can go a long way to avoid serious consequences.