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To determine the age-specific prevalence of
Lyme disease and whether preventive behaviors on Nantucket Island correlate with
Lyme disease, we surveyed island residents.
A survey with questions on
Lyme disease symptoms, history, and preventive behaviors was mailed to all residents. Respondents were stratified by likelihood of having had
Lyme disease. A subsample was selected for examination, and then classified according to the
Lyme disease national surveillance case definition.
The overall lifetime prevalence of
Lyme disease for Nantucket residents was 15% (CI, 10%-19.8%): 19% among females, and 11% among males. The prevalence was highest among age groups 0-16 and 30-49 years. Overall, 86% of the population practiced at least one behavior. The most frequently reported preventive behavior was checking oneself for ticks (80%), followed by wearing protective clothing (53%), avoiding tick areas (34%), and using tick repellent (11%). Younger individuals practiced fewer preventive behaviors than older individuals (p=0.001). Although males reported greater tick exposure than females, females uniformly practiced preventive behaviors more frequently (p=0.001). The practice of preventive behaviors was not associated with a history of
Lyme disease, but finding more than 5 ticks per year on oneself was (p=0.001).
Lyme disease is highly prevalent on Nantucket Island. Young people are particularly at risk and health education should emphasize preventive behaviors less frequently practiced: using tick repellent, avoiding tick areas, and wearing protective clothing.