Are Lyme disease prevention methods really working?
There are a growing number of measures promoted to prevent Lyme disease. Yet, the number of cases continues to grow. So, how effective are these prevention methods? To answer that question, Richardson and colleagues reviewed the literature on such recommendations. In their assessment, the authors used a modified Cochrane Risk of Bias tool.
by Daniel J. Cameron, MD, MPH
In the article “Interventions to prevent Lyme disease in humans: A systematic review,” Richardson writes, “In general the quality of evidence was low. There were typically only 1 to 3 studies and these had mixed results. 
Following are several personal protective measures promoted to prevent Lyme disease:
- Tick repellents and protective clothing: “Tick repellents and protective clothing may be associated with a lower incidence of Lyme disease (LD) (2 studies).”
- Tick checks: “Eﬀects were mixed for the association between tick checks and incidence of LD (2 studies).”
- Showering: “Bathing within 2 hours of being outside may be associated with a lower incidence of LD (1 study).”
- Treated clothing: “Permethrin-treated battle dress uniform (1 study) and Citriodiol insect repellent (1 study) may reduce the number of ticks crawling or bites.”
Following is a list of interventions intended to reduce tick bites:
- “Having a fence or stone wall, trimming overhanging branches, having a dry barrier, spraying the yard, and killing other pests may be associated with a lower incidence of LD (1 study).
- Mowing the lawn frequently, and having a vegetable garden, bird feeder, woods near the property, log pile and clearing leaves may be associated with a higher incidence of LD (1 study).
- Spraying properties reduces the frequency of ticks crawling or attached (1 study).
- Eﬀects were mixed for spraying property on the incidence of LD (3 studies).”
Richardson and colleagues’ findings reveal just how little we know about the effectiveness of the current strategies used to prevent tick bites.
As the authors state, “Tick repellents and protective clothing MAY be associated with a lower incidence of [Lyme disease].”
And, “Effects were MIXED for the association between tick checks and incidence of LD.”
Meanwhile, the incidence of Lyme disease grows. As we continue to promote these protection strategies, it’s important that their effectiveness in preventing tick bites continues to be investigated.
- Richardson M, Khouja C, Sutcliffe K. Interventions to prevent Lyme disease in humans: A systematic review. Prev Med Rep. 2019;13:16-22.