Impact of Lyme disease prevention forums - Maine, 2013
Sarah Levine , Sara Robinson , Anne Redmond Sites , Johanna Mackenzie , Megan Saunders
Maine Center for Disease Control and Prevention; 2 Walden University; 3 Simon Fraser University; 4University of Maryland, College Park
Maines case rate for Lyme disease was 83.7 cases per
100,000 persons in 2012, which was an all-time high.
Lyme disease is the most common vector-borne disease
reported in the US and the 3rd most commonly reported
infectious disease in Maine.
In order to prevent the transmission of Lyme disease, quick
identification of a tick and prompt removal are critical. 1
The rate of transmission increases exponentially the longer
the tick is attached from 24 to 72 hours. 1
The use of protective behaviors to prevent Lyme disease has
been shown to be significantly correlated to knowledge of the
In order to educate Mainers to protect themselves from ticks
and Lyme disease, public forums were planned by Maine CDC
Of the 168 participants who signed in at the forums, 85 (50%) completed the
paper-based questionnaire. Of those 85 participants, 62 (73%) reported a
medium to high level of knowledge about ticks or Lyme disease prior to the
Of the 168 participants who signed in at the forums, 110 (68%) provided an
email address and were asked to complete an electronic-based survey. Of
those 110 participants, 34 (31%) completed the survey and 33 (97%) of
those participants reported a medium to high level of knowledge about ticks
or Lyme disease after the forums.
Eight Lyme disease forums were held in public health districts
from May 1 August 31, 2013.
An epidemiologist provided Lyme disease prevention
messages and an expert panel of health care providers,
biologists, veterinarians, and epidemiologists answered
Participants completed a paper-based questionnaire about
their knowledge of ticks and Lyme disease at the end of the
Participants who provided an email address were asked to
complete an electronic-based survey via SurveyMonkey after
all forums were completed.
3. Name this tick (Deer, Dog)
4. Which of these ticks carries Lyme
10. Have you done a tick check since
Knowledge of Lyme disease or ticks, before and after the forums Maine, 2013
variabilis (Dog tick)
Participants in the Lyme disease forums reported an increase in
knowledge of ticks and Lyme disease.
In addition, the majority of participants reported completing tick
checks as part of a Lyme disease prevention plan.
Although participant responses to the paper-based questionnaire
and electronic-based survey were not linked, it appears this health
education and outreach effort was successful in promoting Lyme
disease awareness and prevention.
Additional evaluation of community education efforts is needed to
see if these health behaviors are sustained over time.
District Lyme forum locations Maine 2013
Participant knowledge level
Participant responses to the paper-based questionnaire and the
electronic-based survey are not linked.
Surveys are a self-reported and voluntary measures and therefore
may be vulnerable to biases.
Lyme disease forum survey and results - Maine 2013
1. Please rank your current level of tick or Lyme Disease knowledge :
Low, Medium, High, Expert
2. Please rank the following topics as to which you are most interested in?
Diagnosis/Treatment, General information, Lyme and animals, Pesticides, Prevention,
Tick biology/ecology, Other (please explain)
3. Name this tick:
Deer, Dog (pictures) 85% correct
4. Which of these tick carries Lyme disease?
Deer, Dog (pictures) 100% correct
5. Which of these are part of the 4 prevention messages against Lyme?
Wear protective clothing, use repellent, use caution in tick infested areas, perform
daily tick checks, install and repair screens, drain artificial sources of standing water, cover
your cough 98% correct
6. How long do ticks need to be attached to transmit Lyme disease?
30 minutes, 12 hours, at least 24 hours, at least 48 hours, 5 days 74% correct
7. How long should you monitor for signs and symptoms after a tick bite?
1 year, 90 days, 30 days, 7 days, 3 days 53% correct
8. How do ticks move?
Jump, fly, walk, jive 67% correct
9. What is the best method to remove a tick (select all that apply)
Fire, tick spoon, tweezers, Vaseline 97% correct
10. Have you done a tick check since the forum? (Y/N) 88% YES
11. How likely are you to recommend a Lyme forum to a friend? 91% Likely/Very Likely
12. Anything else you would like us to know?
Piesman J, Mather TN, Sinsky RJ, Spielman A. Duration of tick
attachment and Borrelia burgdorferi transmission. J Clin Microbiol
Hannah GL, Nelson RS, Griffith KS, Hayes EB, Piesman J, Mead PS,
Cartter ML. Knowledge, attitudes, and behaviors regarding Lyme
disease prevention among Connecticut residents, 1999-2004. Vector
Borne Zoonotic Dis. 2008;8(6):769776.
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