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Strategies for primary and secondary prevention of Lyme disease

Nature Clinical Practice Rheumatology volume 3, pages 20–25 (2007)Cite this article

Abstract

Lyme disease (borreliosis) incidence continues to increase despite a growing knowledge of primary and secondary prevention strategies. Primary prevention aims to reduce the risk of tick exposure and thereby decrease the incidence of new Lyme disease cases. Secondary prevention targets the development of disease or reduces disease severity among people who have been bitten by infected ticks. Numerous prevention strategies are available, and although they vary in cost, acceptability and effectiveness, uptake has been universally poor. Research in areas where Lyme disease is endemic has demonstrated that despite adequate knowledge about its symptoms and transmission, many people do not perform behaviors to reduce their risk of infection. New prevention strategies should aim to increase people's confidence in their ability to carry out preventive behaviors, raise awareness of desirable outcomes, and aid in the realization that the necessary skills and resources are available for preventive measures to be taken. In this article we evaluate the prevention and treatment strategies for Lyme disease, and discuss how these strategies can be implemented effectively. As many patients with Lyme disease develop arthritis and are referred to rheumatologists it is important that these health-care providers can educate patients about disease-prevention strategies.

Key Points

  • Lyme disease is preventable, but its incidence continues to rise

  • Primary prevention strategies, from vector elimination to human vaccination, have intrinsic obstacles to implementation; none has been sustained successfully in communities at risk

  • Despite adequate knowledge about the symptoms and transmission of Lyme disease, many people who live in endemic areas do not practice any behaviors to prevent the disease

  • Prevention strategies should aim to increase people's confidence in their ability to perform preventive behaviors and to raise awareness that desirable outcomes are attainable

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Figure 1: Modified health belief model that incorporates self-efficacy.44

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Acknowledgements

The paper was supported in part by grants from the NIH and the Arthritis Foundation.

Author information

Authors and Affiliations

  1. KM Corapi is a medical student at the Royal College of Surgeons in Ireland.,

    Kristin M Corapi

  2. MI White is a Research Fellow and NA Shadick is an Assistant Professor of Medicine and the Director of the Lyme Disease Clinic at the Brigham and Women's Hospital, Boston, MA, USA.,

    Marc I White & Nancy A Shadick

  3. MH Liang is a Professor of Medicine at Harvard Medical School, Boston, MA, USA.,

    Matthew H Liang

  4. CB Phillips is the Director of Research Administration at New England Baptist Hospital, Boston, MA, USA.,

    Charlotte B Phillips

  5. LH Daltroy was the Associate Director of the Robert B Brigham Arthritis and Musculoskeletal Diseases Clinical Research Center at the Brigham and Women's Hospital, Boston, MA, USA.,

    Lawren H Daltroy

Authors
  1. Kristin M Corapi
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Correspondence to Kristin M Corapi.

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The authors declare no competing financial interests.

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Corapi, K., White, M., Phillips, C. et al. Strategies for primary and secondary prevention of Lyme disease. Nat Rev Rheumatol 3, 20–25 (2007). https://doi.org/10.1038/ncprheum0374

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