{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:53:52Z","timestamp":1791816832108,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Lyme disease, the most commonly reported vector\u2010borne disease in the United States, is caused by the bacteria\n                    <jats:italic>Borrelia burgdorferi<\/jats:italic>\n                    and is transmitted through the bite of an infected blacklegged tick. In the absence of a licensed vaccine, the prevention of Lyme disease relies heavily on limiting tick exposure. Methods for limiting tick exposure include personal protection measures such as repellent use, wearing protective clothing, avoiding areas where ticks may be present, bathing after exposure to tick habitat and performing regular tick checks. Public health officials typically recommend all these personal protection measures; however, there is limited evidence to promote one behaviour or practice over another. The focus of this article is to review available literature that examines the effectiveness of recommended personal protection measures to prevent Lyme and other\n                    <jats:italic>Ixodes<\/jats:italic>\n                    \u2010transmitted diseases in humans. Articles included in this review were identified through Google Scholar and PubMed searches using specific search terms. We identified over 56,000 articles using Google Scholar and PubMed searches. Of those, 16 studies fit our criteria for inclusion and were reviewed in their entirety. Among the personal protection measures evaluated, no intervention was predominantly or consistently effective across studies, demonstrating that, currently, there is no single best method for primary prevention of\n                    <jats:italic>Ixodes<\/jats:italic>\n                    \u2010transmitted diseases in the United States. Frequently recommended practices such as tick checks, repellent use and protective clothing had mixed results across studies. Study design differences limited comparability among studies, and sample sizes for these studies may have been too small to detect statistically significant results even if a prevention method was effective. Though many of the reviewed personal protection measures are frequently recommended to the public, limited evidence demonstrates their ability to prevent tick\u2010borne disease. Additional standardized studies are needed to evaluate personal protection measures.\n                  <\/jats:p>","DOI":"10.1111\/zph.12984","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:54:21Z","timestamp":1657068861000},"page":"777-791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Effectiveness of personal protection measures against Lyme disease: A review of epidemiologic studies from the United States"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8244-7225","authenticated-orcid":false,"given":"Amy M.","family":"Schwartz","sequence":"first","affiliation":[{"name":"Bacterial Diseases Branch, Division of Vector Borne Diseases National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention  Fort Collins Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Montague","family":"Mackeprang","sequence":"additional","affiliation":[{"name":"Bacterial Diseases Branch, Division of Vector Borne Diseases National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention  Fort Collins Colorado USA"},{"name":"Association of Schools of Public Health (ASPH)  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Mead","sequence":"additional","affiliation":[{"name":"Bacterial Diseases Branch, Division of Vector Borne Diseases National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention  Fort Collins Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2853-5165","authenticated-orcid":false,"given":"Alison F.","family":"Hinckley","sequence":"additional","affiliation":[{"name":"Bacterial Diseases Branch, Division of Vector Borne Diseases National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention  Fort Collins Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010015\u20101539\u20102"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102458\u201013\u2010225"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/313532"},{"key":"e_1_2_9_5_1","unstructured":"California Department of Public Health. (2018).Vector\u2010borne disease section annual report 2017.https:\/\/westnile.ca.gov\/pdfs\/VBDSAnnualReport17.pdf"},{"key":"e_1_2_9_6_1","unstructured":"Centers for Disease Control and Prevention. (2011).Workplace safety and health topics: tick\u2010borne diseases.https:\/\/www.cdc.gov\/niosh\/topics\/tick\u2010borne\/recommendation.html"},{"key":"e_1_2_9_7_1","unstructured":"Centers for Disease Control and Prevention. (2019a).National notifiable diseases surveillance system 2019 annual tables of infectious disease data.https:\/\/wonder.cdc.gov\/nndss\/nndss_annual_tables_menu.asp"},{"key":"e_1_2_9_8_1","unstructured":"Centers for Disease Control and Prevention. (2019b January 3).Transmission.https:\/\/www.cdc.gov\/lyme\/transmission\/index.html."},{"key":"e_1_2_9_9_1","unstructured":"Centers for Disease Control and Prevention. (2020 February 19).Preventing tick bites. Retrieved fromhttps:\/\/www.cdc.gov\/lyme\/prev\/index.html"},{"issue":"4","key":"e_1_2_9_10_1","first-page":"625","article-title":"Repellents and acaricides as personal protection measures in the prevention of tick\u2010borne diseases","volume":"19","author":"Cisak E.","year":"2012","journal-title":"Annals of Agricultural and Environmental Medicine"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1995.53.237"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.04.026"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncprheum0374"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090198106294646"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tjw092"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114865"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084758"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2007.0221"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra021397"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.12.2035"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12810"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.7326\/AITC201605030"},{"key":"e_1_2_9_23_1","volume-title":"Critical needs and gaps in understanding prevention, amelioration, and resolution of Lyme and other tick\u2010borne diseases: The short\u2010term and long\u2010term outcomes: Workshop report","author":"Institute of Medicine","year":"2011"},{"issue":"12","key":"e_1_2_9_24_1","first-page":"677","article-title":"The prevalence of Borrelia burgdorferi seropositivity in an area endemic for Lyme disease","volume":"89","author":"Jochimsen E.","year":"1990","journal-title":"Wisconsin Medical Journal"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10393\u2010008\u20100171\u20103"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992289603500705"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2108.141878"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116448"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/142.supplement_9.s39"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745\u20107599.2004.tb00368.x"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2017.11.006"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tjaa061"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2019.07.008"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009462"},{"issue":"2","key":"e_1_2_9_35_1","first-page":"165","article-title":"Lyme disease in outdoor workers on Assateague Island: High tick\u2010exposure but low disease risk","volume":"42","author":"Parrott C.","year":"1993","journal-title":"Maryland Medical Journal"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749\u20103797(00)00315\u20109"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.25.3.557\u2010558.1987"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6717e1"},{"key":"e_1_2_9_39_1","volume-title":"Modern Epidemiology","author":"Rothman K. 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