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. 2023 Dec;2(4):10.1002/puh2.136.
doi: 10.1002/puh2.136.

Tick bite risk factors and prevention measures in an area with emerging Powassan virus disease

Nicolette Wilson  1   2 , Grace M Vahey  3   4 , Emily McDonald  3   4 , Kelly Fitzpatrick  4 , Jennifer Lehman  4 , Sandhya Clark  1 , Kristine Lindell  4 , Daniel M Pastula  4 , Stephen Perez  1   3 , Heather Rhodes  3 , Carolyn V Gould  4 , J Erin Staples  4 , Stacey W Martin  4 , Kim Cervantes  1
Affiliations

Tick bite risk factors and prevention measures in an area with emerging Powassan virus disease

Nicolette Wilson et al. Public Health Chall. 2023 Dec.

Abstract

Background: In the United States (U.S.), Powassan virus is primarily transmitted to humans by the black-legged tick (Ixodes scapularis). Rarely, infections can present as severe neuroinvasive disease. In 2019, four neuroinvasive disease cases were reported in Sussex County, New Jersey, U.S. We administered a survey to county residents to better understand tick bite risk factors and the performance of personal prevention measures.

Methods: A survey was administered in October 2019 to adult residents of randomly selected households. Questions focused on tick bite prevention and risk factors. Crude and adjusted odds ratios (ORs) and 95% confidence intervals were calculated for various outcomes.

Results: Of 274 participants, 25% were previously diagnosed with a tick-borne disease, and 42% reported finding an attached tick in 2019. Yardwork and gardening (OR = 7.38) and spending >50 hours outdoors per week (OR = 8.15) were associated with finding an attached tick. Finding an attached tick was inversely associated with the number of prevention measures used, indicating that a layered approach could reduce the risk of tick bites. Those who performed post-outdoor activity prevention measures (e.g., tick checks) were less likely to have a tick attached compared to finding a crawling tick.

Conclusion: Compliance with prevention recommendations was low, despite a high prevalence of reported tick bites and significant outdoor exposures. Older adults and persons who spend significant time outdoors or engage in yardwork or gardening were at the highest risk of tick bites. Additional research is needed to further understand the barriers to tick bite prevention.

Keywords: Powassan virus; prevention; risk factors; tick-borne disease; ticks.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT The authors do not have any conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Additive effect of using one or more prevention measures to reduce odds of tick bites. Comparison of the odds ratios of finding a tick attached in relation to the number of prevention measures used. Prevention measures include both pre-and post-activity prevention measures.
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