Increase in Ticks and Lyme Borreliosis, Yet Research into Its Prevention on the Wane.

There is increased concern about the upward incidence of Lyme Borreliosis (LB) in Europe, the United States, Asia, and Northern Africa. However, effective measures to control tick populations or vaccines for LB are not yet available. Therefore, behavioral measures including avoidance of areas inhabited by ticks, performing routine body checks, using protective clothing, and the application of tick repellents are of great importance. Unfortunately, acceptance and uptake of many of these preventive behaviors are currently low. Hence, effective health education and public health communication aimed at promoting the uptake of preventive behaviors regarding tick bites and LB are urgently needed. In 2012, Mowbray recommended to conduct more research aimed at improving evidence-based insights regarding the promotion of preventive behaviors among the general public when exposed to the risk of LB. We fully agree with Mowbray and repeated her systematic review in May 2015 covering the period 1995-May 2015. Unfortunately, our review yielded exactly the same studies as already included in the review by Mowbray. Therefore, we again sound the alarm bell, just as Mowbray did a few years ago. As long as there are no effective measures for controlling tick populations and there is no vaccine available, we rely solely on health education and communication efforts to prevent tick bites and LB. We call on researchers and funders to prioritize research in the field of public health interventions for tick bites and LB because, in the words of Benjamin Franklin, "an ounce of prevention is worth a pound of cure."