The public health risks of Lyme disease in Breckland, U.K.: an investigation of environmental and social factors.

This paper considers the public health risks of Lyme disease, a borrelial infection transmitted to humans chiefly by nymphal Ixodes ticks. A study undertaken in the Breckland area of East Anglia, U.K., combined analysis of the spatial and temporal factors affecting tick activity at recreational sites with a survey of current levels of disease awareness among visitors to these locations. Significant relationships were found between densities of questing ticks and vegetation type, relative humidity and temperature. More than two thirds of the general public visiting the sites were aware ticks could carry diseases, but only 13% recognized an unfed nymph, and under half knew that Lyme disease could be contracted from tick bites. Such results need to be taken into account when formulating public health and education measures.