Intended for healthcare professionals

Letters Tick bite prevention and removal

Preventive behaviours regarding tick bites

BMJ 2014; 348 doi: (Published 15 January 2014) Cite this as: BMJ 2014;348:g231
  1. Rik Crutzen, senior researcher1,
  2. Desirée Beaujean, head of department guideline development and implementation2
  1. 1Maastricht University/CAPHRI, 6200 MD Maastricht, Netherlands
  2. 2RIVM, Centre for Infectious Diseases, Bilthoven, Netherlands
  1. rik.crutzen{at}

Due and colleagues provide an insightful overview of tick bite prevention and tick removal.1 However, we would like to raise three matters related to prevention.

Firstly, preventive strategies include avoidance of tick infested areas, use of protective clothing (such as wearing long sleeved shirts and long trousers), routine body checks for ticks after being outdoors, and the use of tick repellents. Except for body checks, compliance with these measures is low.2

Secondly, each of these behaviours has different determinants. For example, people believe that protective clothing interferes with their enjoyment (for example, wearing long clothes on a hot day), they do not know how to identify ticks, and they do not believe that tick repellents can effectively prevent tick bites.2 3 Insight into determinants underlying preventive behaviours is essential for developing effective health education material.

Thirdly, health education materials and prevention research on tick bites currently focus on adults, but children are also vulnerable.4 Although parents should check children for ticks, children themselves should also be aware of the need to check. Teaching them to recognise the tiny nymphal stage of ticks and the features of tick habitats can encourage them to urge parents to do timely body checks. It therefore seems logical to develop health education materials aimed at children as well as parents. Again, insight into the determinants of children’s behaviour (such as asking their parents to do a body check) should be used in the development of such materials.5


Cite this as: BMJ 2014;348:g231



View Abstract