Date of Completion


Document Type

Honors College Thesis



Type of Thesis

Honors College

First Advisor

Jeanne Shea

Second Advisor

Burton Wilcke

Third Advisor

Jan Carney


Lyme disease, prevention, strategies


In this thesis I examined past, present and future public health approaches to Lyme disease in Vermont to identify ways in which the state can improve prevention. Within these research questions, areas of inquiry focused on education and awareness, preventative strategies, diagnosis and treatment of Lyme disease. This topic is highly significant because the number of cases of Lyme disease has been increasing considerably in the past ten years throughout Vermont, and many experts believe there is a serious potential for the number of cases to continue to increase in the future. If undiagnosed and/or not promptly treated, Lyme disease can lead to serious health complications.

In undertaking this research, scholarly literature on Lyme disease prevention at the state and national level was reviewed. Next, grey literature on the Vermont Department of Health website was compared with the CDC website and the website of other surrounding states with a high prevalence of Lyme disease. Finally, eight interviews were conducted with experts in the field of public health and medicine, including one clinical Lyme disease specialist. Information from all of these sources was compared for similarities and differences to see how Vermont fares against national standards for Lyme disease prevention, as well as the best practices of other states.

In my research, I found that there was a large degree of consonance between the scholarly literature, the CDC website, other states’ websites and the Vermont Department of Health website, as well as the responses of my interviewees. Interviewees as well as scholarly and grey literature agreed that education and awareness should be at the forefront of any public health campaign against Lyme disease. The one small difference between the scholarly literature and the Vermont website and the interview responses was that the scholarly literature stressed the importance of educating the public not only on preventative behaviors, but persuasively educating them on the relevant efficacy of those preventative behaviors. In comparing the CDC website and Vermont’s, the CDC website offers information on post-treatment Lyme disease, in addition to the diagnostic, treatment and prevention information also available on the Vermont Department of Health website. In comparing with the websites of other states, the Vermont Department of Health site has a more well designed, “user friendly” appearance, yet their educational resources are limited in comparison with those available on Connecticut’s. No state’s health website in regards to Lyme disease excels in all areas of educational resources, aesthetics, and usability. According to my interviewees, one of the main problems in Vermont is that there is an overall low level of awareness of Lyme disease compared with surrounding states also affected by Lyme disease. In part, this is because Lyme disease came to Vermont later than in surrounding states. In comparing interview responses with the scholarly literature, both agreed that efforts to prevent Lyme disease shouldn’t focus on human vaccination, host removal, or tick surveillance. For the most part, mirroring the scholarly literature, interviewees agreed that human vaccination, tick surveillance, and host removal were not viable or feasible options for Lyme disease prevention in Vermont. However, targeting large mammals with bait boxes, landscape management and disease surveillance were viewed by the interviewees as important secondary techniques to be used in conjunction with public education. Beyond that, my research shows that, increasing education amongst at-risk groups as well as among political and medical communities, addressing budgetary constraints by increasing collaboration amongst state and governmental organizations and increasing electronic communication could all help to improve Lyme disease prevention in Vermont. The need remains to find an evaluation tool to examine what educational tools are currently working, and what demographics are using which news outlets in order to prioritize our educational tools and public service announcements to be fiscally effective. Furthermore, within the above mentioned secondary techniques, I argue that consideration should be given to using natural alternatives to synthetic acaricides and reducing certain invasive species.

According to my interviewees and comparing with best practices recommended in the scholarly literature and by the CDC, overall Vermont is currently doing a reasonably effective job at marshaling sound Lyme disease public health prevention measures. Vermont offers educational resources on their department of health website, as well as preventative behavioral strategies. Vermont is also implementing sound landscape management best practices to reduce tick habitat, and is meeting basic Lyme disease case reporting standards. However, by increasing education and awareness, further targeting at-risk groups, using bait boxes for large mammals, reducing invasive species, improving diagnostics and treatment options for those infected with Lyme disease, and increasing education and awareness amongst political and medical communities, Vermont can better prevent cases of Lyme disease from increasing throughout the state in the coming years.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Available for download on Tuesday, May 08, 2018