Tick bite prevention and management: integrating patient perspectives to shape patient education.

Background: The rise in tick anaphylaxis (TA) in Australia and worldwide underscores the need for effective tick bite prevention and management strategies. Objectives: This retrospective survey of a clinical TA cohort aimed to determine prevention and management strategies employed by patients who had received education following diagnosis of TA and identify areas for improvement in patient education. Methods: Patients diagnosed with TA by a consultant immunologist between 2005 and 2021 in NSW, Australia, completed a survey in 2021 assessing tick bite recurrence, life stage identification, removal methods, need for medical assistance, prevention strategies, and geographic tick bite locations. Relationships between tick bite occurrence and prevention methods, such as the use of permethrin-treated clothing and backyard pest control, were analyzed with Kaplan-Meier curves and log-rank tests. Results: Despite receiving education at the time of their previous TA, 59% of patients experienced further tick bites, and 50% struggled to identify the tick life stage. Preferred prevention methods included avoidance, untreated clothing, and repellents, with some using backyard insecticides. We observed a trend towards reduced tick bite recurrence among patients who treated their backyards and wore permethrin-treated clothing. Almost 46% of bites occurred in patients' backyards. Adherence to tick removal advice was highly variable. Only 30% of patients sought medical help when bitten again. Conclusion: The recurrence of tick bite in TA patients despite education at first diagnosis indicates a need for clearer and more frequent education to encourage adherence to prevention strategies, targeting high-risk groups, to prevent further fatalities.