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Sock It To Lyme™ - A Good News Story

Impact of the Sock It To Lyme program on a New England Island, 2017

Based on previous mast crop abundance, 2017 in New England was predicted to be a year of high Lyme disease incidence.  Cuttyhunk Island, located off the coast of Massachusetts and historically hard hit by Lyme, decided to try to reduce the tick borne disease threat through the introduction of a single garment of factory bonded permethrin clothing, socks, for all community members.  Program impact was measured by the number of tick bite related visits to the island clinic relative to previous years. At season end, the island’s clinic reported a significant drop in bite related visits.

The island has 150 homes, 2 inns and a summer population of about 500. There is a strong sense of community and a high level of awareness of the significant risk of Lyme disease based on shared experiences with the disease. Through the years, community leaders have come together in annual efforts to reduce the toll of tick borne diseases.  Previous efforts had included “all the standard amelioration protocols: education, spraying, lots of DEET, mouse boxes, better mowing, goats to reduce vegetation, deer stands to treat deer with permethrin. You name it.” But Lyme continued to be a major threat for residents.

In 2017, local businesses partnered with a generous summer resident in an effort to put factory bonded repellent socks into the hands (and on to the feet) of all community members. Socks and educational material (including the Miller/Mather study on the effectiveness of summer weight clothing) were secured through BugBeWear’s Sock It To Lyme™ program. The island began sock distribution in early June and continued through the season. By August, 500 pairs of socks had been distributed through varied mechanisms: outright gifts, free premiums from retailers, payment for services, and achievement awards (mastering sailing knots).  Approximately 2 pairs of socks per resident were distributed by season end.

At season end, November 2017, the island’s single clinic supplied data on tick associated visits.  23 tick related visits were reported by the island clinic in 2017. This represents an approximate 40% reduction against average visits from the prior two years; 2016 (38% reduction from 37 visits) and 2015 (44% reduction from 41 visits). No data was collected on patients to determine whether they had received or wore socks at the time of their exposure. No data is available to us to support or deny the assumption that 2017 would be a bad year for tick borne illnesses in New England which would provide better context for these results.

Good science supports the effectiveness of factory bonded repellent garments in reducing tick bites for uniformed outdoor workers. Uniforms that included long sleeves and pants reduced bites by 93%; 84% when uniforms included short sleeves and shorts (Meshnick and Vaughn). Additionally, Dr.s Miller/Mather’s study of the Effectiveness of Summer Weight Clothing identified the particular importance of protecting the area around the foot and ankle.  BugBeWear’s Sock It To Lyme™program rests on this science and theorized there might be some protective value from utilizing a single repellent garment, socks. This theory was put to a test on Cuttyhunk Island with encouraging results.

We believe Cuttyhunk was the first community, non-uniformed, experience and the first that examines the impact of a single garment, socks. Protective benefits might have been greater had all residents received their socks upon reaching the island. Benefits might have been lessened in a less cohesive community. The capture of data on whether the patient was in possession and wearing repellent socks at the time of presumed exposure would have improved our understanding of the impact of the program.  BugBeWear is actively seeking other groups and communities for similar programs.