EUCALB Home

European Union Concerted Action on Lyme Borreliosis
Environmental Awareness Questionnaire
 

Translate this page from:

Country of Residence: _________________________________________
Locality of Residence:   _________________________________________
Age (in years):
< 20    20-29    30-39    40-49    50-59    > 80   
Gender:
Male    Female   

1. Have you ever heard of a tick?
Yes    No   

If "No" please go to question 7


2. What do ticks eat? (mark one only)
Leaves
Sap
Blood
Pollen
Other Insects
Don't Know

3. How long do ticks feed for? (mark one only)
Seconds    Minutes    Days    Don't know   

4. Do ticks feed on humans?
Yes    No   

If "No" please go to question 7


5. If "Yes", how do you think ticks get onto humans? (mark one only)
Land from flight
Drop from trees
Crawl from vegetation
Don't know

6. Would you remove a tick attached to the skin...
yourself immediately ?    get professional help ?   

7. Have you heard of Lyme disease?
Yes    No   

If Yes continue, otherwise - "Thank you for your help"


8. Did you know that ticks transmit Lyme disease?
Yes    No   

  
 


9. What is the most typical early symptom of Lyme disease? (mark one only)
Vomiting   
High Fever   
Spreading Rash   
Don't Know   

10. Can Lyme disease be treated (or prevented) by...
(mark one only)
vaccination?   
antibiotic treatment?   
both vaccination and antibiotic treatment?   
don't know   

11. Where did you hear about Lyme disease?
Radio/television
Newspaper/magazine
Doctor/health authorities
Scout leaders, teachers etc  
Information leaflet
Affected Person(s)
Other

 12. Does Lyme disease occur in this country?
Yes No Don't Know

Thank you very much for your help.