An update on Borrelia burgdorferi s.l. prevalence and hazard in ticks at recreational areas in England and Wales between 2021 and 2023

Estimating tick-borne disease hazard in highly visited natural landscapes is essential for assessing public health risks. Lyme disease, caused by bacteria of the Borrelia burgdorferi sensu lato (s.l.) complex and transmitted by the tick Ixodes ricinus in Europe, is the most prevalent vector-borne disease. This study aimed to measure Lyme disease hazard across a range of recreational areas, building on previous research. From 2021 to 2023, 84 sites within 36 recreational areas across England and Wales were sampled. The density of questing I. ricinus nymphs was significantly higher in woodlands than in grasslands and significantly increased in the presence of deer. Tick density was significantly higher in the north and south of England compared to central England. The overall prevalence of B. burgdorferi s.l. in I. ricinus nymphs was 5.8 % 95 % CI: 5.1-6.6 % (228/3914), with site-level prevalences ranging from 0 % to 30.4 %. The dominant genospecies was B. garinii (39 % of positive samples), followed by B. valaisiana (21.9 %), B. afzelii (15.4 %) and B. burgdorferi s.s. (3.1 %), which sets England and Wales apart from other European countries where B. afzelii typically dominates. The density of nymphs infected with B. burgdorferi s.l., which represents Lyme disease hazard, was significantly higher in the north and south of England compared to central England and Wales. Notably, the highest densities of infected nymphs were identified in Kielder Forest, Yorkshire Dales, Exmoor, Blackdown Hills and South Devon. We did not find any significant association between the density of infected nymphs and the presence of deer at the survey location.