Human behaviors elevating exposure to Ixodes pacificus (Acari: Ixodidae) nymphs and their associated bacterial zoonotic agents in a hardwood forest.

Epidemiological evidence suggests that the nymph of the western black-legged tick, Ixodes pacificus Cooley and Kohls, is the primary vector of the Lyme disease spirochete, Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt, and Brenner, to humans in northwestern California. In spring 2002, six different human behaviors were evaluated as potential risk factors for acquiring I. pacificus nymphs in a deciduous woodland in Mendocino County, California. Also, the prevalence of B. burgdorferi sensu lato (s.l.) and the causative agents of human granulocytic (Anaplasma phagocytophilum [Foggie] Dumler, Barbet, Bekker, Dasch, Palmer, Ray, Rikihisa, and Rurangirwa) and monocytic ehrlichioses (Ehrlichia chaffeensis Anderson, Dawson, Jones, and Wilson) was determined in nymphs that had been collected from subjects or by dragging leaf litter. Activities involving a considerable degree of contact with wood resulted in greater acquisition of nymphs than those involving exposure solely to leaf litter. Time-adjusted tick-acquisition rates demonstrated that sitting on logs was the riskiest behavior, followed, in descending rank, by gathering wood, sitting against trees, walking, stirring and sitting on leaf litter, and just sitting on leaf litter. The number of ticks acquired appeared to be unrelated to the type of footwear worn (hiking boots, hiking sandals, or running shoes). Overall, 3.4% (n = 234) of the nymphs were infected with A. phagocytophilum, 3.9% (n = 181) with B. burgdorferi s.l., and none (n = 234) with E. chaffeensis. Of 13 nymphs infected with either A. phagocytophilum or B. burgdorferi s.l., 2 (15.4%) were coinfected with both bacteria, as were 1.3% of 158 nymphs obtained from leaf litter, the first report of coinfection in this life stage of I. pacificus. Four unattached, infected nymphs were removed from subjects, including two acquired while sitting on logs that contained A. phagocytophilum, another with the same bacterium obtained while walking, and one acquired while gathering wood that was infected with B. burgdorferi s.l. Despite the use of extreme personal preventive measures by both subjects, two attached, uninfected nymphs were removed from one of them > or = 1-2 d postexposure. The public health implications of these findings are discussed.