Nymphal Ixodes scapularis questing behavior explains geographic variation in Lyme borreliosis risk in the eastern United States.

Most people who contract Lyme borreliosis in the eastern United States (US) acquire infection from the bite of the nymphal life stage of the vector tick Ixodes scapularis, which is present in all eastern states. Yet <5% of Lyme borreliosis cases are reported from outside the north-central and northeastern US. Geographical differences in nymphal questing (i.e., host-seeking behavior) may be epidemiologically important in explaining this latitudinal gradient in Lyme borreliosis incidence. Using field enclosures and a 'common garden' experimental design at two field sites, we directly tested this hypothesis by observing above-litter questing of laboratory-raised nymphal I. scapularis whose parents were collected from 15 locations (= origins) across the species' range. Relative to southern nymphs from origins considered to be of low acarologic risk, northern nymphs from high-risk origins were eight times as likely to quest on or above the surface of the leaf litter. This regional variation in vector behavior (specifically, the propensity of southern nymphs to remain under leaf litter) was highly correlated with Lyme borreliosis incidence in nymphs' counties of origin. We conclude that nymphal host-seeking behavior is a key factor contributing to the low incidence of Lyme borreliosis in southern states. Expansion of northern I. scapularis populations could lead to increased incidence in southern states of Lyme borreliosis and other diseases vectored by this tick, if the 'northern' host-seeking behavior of immigrant nymphs is retained. Systematic surveillance for I. scapularis nymphs questing above the leaf litter in southern states will help predict future geographic change in I. scapularis-borne disease risk.