Seroprevalence for Borrelia burgdorferi sensu lato and tick-borne encephalitis virus antibodies and associated risk factors among forestry workers in northern France, 2019 to 2020

Background: Lyme borreliosis (LB) is the most common tick-borne disease ( TBD) in France. Forestry workers are at high risk of TBD because of frequent exposure to tick bites. Aim: We aimed to estimate the seroprevalence of Borrelia burgdorferi sensu lato and tick- borne encephalitis virus ( TBEV) antibodies among forestry workers in northern France. We compared seroprevalence by geographical area and assessed factors associated with seropositivity. Methods: Between 2019 and 2020, we conducted a randomised cross-sectional seroprevalence survey. Borrelia burgdorferi sl seropositivity was defined as positive ELISA and positive or equivocal result in western blot. Seropositivity for TBEV was defined as positive result from two ELISA tests, confirmed by serum neutralisation. We calculated weighted seroprevalence and adjusted prevalence ratios to determine association between potential risk factors and seropositivity. Results: A total of 1,778 forestry workers participated. Seroprevalence for B. burgdorferi sl was 15.5% ( 95% confidence interval (CI): 13.9-17.3), 3.5 times higher in the eastern regions than in the western and increased with seniority and with weekly time in a forest environment. Seroprevalence was 2.5 times higher in forestry workers reporting a tick bite during past years and reporting usually not removing ticks rapidly. Seroprevalence for TBEV was 0.14% (95% CI: 0.05-0.42). Conclusion: We assessed for the first time seroprevalence of B. burgdorferi sl and TBEV antibodies among forestry workers in northern France. These results will be used, together with data on LB and tick-borne encephalitis ( TBE) incidence and on exposure to tick-bites, to target prevention programmes.