ArticleJournal of travel medicine2026
Assessment of the healthcare burden of dengue disease in Germany: a retrospective analysis of statutory health insurance data (2014-23).
Article in Journal of travel medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe burden of dengue disease in Germany is a growing public health concern. While travellers to dengue-endemic countries are at increased risk of contracting a dengue infection, data describing dengue-related healthcare utilization and outcomes in Germany are limited. This study investigated the healthcare burden of dengue disease in travellers returning to Germany.
methodsA retrospective analysis (InGef research database) was used to estimate dengue incidence using anonymized representative data from the German Statutory Health Insurance from approximately 7 million insured persons/year during 2015-23. Outpatient and inpatient healthcare use and dengue associated costs were investigated.
resultsFrom 2015 to 2023, among 10 151 240 insured persons, 887 dengue episodes were recorded. Patients had a median age of 33 years (interquartile range 26-46) and 52% were male. Each year, 103-182 episodes were reported (COVID-19 pandemic period [2020-22]: 10-62). Excluding the pandemic years, incidence was 1.4-2.5/100 000 persons, with an estimated total of 1453-2639 cases/year in Germany. Of the 37% hospitalized persons, 4% required intensive care. Mean hospital stay was 3.3 days; most patients were discharged after 1 overnight stay and no dengue related deaths were reported. Overall, 41% of patients took sick leave during their episode (mean sick leave for hospitalized patients: 8.8 working days); 38% of those not hospitalized took sick leave lasting 6.9 working days on average. Patients with dengue had 2-fold increased healthcare visits, resulting in a 162% increase in costs (mean costs/episode/quarter: 930€) compared with the pre-index period, with these costs mainly driven by outpatient care (23%) and hospitalization (64%). Hospitalized patients had a 4-fold rise in costs (quarterly costs/episode: 1700€; inpatient care accounting for 80%) compared with the pre-index period.
conclusionsDengue virus infection in travellers returning to Germany impacted the healthcare system in Germany, leading to high costs, hospitalizations and physician visits and considerable sick leave.
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