{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:49:32Z","timestamp":1782913772958,"version":"3.54.5"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016469","name":"Takeda Pharmaceuticals International AG","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016469","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Nathaniel Holman"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 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\u201323. Outpatient and inpatient healthcare use and dengue associated costs were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2015 to 2023, among 10\u2009151\u2009240 insured persons, 887 dengue episodes were recorded. Patients had a median age of 33\u00a0years (interquartile range 26\u201346) and 52% were male. Each year, 103\u2013182 episodes were reported (COVID-19 pandemic period [2020\u201322]: 10\u201362). Excluding the pandemic years, incidence was 1.4\u20132.5\/100\u2009000 persons, with an estimated total of 1453\u20132639 cases\/year in Germany. Of the 37% hospitalized persons, 4% required intensive care. Mean hospital stay was 3.3\u00a0days; 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\u20ac) 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\u20ac; inpatient care accounting for 80%) compared with the pre-index period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dengue 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taag047","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:44:43Z","timestamp":1781178283000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of the healthcare burden of dengue disease in Germany: a retrospective analysis of statutory health insurance data (2014\u201323)"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6942-5785","authenticated-orcid":false,"given":"Christoph","family":"L\u00fcbbert","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Leipzig University Medical Center , Leipzig ,","place":["Germany"]},{"name":"Interdisciplinary Center for Infectious Diseases, Leipzig University Medical Center , Leipzig ,","place":["Germany"]},{"name":"Department of Infectious Diseases and Tropical Medicine, Hospital St. Georg gGmbH , Leipzig ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Fr\u00fchwein","sequence":"additional","affiliation":[{"name":"Dr. Fr\u00fchwein and Partner, Practice for General Medicine, Travel Medicine and Tropical Disease , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin Stephanie","family":"Dinjer","sequence":"additional","affiliation":[{"name":"Takeda Pharma Vertrieb GmbH & Co. KG , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"M\u00e4chler","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceuticals International AG , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Bittencourt","family":"de Gomensoro","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceuticals International AG , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Vogelmann","sequence":"additional","affiliation":[{"name":"LinkCare GmbH , Ludwigsburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bojana","family":"Milovanovi\u0107","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceuticals International AG , Zurich 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