{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:51:43Z","timestamp":1788306703008,"version":"build-2803163510"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T00:00:00Z","timestamp":1571011200000},"content-version":"vor","delay-in-days":286,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004895","name":"European Social Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004895","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Acci\u00f3n Estrategica en Salud projects","award":["PI18\/00850"],"award-info":[{"award-number":["PI18\/00850"]}]},{"name":"Acci\u00f3n Estrategica en Salud projects","award":["PI15\/01398"],"award-info":[{"award-number":["PI15\/01398"]}]},{"DOI":"10.13039\/501100010198","name":"Ministry of Economy, Industry and Competitiveness","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010198","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Of febrile illnesses in Europe, dengue is second only to malaria as a cause of travellers being hospitalized. Local transmission has been reported in several European countries, including Spain. This study assesses the evolution of dengue-related admissions in Spain in terms of time, geographical distribution and individuals\u2019 common characteristics; it also creates a predictive model to evaluate the risk of local transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective study using the Hospital Discharge Records Database from 1997 to 2016. We calculated hospitalization rates and described clinical characteristics. Spatial distribution and temporal behaviour were also assessed, and a predictive time series model was created to estimate expected cases in the near future. Figures for resident foreign population, Spanish residents\u2019 trips to endemic regions and the expansion of Aedes albopictus were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 588 dengue-related admissions were recorded: 49.6% were women, and the mean age was 34.3\u00a0years. One person died (0.2%), 82% presented with mild-to-moderate dengue and 7\u20138% with severe dengue. We observed a trend of steady and consistent increase in incidence (P\u2009&amp;lt;\u20090.05), in parallel with the increase in trips to dengue-endemic regions. Most admissions occurred during the summer, showing significant seasonality with 3-year peaks. We also found important regional differences. According to the predictive time series analysis, a continuing increase in imported dengue incidence can be expected in the near future, which, in the worst case scenario (upper 95% confidence interval), would mean an increase of 65% by 2025.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We present a nationwide study based on hospital, immigration, travel and entomological data. The constant increase in dengue-related hospitalizations, in combination with wider vector distribution, could imply a higher risk of autochthonous dengue transmission in the years to come. Strengthening the human and vector surveillance systems is a necessity, as are improvements in control measures, in the education of the general public and in fostering their collaboration in order to reduce the impact of imported dengue and to prevent the occurrence of autochthonous cases.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jtm\/taz072","type":"journal-article","created":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T08:13:29Z","timestamp":1570522409000},"source":"Crossref","is-referenced-by-count":51,"title":["Imported dengue in Spain: a nationwide analysis with predictive time series analyses"],"prefix":"10.1093","volume":"26","author":[{"given":"Lidia","family":"Redondo-Bravo","sequence":"first","affiliation":[{"name":"Servicio de Medicina Preventiva, Hospital Universitario la Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Ruiz-Huerta","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Preventiva, Hospital Universitario de la Cruz Roja, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Gomez-Barroso","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Instituto de Salud Carlos III (ISCIII in Spanish), Madrid, Spain"},{"name":"Consorcio de Investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Sierra-Moros","sequence":"additional","affiliation":[{"name":"Centro de Coordinaci\u00f3n de Alertas y Emergencias Sanitarias, Direcci\u00f3n General de Salud P\u00fablica, Calidad e Innovaci\u00f3n, Ministerio de Sanidad, Consumo y Bienestar Social, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Benito","sequence":"additional","affiliation":[{"name":"Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III (ISCIII in Spanish), Madrid, Spain"},{"name":"Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaida","family":"Herrador","sequence":"additional","affiliation":[{"name":"Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III (ISCIII in Spanish), Madrid, Spain"},{"name":"Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"2019122309080768600_ref1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1111\/jtm.12052","article-title":"Dengue fever and international travel","volume":"20","author":"Ratnam","year":"2013","journal-title":"J Travel Med"},{"key":"2019122309080768600_ref2","volume-title":"Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever","author":"WHO Regional Office for South-East Asia","year":"2011"},{"key":"2019122309080768600_ref3","article-title":"Dengue and severe dengue","author":"World Health Organization (WHO)"},{"key":"2019122309080768600_ref4","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/S1473-3099(14)70834-5","article-title":"Dengue and dengue vectors in the WHO European region: past, present, and scenarios for the future","volume":"14","author":"Schaffner","year":"2014","journal-title":"Lancet Infect Dis"},{"key":"2019122309080768600_ref5","article-title":"Surveillance atlas of infectious diseases","author":"European Centre for Disease Prevention and Control"},{"key":"2019122309080768600_ref6","first-page":"583","article-title":"Dengue: a re-emerging disease. 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