{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:34:01Z","timestamp":1791689641722,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,13]],"date-time":"2023-08-13T00:00:00Z","timestamp":1691884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Program of Zhejiang Province","award":["2022KY715"],"award-info":[{"award-number":["2022KY715"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Dengue imposes a heavy economic burden on families and society. We used surveillance data reported in 2019 to characterize the dengue epidemic in Zhejiang Province, China, which provided guidance for dengue prevention and control. Dengue epidemics mostly occurred in July to October. People aged 30\u201344 years, males, and commercial service workers were more likely to suffer from dengue. The epidemic areas were mainly in Hangzhou and Wenzhou. Meanwhile, we assessed the economic cost of dengue in the province from both family and organizational perspectives. The direct economic burden of dengue patients was estimated to be USD 405,038.25, and the indirect economic burden was USD 140,364.90, for a total economic burden of USD 543,213.00. The direct economic burden of dengue patients should be reduced by increasing the coverage and reimbursement of health insurance. Additionally, the total annual cost of dengue prevention and control for the government and organizational sectors was estimated to be USD 7075,654.83. Quantifying the dengue burden is critical for developing disease control strategies, allocating public health resources, and setting health policy priorities.<\/jats:p>","DOI":"10.3390\/v15081731","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T10:20:14Z","timestamp":1692008414000},"page":"1731","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Epidemiological Characteristics and Economic Burden of Dengue in Zhejiang Province, China"],"prefix":"10.3390","volume":"15","author":[{"given":"Yi","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou 311121, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Ling","sequence":"additional","affiliation":[{"name":"Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimin","family":"Sun","sequence":"additional","affiliation":[{"name":"Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1146\/annurev.micro.62.081307.163005","article-title":"Global Spread and Persistence of Dengue","volume":"62","author":"Kyle","year":"2008","journal-title":"Annu. Rev. Microbiol."},{"key":"ref_2","unstructured":"(2023, May 09). Dengue: A Continuing Global Threat|Nature Reviews Microbiology. Available online: https:\/\/www.nature.com\/articles\/nrmicro2460."},{"key":"ref_3","unstructured":"(2023, May 09). Dengue and Dengue Hemorrhagic Fever: The Pediatric Infectious Disease Journal. Available online: https:\/\/journals.lww.com\/pidj\/Citation\/1992\/04000\/Dengue_and_dengue_hemorrhagic_fever.10.aspx."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/S1473-3099(16)00026-8","article-title":"The Global Burden of Dengue: An Analysis from the Global Burden of Disease Study 2013","volume":"16","author":"Stanaway","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","unstructured":"(2023, May 09). WHO: Strengthening Implementation of the Global Strategy for Dengue Fever\/Dengue Haemorrhagic Fever Prevention and Control\u2014Report of the Informal Consultation\u2014Google Scholar. Available online: https:\/\/scholar.google.com\/scholar_lookup?hl=en&publication_year=2000&author=WHO&title=Strengthening+Implementation+of+the+Global+Strategy+for+Dengue+Fever%2FDengue+Haemorrhagic+Fever+Prevention+and+Control."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101674","DOI":"10.1016\/j.tmaid.2020.101674","article-title":"Increase in Cases of Dengue in China, 2004\u20132016: A Retrospective Observational Study","volume":"37","author":"Zhang","year":"2020","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.meegid.2015.03.005","article-title":"Dengue Is Still an Imported Disease in China: A Case Study in Guangzhou","volume":"32","author":"Sang","year":"2015","journal-title":"Infect. Genet. Evol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.arcmed.2005.03.041","article-title":"Global Warming and Infectious Disease","volume":"36","author":"Khasnis","year":"2005","journal-title":"Arch. Med. Res."},{"key":"ref_9","first-page":"1","article-title":"Dengue Fever in China: New Epidemical Trend, Challenges and Strategies for Prevention and Control","volume":"31","author":"Liu","year":"2020","journal-title":"Chin. J. Vector Biol. Control."},{"key":"ref_10","unstructured":"Shepard, D., Suaya, J., and Beatty, M.E. (2007). Dengue Burden of Disease and Cost of Illness: Report of the Scientific Working Group Meeting on Dengue, Geneva, 1\u20135 October 2006 (TDR\/SWG\/07), World Health Organization. Special Programme for Research and Training in Tropical Diseases (TDR)."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/S1473-3099(16)00146-8","article-title":"The Global Economic Burden of Dengue: A Systematic Analysis","volume":"16","author":"Shepard","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_12","first-page":"77","article-title":"Cost of Dengue in Thailand","volume":"34","author":"Kongsin","year":"2010","journal-title":"Dengue Bulletin."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Carrasco, L.R., Lee, L.K., Lee, V.J., Ooi, E.E., Shepard, D.S., Thein, T.L., Gan, V., Cook, A.R., Lye, D., and Ng, L.C. (2011). Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore. PLoS Neglected Trop. Dis., 5.","DOI":"10.1371\/journal.pntd.0001426"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Shepard, D.S., Undurraga, E.A., and Halasa, Y.A. (2013). Economic and Disease Burden of Dengue in Southeast Asia. PLoS Neglected Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002055"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"857911","DOI":"10.3389\/fpubh.2022.857911","article-title":"Epidemiology of Indigenous Dengue Cases in Zhejiang Province, Southeast China","volume":"10","author":"Ren","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ren, J., Ling, F., Sun, J., Gong, Z., Liu, Y., Shi, X., Zhang, R., Zhai, Y., Chen, E., and Chen, Z. (2018). Epidemiological Profile of Dengue in Zhejiang Province, Southeast China. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0208810"},{"key":"ref_17","unstructured":"(2023, May 24). Dengue and Severe Dengue. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dengue-and-severe-dengue."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11684-017-0605-9","article-title":"Landscape of Emerging and Re-Emerging Infectious Diseases in China: Impact of Ecology, Climate, and Behavior","volume":"12","author":"Liu","year":"2018","journal-title":"Front. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.4269\/ajtmh.2007.76.1182","article-title":"An Outbreak of Dengue Virus Serotype 1 Infection in Cixi, Ningbo, People\u2019s Republic of China, 2004, Associated with a Traveler from Thailand and High Density of Aedes Albopictus","volume":"76","author":"Xu","year":"2007","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_20","first-page":"17","article-title":"Male\u2013Female Differences in the Number of Reported Incident Dengue Fever Cases in Six Asian Countries","volume":"2","author":"Anker","year":"2011","journal-title":"West. Pac. Surveill. Response J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3201\/eid2501.180178","article-title":"Epidemiology of Imported Infectious Diseases, China, 2005\u20132016","volume":"25","author":"Wang","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1016\/j.ijid.2019.01.004","article-title":"Epidemiology of Dengue Fever in India, Based on Laboratory Surveillance Data, 2014\u20132017","volume":"84","author":"Murhekar","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e21982","DOI":"10.1097\/MD.0000000000021982","article-title":"Epidemiological Characteristics of Dengue in Mainland China from 1990 to 2019: A Descriptive Analysis","volume":"99","author":"Lin","year":"2020","journal-title":"Medicine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s40249-022-00937-5","article-title":"Epidemiological Characteristics and Temporal-Spatial Analysis of Overseas Imported Dengue Fever Cases in Outbreak Provinces of China, 2005\u20132019","volume":"11","author":"Lun","year":"2022","journal-title":"Infect. Dis. Poverty"},{"key":"ref_25","first-page":"123","article-title":"Frequent Import and Multiple Sources of Dengue Fever Have Changed the Epidemic Situation of the Disease in Fujian Province, China","volume":"33","author":"Wang","year":"2020","journal-title":"Biomed. Environ. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Sang, S., Yin, W., Bi, P., Zhang, H., Wang, C., Liu, X., Chen, B., Yang, W., and Liu, Q. (2014). Predicting Local Dengue Transmission in Guangzhou, China, through the Influence of Imported Cases, Mosquito Density and Climate Variability. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0102755"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Lai, S., Huang, Z., Zhou, H., Anders, K.L., Perkins, T.A., Yin, W., Li, Y., Mu, D., Chen, Q., and Zhang, Z. (2015). The Changing Epidemiology of Dengue in China, 1990\u20132014: A Descriptive Analysis of 25 Years of Nationwide Surveillance Data. BMC Med., 13.","DOI":"10.1186\/s12916-015-0336-1"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.tmaid.2016.02.002","article-title":"Surveillance of Mosquito-Borne Infectious Diseases in Febrile Travelers Entering China via Shenzhen Ports, China, 2013","volume":"14","author":"Shi","year":"2016","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zhang, J.H., Yuan, J., and Wang, T. (2017). Direct Cost of Dengue Hospitalization in Zhongshan, China: Associations with Demographics, Virus Types and Hospital Accreditation. PLoS Neglected Trop. Dis., 11.","DOI":"10.1371\/journal.pntd.0005784"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1016\/S1473-3099(16)30545-X","article-title":"Disease and Economic Burdens of Dengue","volume":"17","author":"Castro","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Xu, M., Chang, N., Tu, T., Sun, J., Jiang, J., Xia, Y., Tang, W., Ji, H., Zhao, X., and Zhu, J. (2022). Economic Burden of Dengue Fever in China: A Retrospective Research Study. PLoS Neglected Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010360"},{"key":"ref_32","first-page":"385","article-title":"Study on the Economic Burden of Dengue Fever Disease in Ningbo City, Zhejiang Province","volume":"31","author":"Chen","year":"2020","journal-title":"Chin. J. Vector Biol. Control."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.jiph.2017.07.021","article-title":"Economic Cost and Burden of Dengue during Epidemics and Non-Epidemic Years in Taiwan","volume":"11","author":"Luh","year":"2018","journal-title":"J. Infect. Public Health"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lee, J.-S., Mogasale, V., Lim, J.K., Carabali, M., Lee, K.-S., Sirivichayakul, C., Dang, D.A., Palencia-Florez, D.C., Nguyen, T.H.A., and Riewpaiboon, A. (2017). A Multi-Country Study of the Economic Burden of Dengue Fever: Vietnam, Thailand, and Colombia. PLoS Neglected Trop. Dis., 11.","DOI":"10.1371\/journal.pntd.0006037"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Machado, A.A.V., Estevan, A.O., Sales, A., Brabes, K.C.d.S., Croda, J., and Negr\u00e3o, F.J. (2014). Direct Costs of Dengue Hospitalization in Brazil: Public and Private Health Care Systems and Use of WHO Guidelines. PLoS Neglected Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0003104"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Thalagala, N., Tissera, H., Palihawadana, P., Amarasinghe, A., Ambagahawita, A., Wilder-Smith, A., Shepard, D.S., and Tozan, Y. (2016). Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka. PLoS Neglected Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004466"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/bjs.9420","article-title":"Impact of Hospital Volume on Hospital Mortality, Length of Stay and Total Costs after Pancreaticoduodenectomy","volume":"101","author":"Yoshioka","year":"2014","journal-title":"Br. J. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s40249-016-0141-x","article-title":"Economic Cost Analysis of Malaria Case Management at the Household Level during the Malaria Elimination Phase in The People\u2019s Republic of China","volume":"5","author":"Xia","year":"2016","journal-title":"Infect. Dis. Poverty"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/8\/1731\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:32:41Z","timestamp":1760128361000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/8\/1731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,13]]},"references-count":38,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["v15081731"],"URL":"https:\/\/doi.org\/10.3390\/v15081731","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,13]]}}}