Assessment of the healthcare burden of dengue disease in England: a retrospective analysis (2010–2023)

Abstract Background Dengue virus is transmitted by Aedes mosquitoes, which are now prevalent in destinations commonly visited by UK travelers. Increased international travel and factors including climate change, contribute to the global increase in dengue cases. Here, we evaluate the healthcare burden of dengue in England. Methods This retrospective, descriptive, cohort study (2010−2023) utilized data collected from National Health Service healthcare records in the Clinical Practice Research Datalink (CPRD) Aurum linked with Hospital Episode Statistics, and Office for National Statistics mortality data. The primary objective was to determine the occurrence of hospitalized dengue. Other objectives were evaluation of healthcare resource utilization and costs, characteristics of hospitalized dengue cases, and complications due to dengue. Exploratory cohorts for suspected dengue in primary care were also reported. Results Data from CPRD-linked records for 596 patients comprising the hospitalized dengue cohort were evaluated; the incidence rate of hospitalized dengue progressively increased from 2010 until the highest in 2019 (5.8 per million person-years); rates increased in 2022 after COVID-19 lockdowns. Approximately one-third of hospitalized dengue cases were aged 18−29 years, most were White or Asian, and the most common complication was gastrointestinal conditions (gastroenteritis/colitis; 34.7 cases per 1000 person-years). Healthcare costs in the year following hospitalized dengue cases were mostly driven by inpatient admission costs; ~20% of cases had a subsequent hospital admission (~50% were dengue-related). A total of 2286 suspected cases of dengue were reported in primary care, with 1066 unconfirmed and 1220 confirmed cases. Conclusions Increasing incidence of dengue cases in England has followed global trends. The associated healthcare burden of imported dengue suggests a need for targeted public health strategies, particularly among younger travelers. Improvements in general practitioners’ reporting of suspected dengue cases and associated details of symptoms and travel history are warranted.