Increase of Dengue in Pediatric Travelers in Madrid: A Multicentric Retrospective Experience

Dengue fever has significantly increased globally, extending into non-endemic regions. This study aims to describe the epidemiological and clinical characteristics of pediatric dengue cases diagnosed in Madrid, Spain, over ten years. We conducted a retrospective observational study across four tertiary hospitals, including all confirmed dengue cases in children under 16 between 2015 and 2024. Epidemiological data, clinical presentation, laboratory findings, and outcomes were collected, with severity assessed according to the 2009 WHO criteria. Forty-six cases were identified, with 72% diagnosed in the last three years and a peak incidence in 2024. Children visiting friends and relatives (VFR) constituted the majority of cases (56%). The most frequent clinical features were fever (100%) and gastrointestinal symptoms (78%), while laboratory findings included leukopenia (72%), thrombocytopenia (70%), and hypertransaminasemia (74%). Five cases (10%) met the criteria for severe dengue, one being fatal in a patient with pre-existing oncological disease. We identified no autochthonous cases. These results highlight the growing impact of imported pediatric dengue in non-endemic regions, the particular vulnerability of VFR travelers, and the need for clinical awareness, improved diagnostic availability and prevention strategies, especially in climate-influenced vector expansion.