Invasive mosquitoes in the non-endemic German region of Saarland: What does the public know and how does it respond?

By assessing public awareness, preventive behavior, and knowledge regarding invasive mosquito species in Saarland, Germany, a non-endemic region at increasing invasion risk, this study aimed to explore how the introduction of invasive mosquitoes can be addressed in non-endemic areas. A population-based anonymous questionnaire in Saarland was conducted from February to June 2024. Participants were recruited through broad public dissemination using digital and analog approaches. Nine items assessed mosquito protection practices, knowledge of invasive species, and potential for pathogen transmission. Among 1064 respondents, 623 (58.6%) met the inclusion criteria. While over half of them recognized stagnant water removal as an effective preventive measure, fewer than one fifth practiced it regularly. Travel medicine consultations were associated with greater use of protective clothing. Among participants aged 26-35, men were more likely than women to report no prior engagement with mosquito prevention measures. Although most participants had heard of Aedes albopictus, fewer than half linked it to chikungunya transmission. Marked discrepancies persist between general awareness and evidence-based preventive behavior. Targeted seasonal education campaigns represent a modifiable lever to delay vector establishment and improve outbreak preparedness.