Rapid global growth and intensification of dengue since 1990

Abstract Dengue is an emerging infectious disease of growing global importance, yet the pace of its expansion remains poorly quantified because surveillance data are inconsistently reported across countries and over time. This undermines prioritisation of interventions and limits the ability to track progress towards international targets, including the WHO 2030 goals. Here we combine an extensive search for dengue data worldwide with Bayesian imputation and downscaling models to produce comprehensive estimates of monthly dengue case counts for 143 countries between 1990 and 2024. We estimate 73.9 million reported dengue cases worldwide over this period, including 10.6 million cases not captured in WHO digitised databases. Reported dengue incidence increased 39-fold between 1990 and 2024, corresponding to an average annual growth rate of 9.1%, with pronounced regional heterogeneity: growth was fastest in recently emerging regions in Africa, the Middle East and South Asia, and slowest in long-established endemic regions of Southeast Asia. Annual and multiannual dengue outbreaks have doubled in cyclical strength and become increasingly synchronised globally. Collectively these data show that dengue is expanding faster, more consistently and more intensely than previously thought. These data provide a foundation for improved understanding, prediction and control of dengue expansion during a period of declining incidence for most other infectious diseases.