Conclusions
This study allowed modelling of dengue fever risk in Europe based on actual clinical data. The model calibrated under Mexican conditions resulted in reliable and geographically meaningful patterns of projected dengue fever risk in Europe. The risk maps indicate that climate change is likely to contribute to increased dengue risk (and possibly other mosquito-borne diseases) in many parts of Europe, especially towards the end of the century. The areas of greatest increased risk are projected to be clustered around the Mediterranean and Adriatic coasts and in northern Italy. The exact incidence is dependent on several other factors, some of which we were unable to model at this stage (such as vaccine development). Nevertheless public health agencies in high risk areas need to plan, implement and evaluate active entomological reporting and sentinel clinical surveillance and should aim to improve awareness of the increased risk amongst health practitioners and the general public.