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Nora Mankel

The US Centres for Disease Control and Prevention (CDC) has urged travellers to China to take “enhanced precautions” as the number of chikungunya infections rises in the country.
By Sunday, more than 7,000 cases had been reported in mainland China since the start of July, with most of them in southern province of Guangdong.
Foshan, the city hit hardest by the outbreak, confirmed more than 6,900 cases as of Thursday. All were mild and none were fatal, according to health authorities.
The city upgraded its public health emergency response on Thursday to level 3, representing a “relatively major” public health event. China has a four-tier public health response system, with level 1 representing the most serious category.
Overall, 13 cities in Guangdong, including Guangzhou, Dongguan and Shenzhen, had reported infections, the provincial disease control centre said on Monday.
Here are a few things you need to know.
What is chikungunya fever?
The chikungunya virus is transmitted through the bite of an infected mosquito. Fever and joint pains are the most common symptoms, but headaches, muscle pain, joint swelling and rashes have also been reported.
The virus does not spread from person to person. Instead, mosquitoes pick up the virus when feeding on an already infected person. They then carry it to the next person.
Long-term complications and deaths are rare and usually connected to pre-existing health problems, according to the Hong Kong Centre for Health Protection (CHP). Data indicates that infection with the virus leads to natural immunity.
Because there is no medicine to treat the viral disease, protecting yourself from mosquito bites is the best way to prevent infection. Vaccinations are available and recommended for travellers to certain regions.
According to health authorities in Foshan, most of the patients had mild cases and 95 per cent were able to be discharged within seven days.

What is China doing about chikungunya?
The outbreak in China originated from an imported case detected in Foshan’s Shunde district on July 8.
During a national teleconference on Wednesday, China’s National Health Commission gave instructions on elimination efforts. They emphasised the need for improved inter-regional coordination as well as monitoring and early warning systems.
They also called for efforts to prevent local spillovers and the spread of more cases from abroad.
Since mid-July, authorities have launched mosquito eradication measures in affected areas of Guangdong province. Health authorities in adjacent regions, including Hunan and Fujian, have urged residents to be more vigilant against the mosquito-borne disease.
These include using drones to detect standing water sources on rooftops and releasing larva-eating fish into lakes. They have also asked the public to check standing water sources and avoid mosquito bites by using screens on doors and windows, and by wearing long-sleeved clothing.
Hospitals have also been designated as treatment centres with more isolation beds for confirmed cases.
The CHP has announced measures to prevent imported cases, including control systems at the border with mainland China and increased local testing capabilities.
How has the US CDC responded to China’s chikungunya outbreak?
Under the US CDC level 2 travel notice, which was updated on Friday, travellers are advised to “practise enhanced precautions” when visiting China.
That includes “using insect repellent, wearing long-sleeved shirts and pants, and staying in places with air conditioning or that have screens on the windows and doors”.
Pregnant women are urged to reconsider travel to the affected areas.
Last week, Chinese foreign ministry spokesman Guo Jiakun said China was communicating with the World Health Organization (WHO) and making every effort to create a safe environment for travellers.
The CDC issues travel health notices to “inform travellers about global health risks” and provide preventive measures and guidelines travellers can follow to protect themselves, according to its website.
The agency has a four-tier notice system, ranging from level 1 (practise usual precautions) to level 4 (avoid all travel). The only notice now in effect for China is a level 1 warning for global measles.
Since June, the agency has issued level 2 (practise enhanced precautions) travel warnings for chikungunya in various countries, including Bolivia, Kenya and Madagascar.
What does ‘chikungunya’ mean?
“Chikungunya” comes from a word in the Kimakonde language of southern Tanzania meaning “that which bends up”, according to the WHO. It describes the contorted posture of infected people with extreme joint pain.
Where have chikungunya cases been reported?
The virus was first identified in Tanzania in 1952. It then spread to other sub-Saharan countries and Southeast Asia.
The virus has been reported in more than 110 countries, according to the WHO.
In 2007, Europe documented its first imported infection in Italy.
In some places, the virus has caused large outbreaks, while in others it has resulted in just a handful of sporadic cases.
In 2008, a major outbreak in southern India saw almost 100,000 infections.
China documented its first chikungunya fever outbreak in 2010 in Guangdong, where around 250 cases were recorded.
The United States reported its first locally transmitted chikungunya infection in late 2013, according to the CDC. Most infections in the US have been associated with travel.


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What you should know about chikungunya fever as cases rise in China

Fever and joint pains are the most common symptoms of illness caused by the Chikungunya virus, which is transmitted through the bite of an infected mosquito. Photo: AP

A worker carries out mosquito eradication work in Guangzhou, China on Wednesday as the southern province of Guangdong launched targeted measures to curb the spread of chikungunya fever. Photo: CNS via Getty Images

South China city’s chikungunya outbreak spurs action to stop mosquito-borne disease

Chikungunya fever is spread by mosquito bites, and those infected typically develop fever and joint pain that can last for months or even years. Photo: Getty Images

Authorities in Foshan’s Shunde and Nanhai districts have called for thorough indoor sanitation and outdoor clean-ups. Photo: Weibo/我被安利了

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Chikungunya fever is spread through mosquito bites. Photo: Reuters

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China

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Outbreak of mosquito-borne disease in Guangdong province prompts US to upgrade travel warning


Outbreak of mosquito-borne disease in Guangdong province prompts US to upgrade travel warning.


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Disease

Guo Jiakun

Chikungunya fever

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Explainer | What you should know about chikungunya fever as cases rise in China

Outbreak of mosquito-borne disease in Guangdong province prompts US to upgrade travel warning

What is chikungunya fever?