The ongoing epidemiological outbreak in the Guangdong area is the largest ever recorded chikungunya (CHIKV) epidemic of 2025 in China. The outbreaks are linked to imported cases which began on July 8th of this year, in the Shunde District of Foshan with more than 3,600 confirmed cases being recorded within the first two weeks and the confirmed cases rose to 10,000 by late August. The spread of the acute fever was associated with travels among regions such as Macao, Hong Kong, Taiwan, and Guangxi. The aedes borne alphavirus is a global health concern. Clinical presentations were typical of chikungunya fever, including acute fever, arthralgia, and rash, with no severe complications or deaths.
In symptomatic patients, CHIKV disease onset is typically 4–8 days (range 2–12 days) after the bite of an infected mosquito. Disease is characterized by an abrupt onset of fever, frequently accompanied by severe joint pain. The joint pain is often debilitating and usually lasts for a few days but may be prolonged, lasting for weeks, months or even years. Other common signs and symptoms include joint swelling, muscle pain, headache, nausea, fatigue and rash. Since these symptoms overlap with other infections, including those with dengue and Zika viruses, cases can be misdiagnosed. In the absence of significant joint pain, symptoms in infected individuals are usually mild and the infection may go unrecognized. Most patients recover fully from the infection; however, occasional cases of eye, heart, and neurological complications have been reported with CHIKV infections.
Patients at extremes of the age spectrum are at higher risk for severe disease including newborns infected during delivery to infected mothers or bitten by infected mosquitoes in the weeks after birth, and older people, particularly those with underlying medical conditions. Patients with severe disease require hospitalization because of the risk of organ damage and death. Once an individual is recovered, available evidence suggests they are likely to be immune from future chikungunya infections.
In China, deployment of vaccines against arboviruses such as CHIKV and dengue virus faces several key obstacles. Sporadic, localized outbreaks hinder trial design and reduce commercial incentives, keeping domestic research and development at an early stage. In addition, imported vaccines must meet stringent National Medical Products Administration requirements for long-term safety and risk mitigation, including antibody-dependent enhancement, which has led to the exclusion of the dengue vaccine Dengvaxia. Furthermore, vaccine hesitancy remains a major challenge in China, driven by concerns over safety, efficacy, and factors such as personal beliefs, family influence, and affordability. Strengthening vaccine uptake will require public–private partnerships, integration of arbovirus vaccines into routine immunization in at-risk regions of southern China, and expansion of the National Immunization Program to include WHO-recommended vaccines.
Sources:
https://www.sciencedirect.com/science/article/pii/S120197122500311X
https://www.sciencedaily.com/releases/2025/10/251009033244.htm
https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON581
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