Southern China is grappling with a major outbreak of chikungunya, a mosquito-borne viral illness that has rapidly infected thousands in recent weeks—marking one of the country’s largest recorded surges since the disease was first detected there nearly 20 years ago.
The epicenter of the outbreak is Foshan, a city of approximately 9 million people in Guangdong Province. More than 7,000 confirmed cases have emerged there alone, with additional infections appearing in surrounding cities like Guangzhou, Shenzhen, Dongguan, and Zhongshan.
The escalation in numbers has prompted concern within China and internationally. Earlier this month, the U.S. Centers for Disease Control and Prevention (CDC) issued a travel advisory for the region, warning visitors about the risk of infection.
The severity of the situation has even led to a visit from one of China’s vice premiers, who toured the hardest-hit district last week, calling for swift action to halt further spread. According to Chinese state-run media outlet Xinhua, the official emphasized the importance of controlling imported cases while implementing widespread containment strategies to protect the wider region.
Chikungunya—named from a word in the Kimakonde language of Tanzania that translates to “that which bends up”—was first identified in East Africa in 1952. The name refers to the hunched posture of sufferers contorted by intense joint pain, which is a hallmark of the disease.
The virus is transmitted primarily through bites from infected female mosquitoes of the Aedes genus, most commonly Aedes aegypti and Aedes albopictus. These same mosquitoes are also responsible for spreading other viruses, such as dengue and Zika, making them a persistent threat in tropical and subtropical climates.
Symptoms of chikungunya usually appear within four to eight days after a bite and often include fever, nausea, rashes, and fatigue. However, the defining and often debilitating symptom is severe joint pain that can linger for weeks, months, or even years in some cases.
“People cannot move because it’s so painful. There are tears in their eyes,” said Dr. Pilar Ramon-Pardo, a clinical adviser for the World Health Organization (WHO), in a 2014 interview with TIME.
Though chikungunya is rarely fatal—estimated to cause death in only about 0.01% of cases—it can significantly impact quality of life. According to a recent study published in Nature, the virus infects more than 35 million people globally each year across 180 countries and territories. Vulnerable populations such as infants and the elderly are most at risk of developing severe complications.
There is currently no antiviral cure for chikungunya, and treatment is limited to managing symptoms, typically with pain relievers, hydration, and rest. Most people recover, but the lingering joint pain can mimic arthritis and lead to long-term disability for some.
The recent spread appears to be the largest chikungunya outbreak ever documented in China, according to Cesar Lopez-Camacho of the University of Oxford.
“What makes this event notable is that chikungunya has never been established in mainland China before. This suggests that most of the population had no preexisting immunity, making it easier for the virus to spread quickly.”
While a vaccine does exist, it has not yet been rolled out to the public in China. In contrast, two vaccines have been approved in the United States. The CDC recommends vaccination for travelers heading to high-risk areas, while advising pregnant women to delay both travel and vaccination until after delivery.
Without widespread access to immunization, China is relying on traditional epidemic control measures. These measures include clearing mosquito breeding sites, mass spraying of insecticides, disinfecting affected neighborhoods, and using mosquito repellents, coils, and nets. Authorities are also turning to tactics honed during the COVID-19 pandemic—such as mass testing and quarantine protocols—to track and contain the spread.
According to Chinese health officials, the current outbreak began with imported cases, likely introduced by travelers returning from regions where chikungunya is endemic. These initial cases then triggered local transmission, fueled by the presence of competent mosquito vectors in Guangdong.
“With the virus spreading globally, imported cases have inevitably reached China,” explained Liu Qiyong, chief expert in vector-borne diseases at the Chinese Center for Disease Control and Prevention (CDC), in an interview with CGTN.
“Given the established presence of local transmission vectors, particularly Aedes mosquitoes, these imported infections have fueled sustained local transmission cycles, leading to concentrated, small-scale outbreaks in affected regions.”
With international attention on Guangdong, officials are under pressure to prevent the outbreak from spreading beyond southern China. Hong Kong has already reported its first imported case, raising concern that more international travel could turn a regional outbreak into a broader public health threat.
For now, the focus remains on mosquito control and limiting transmission. Chinese health agencies continue to promote public education campaigns, urging citizens to eliminate stagnant water, use insect repellents, and take personal precautions—especially during peak mosquito hours, around dawn and dusk.
Authorities have warned people that failure to remove stagnant water from areas such as flowerpots, coffee makers, or extra bottles could result in fines of up to 10,000 yuan ($1,400).
Mosquitoes “don’t actually need a lot of water, or even a lake. They can spread and reproduce in even the smallest pool of water, like a Coke bottle cap,” Ren Chao, a professor at the University of Hong Kong who studies how climate change affects the transmission of diseases carried by mosquitoes in urban areas, told The New York Times.
Although the most drastic procedures, such as requiring quarantine for infected individuals, have not yet been implemented, experts say China’s pandemic preparations are set up to be swiftly intensified if needed.
“Essentially, you raise the specter of the zero Covid strategy, with its zero-tolerance approach, the mass mobilization, the surveillance and testing,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.
According to Dr. Huang, there are parallels to much earlier mobilizations. Sparrows were mass-exterminated in China in the late 1950s as a result of the notorious “four pests” campaign, which aimed to eradicate rats, flies, mosquitoes, and sparrows. The extermination led to a rise in locust populations, which later contributed to a famine.
“It’s fundamentally no different from the Maoist-style public health campaigns. It involves the mass mobilization of the people. It’s targeting a particular threat to public health and potentially could lead to unintentional consequences.”
Additionally, an army of mosquito-eating fish and enormous “elephant mosquitoes” that can consume smaller, chikungunya-spreading insects are being released.
Foshan officials introduced 5,000 of these fish, which devour larvae, into the city’s lakes last week. Drones are also being used in some areas of the city to find the sources of standing water.
China had largely avoided domestic outbreaks until now. Although the country previously reported imported cases in places like Dongguan in 2010 and Ruili in 2019, local transmission was limited and did not escalate to the current level seen in Foshan.
China’s CDC identified June 16 as the date of the earliest known symptomatic case in this outbreak. Between July 27 and August 2, nearly 2,900 new local cases were reported, with 95% of those occurring in Foshan’s Shunde District.
Officials also warn that the outbreak is being exacerbated by seasonal weather. Kang Min, director of the Guangdong Center for Disease Control and Prevention, cited heavy rains, flooding, and ongoing typhoon activity as contributing factors to the surge in mosquito populations. Stagnant water left behind by storms provides the perfect breeding ground for the Aedes species.
Though often overlooked in global health conversations, chikungunya has a long and turbulent history. After its initial emergence in Africa, outbreaks were documented in Asia during the 1960s and 1970s, particularly in India and Thailand. A massive resurgence occurred in 2004 when an outbreak on Kenya’s Lamu Island infected roughly 70% of the local population. The virus then jumped across the Indian Ocean, hitting Mauritius, the Seychelles, and eventually causing widespread epidemics in India, where over 1.3 million suspected cases were reported in 2006.
Other outbreaks followed in Sri Lanka, Singapore, Thailand, and even Europe, where Italy and France experienced localized transmissions. More recently, the French territory of La Réunion has been experiencing a high level of sustained transmission since 2024, with nearly 50,000 cases reported as of this May, according to the WHO.
The virus also reached the Americas in 2013 and 2014, when locally transmitted cases were recorded in the Caribbean and later in the United States—including Florida, Texas, Puerto Rico, and the U.S. Virgin Islands. While the WHO has stated that large-scale outbreaks in the continental U.S. remain unlikely, isolated cases continue to appear in warmer regions.
The chikungunya outbreak serves as a reminder that even as the world recovers from the COVID-19 pandemic, new and familiar infectious diseases continue to pose complex challenges, particularly in an era of global travel and climate change. As the summer heat fuels mosquito activity, China’s battle with chikungunya is far from over.
Moumita Basuroychowdhury is a Contributing Reporter at The National Digest. After earning an economics degree at Cornell University, she moved to NYC to pursue her MFA in creative writing. She enjoys reporting on science, business and culture news. You can reach her at moumita.b@thenationaldigest.com.
