Global Chikungunya Update‘

The World Health Organization (WHO) has issued an urgent global warning as Chikungunya cases surge across the Indian Ocean islands, several African nations, Southeast Asia, and parts of Europe. Approximately 5.6 billion people in 119 countries are currently at risk. France has reported around 800 cases since May, including 12 confirmed local transmission events, while Italy has recorded its first local cases. In China, the Shunde district of Foshan City (Guangdong Province) has reported 4,014 confirmed cases, with local authorities declaring the outbreak “severe.” Since the beginning of 2025, more than 220,000 cases and 80 deaths have been reported worldwide.

Key Facts

• Population at risk: ~5.6 billion people across 119 countries.

• Global case burden: Over 220,000 cases and 80 deaths since early 2025 (per The Lancet commentary).

• Hotspot regions:

  • Indian Ocean islands: Reunion, Mayotte, and Mauritius face major outbreaks; up to one-third of Reunion’s population may already be infected.

  • Africa: Madagascar, Somalia, and Kenya report ongoing cases; Kenya confirmed local transmission in Mombasa in June.

  • Asia: As of early June, India, Sri Lanka, and Pakistan have reported >33,000 cases; Sri Lanka noted rising transmission between November 2024 and March 2025.

  • Europe: France reports ~800 cases and 12 local transmissions; Italy confirms local cases.

  • China: Shunde District, Foshan, Guangdong Province, has reported 4,014 confirmed cases.

• Americas: PAHO data show 431,223 cases in 2024, surpassing 2023 levels (411,560), with an upward trend continuing into 2025.

• Clinical note: There is no specific antiviral treatment; newborns, elderly, and those with comorbidities face higher risks.

WHO and Expert Assessments

WHO medical officer Diana Rojas Álvarez warns that patterns similar to the 2004–2005 pandemic are re-emerging—starting from Indian Ocean islands, spreading through Africa and Asia, and now appearing in Europe via imported and local cases. Climate change is expanding the range of Aedes mosquitoes (including Aedes albopictus, the Asian tiger mosquito), making temperate zones, including southern Europe, susceptible to summer outbreaks.

Recommendations

For Governments and Public Health Authorities

1. Strengthen vector control: Implement large-scale mosquito surveillance and community-based larval source reduction.

2. Enhance laboratory capacity: Ensure suspected cases can be confirmed and reported within 48 hours.

3. Risk communication: Targeted guidance for pregnant women, neonates, elderly, and immunocompromised individuals.

4. Cross-border coordination: Share data with WHO, ECDC, PAHO to detect unusual clusters or autochthonous cases.

For Clinics and Laboratories

• Include Chikungunya in differential diagnosis for acute fever + severe joint pain, alongside dengue and Zika, and confirm via RT-PCR or serology.

• Monitor complications in pregnant women, newborns, and high-risk groups, with hospital admission when needed.

For the Public

• Protect yourself during the day: Aedes mosquitoes bite during daylight; use DEET, picaridin, or IR3535 repellents, wear long sleeves, and use screens and bed nets.

• Remove standing water: Flower pot trays, old tires, and containers are key breeding sites.

• If you experience persistent fever, joint pain, or rash, seek medical care and avoid NSAIDs until dengue is ruled out due to bleeding risk.

Monitoring & Next Steps

• WHO’s June 2025 Global Chikungunya Update urges enhanced surveillance and hotspot mapping.

• ECDC issues monthly global updates and weekly threat assessments.

• The Lancet and other journals highlight Europe’s re-emerging local transmissions, urging high vigilance during the summer season.