In early 2024, Foshan City, a significant urban hub in China’s Guangdong Province, faced a sudden and alarming outbreak of chikungunya fever. This viral disease, transmitted primarily through Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus, unleashed a wave of infections that caught public health authorities off guard. Chikungunya fever, known for causing debilitating joint pain, fever, and rash, is a mosquito-borne virus closely related to dengue and Zika viruses. The sudden spike in cases in Foshan highlighted critical challenges in vector control, public health preparedness, and epidemic response. The episode has now become a striking case study in epidemic management and epidemiological reflection.
The outbreak’s genesis was linked to the region’s extensive urbanization, which inadvertently created ideal environments for mosquito breeding. Urban water storage practices, unchecked garbage accumulation, and climate factors contributed to the rapid expansion of the mosquito population. Epidemiological data revealed a sharp increase in the mosquito vector density during the initial months of 2024, corresponding closely with the surge in chikungunya cases. This correlation underscored the critical need for integrated vector management programs in rapidly developing urban spaces, where infrastructural changes can unexpectedly influence disease ecology.
As the first cases were reported in January 2024, local healthcare facilities quickly became overwhelmed by patients presenting with symptoms consistent with chikungunya infection: acute fever, polyarthralgia, myalgia, and rash. Laboratory confirmation confirmed the presence of chikungunya virus in serum samples. Early misdiagnoses as dengue fever further complicated initial response efforts. This diagnostic challenge highlighted the necessity for differential diagnostic capabilities in endemic regions, where spectrums of arboviral diseases often overlap clinically but require different management and public health interventions.
The response mounted by Foshan’s municipal health authorities was multifaceted and aggressive. Early detection teams worked in tandem with entomological surveillance units to map infection hotspots and vector breeding sites. Rapid deployment of insecticide spraying, public education campaigns, and community mobilization were initiated to curb mosquito populations and interrupt transmission cycles. Despite these efforts, the outbreak experienced a protracted course, illustrating the difficulties in containing diseases driven by pervasive and resilient vector species.
A particularly impactful intervention was the establishment of a chikungunya fever epidemiological monitoring system, which facilitated real-time data sharing across healthcare institutions and public health agencies. This system enabled more accurate trend analysis, allowing policymakers to allocate resources efficiently and adjust control measures dynamically. Data from this surveillance system showed the epidemic reached a peak by late March 2024 but persisted with sporadic clusters until June, suggesting a prolonged seasonal influence on viral transmission.
Clinical management of chikungunya patients during the outbreak relied on supportive care, as no specific antiviral treatment exists. Pain management for severe joint symptoms was critical, with nonsteroidal anti-inflammatory drugs (NSAIDs) being the mainstay. Importantly, the healthcare system in Foshan adjusted to this need by training physicians and healthcare providers to recognize and manage post-acute or chronic chikungunya arthritis, a condition affecting a subset of patients and posing long-term disability risks. This adjustment underlined the broader clinical and social burden arboviral diseases can impose on affected populations.
One striking epidemiological insight from this outbreak was the demographic distribution of cases. Data indicated a disproportionately high incidence among middle-aged adults, likely reflecting occupational and behavioral factors that increase mosquito exposure risk. Moreover, household clustering of cases reinforced the role of domestic environments as epicenters of transmission. These findings prompted targeted community interventions, such as household larviciding and education on personal protective measures, emphasizing an integrated “One Health” approach linking human health, vector control, and environmental management.
Genomic sequencing performed on viral isolates from Foshan elucidated the genetic lineage of the chikungunya virus responsible for the outbreak. Phylogenetic analysis linked the strain to a Southeast Asian clade known for enhanced transmissibility in Aedes albopictus mosquitoes. This molecular insight provided critical information for anticipating transmission dynamics and tailoring control strategies based on vector-virus compatibility. It also raised concerns about the potential for regional spread to neighboring urban centers with similar ecological conditions.
Reflecting on the outbreak’s trajectory revealed several critical lessons for future epidemic preparedness. Notably, the importance of early detection and rapid vector control emerged as paramount. Delay in recognizing the chikungunya virus’s presence allowed for unchecked transmission in the initial weeks. In response, health authorities committed to strengthening arboviral surveillance infrastructure, integrating climate and environmental data to enable predictive modeling for outbreak risk, and enhancing community engagement frameworks to bolster public compliance with control measures.
Additionally, the Foshan epidemic demonstrated the necessity for regional collaboration. Given the extensive movement of people and goods across Guangdong Province and adjacent regions, collaborative surveillance and joint response protocols are essential. Sharing epidemiological data and harmonizing vector control activities can prevent the establishment of sustained transmission cycles beyond single urban centers. This regional perspective is vital for emerging urban epidemics driven by vector-borne diseases, which often transcend administrative boundaries.
From a scientific standpoint, the outbreak rekindled interest in vaccine development for chikungunya virus. Although candidate vaccines exist, none have reached widespread licensure. The Foshan experience underscored the potential public health impact such vaccines could have in urban centers facing periodic arbovirus epidemics. Furthermore, it bolstered calls for research into novel vector control technologies, including genetically modified mosquitoes and Wolbachia-based biocontrol agents, which offer promising alternatives to insecticides and could transform urban vector management.
Public communication efforts played a crucial role in mitigating panic and misinformation during the outbreak. Foshan’s health authorities deployed multimedia campaigns targeting diverse demographic groups, emphasizing facts about chikungunya transmission, symptom management, and prevention. Transparent updates on outbreak status fostered trust and encouraged public participation in vector control activities. This strategy illustrates the importance of effective risk communication in epidemic contexts, which can directly influence compliance with health advisories and ultimately shape outbreak outcomes.
In summary, the chikungunya fever epidemic in Foshan City in 2024 served as a vivid example of the challenges posed by urban arboviral diseases in an era of rapid urbanization and global environmental change. The epidemic’s dynamics underscored the interplay between viral genetics, vector ecology, human behavior, and public health system readiness. It highlighted the multidimensional nature of epidemic control, from diagnostic precision to community engagement, surveillance innovation, and international cooperation.
Looking forward, the Foshan outbreak is likely to inform a broad swath of public health policies. Strengthened arbovirus surveillance networks, urban planning that incorporates vector control principles, investment in novel countermeasures, and enhanced clinical training for arboviral diseases are among the envisaged strategic outcomes. Furthermore, this event emphasizes the urgency of preparing megacities in Asia and beyond for the recurrent threat of mosquito-borne viral epidemics amid evolving climate patterns.
Ultimately, Foshan’s experience with chikungunya fever calls for a reimagined, holistic approach to managing vector-borne diseases in urban contexts—one that integrates cutting-edge science, resilient health systems, and empowered communities to interrupt the complex web of transmission and reduce the human toll of these epidemics.
Subject of Research:
The outbreak, response, and epidemiological analysis of a chikungunya fever epidemic in Foshan City, China.
Article Title:
The outbreak, response, and reflections on the chikungunya fever epidemic in Foshan City, China.
Article References:
Nama, N., Ma, Y., Zhou, J. et al. The outbreak, response, and reflections on the chikungunya fever epidemic in Foshan City, China. glob health res policy 10, 59 (2025). https://doi.org/10.1186/s41256-025-00458-2
Image Credits: AI Generated
