{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:07Z","timestamp":1785218407296,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Following a major chikungunya outbreak in Foshan City, China, locally transmitted cases have been reported across the country. Research remains limited to epidemiology, transmission dynamics, vector characteristics, and risk factors of chikungunya fever.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 164 chikungunya cases reported in Quanzhou City, Fujian Province, between August 18 and September 9, 2025, along with mosquito surveillance data collected from August 25 to September 13, 2025. We examined case characteristics, symptom patterns, Cycle threshold (Ct) values trends, and vector distributions. Logistic regression was used to identify demographic factors and mosquito density indices associated with infection risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 164 cases, 50.0% were male and 38.4% were aged \u2265 60\u202fyears. Ct values were significantly influenced by age (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0044) and the onset-to-diagnosis intervals (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001), but not by symptom patterns. Advanced age was a major risk factor, particularly for individuals aged 70\u201389\u202fyears (OR\u202f=\u202f6.18, 95% CI\u202f=\u202f4.08\u20138.98) and those 90\u202fyears or older (OR\u202f=\u202f4.37, 95% CI\u202f=\u202f1.36\u201310.29). Higher mosquito larval and adult densities also increased infection risk. Following implementation of emergency response protocols and intensive mosquito control measures, zero incident cases were reported within 21\u202fdays.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Chikungunya disproportionately affects older adults, especially those aged \u2265 70\u202fyears. Viral load increases with age and decreases with delayed diagnosis. The lack of correlation between symptoms and viral load may suggest that asymptomatic individuals could be equally infectious, providing guidance for the screening and management of high-risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1895402","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:34:28Z","timestamp":1785216868000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology, transmission, vector and factors analysis of chikungunya outbreak in 2025, Quanzhou City of China"],"prefix":"10.3389","volume":"14","author":[{"given":"Shenggen","family":"Wu","sequence":"first","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, Fujian, China"]},{"name":"School of Public Health, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayuan","family":"Xie","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Quanzhou Center for Disease Control and Prevention","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruyi","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Quanzhou First Hospital Affiliated to Fujian Medical University","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senshuang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Lin","sequence":"additional","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Cai","sequence":"additional","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Ye","sequence":"additional","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuping","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Frutos","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University","place":["Xiamen, Fujian, China"]},{"name":"CIRAD, URM 17, Intertryp","place":["Montpellier, France"]},{"name":"Department of Pathology, Faculty of Medicine-Ramathibodi Hospital, Mahidol University","place":["Bangkok, Thailand"]},{"name":"Department of Health, Faculty of Vocational Studies, Universitas Airlangga","place":["Surabaya, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhua","family":"Su","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianming","family":"Ou","sequence":"additional","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiming","family":"Wang","sequence":"additional","affiliation":[{"name":"Quanzhou Center for Disease Control and Prevention","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Weng","sequence":"additional","affiliation":[{"name":"Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research","place":["Fuzhou, Fujian, China"]},{"name":"School of Public Health, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1056\/NEJMra1406035","article-title":"Chikungunya virus and the global spread of a mosquito-borne disease","volume":"372","author":"Weaver","year":"2015","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e107","DOI":"10.1016\/S1473-3099(16)30385-1","article-title":"Chikungunya virus: an update on the biology and pathogenesis of this emerging pathogen","volume":"17","author":"Burt","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1038\/s41590-020-0648-y","article-title":"Climate change: an enduring challenge for vector-borne disease prevention and control","volume":"21","author":"Rockl\u00f6v","year":"2020","journal-title":"Nat Immunol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0007213","DOI":"10.1371\/journal.pntd.0007213","article-title":"Global expansion and redistribution of Aedes-borne virus transmission risk with climate change","volume":"13","author":"Ryan","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e42830","DOI":"10.1371\/journal.pone.0042830","article-title":"Maiden outbreak of chikungunya in Dongguan city, Guangdong province, China: epidemiological characteristics","volume":"7","author":"Qiaoli","year":"2012","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.imj.2023.11.005","article-title":"Chikungunya in Zhejiang Province, Southeast China","volume":"2","author":"Ren","year":"2023","journal-title":"Inf Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s40249-025-01376-8","article-title":"Estimating the transmissibility of the 2025 chikungunya fever outbreak in Foshan, China: a modelling study","volume":"14","author":"Zhao","year":"2025","journal-title":"Infect Dis Poverty"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.tmaid.2018.02.006","article-title":"Under-diagnosis of rickettsial disease in clinical practice: a systematic review","volume":"26","author":"van Eekeren","year":"2018","journal-title":"Travel Med Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1172\/JCI84417","article-title":"Chikungunya virus: epidemiology, replication, disease mechanisms, and prospective intervention strategies","volume":"127","author":"Silva","year":"2017","journal-title":"J Clin Invest"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0013580","DOI":"10.1371\/journal.pntd.0013580","article-title":"Clinical outcomes of chikungunya across age groups: a systematic review","volume":"19","author":"Bentvelzen","year":"2025","journal-title":"PLoS Negl Trop Dis"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e3066","DOI":"10.1371\/journal.pone.0003066","article-title":"Seroprevalence and risk factors of chikungunya virus infection in Mayotte, Indian Ocean, 2005-2006: a population-based survey","volume":"3","author":"Sissoko","year":"2008","journal-title":"PLoS One"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3390\/v15091869","article-title":"Immune response to chikungunya virus: sex as a biological variable and implications for natural delivery via the mosquito","volume":"15","author":"Taylor","year":"2023","journal-title":"Viruses"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"100088","DOI":"10.1016\/j.imj.2024.100088","article-title":"Viremia and clinical manifestations in acute febrile patients of chikungunya infection during the 2016 CHIKV outbreak in Delhi, India","volume":"3","author":"Sagar","year":"2024","journal-title":"Infect Med (Beijing)"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"100200","DOI":"10.1016\/j.imj.2025.100200","article-title":"Chikungunya outbreak in Guangdong Province, China, 2025","volume":"4","author":"Luo","year":"2025","journal-title":"Inf Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e2848","DOI":"10.1371\/journal.pntd.0002848","article-title":"Assessing the relationship between vector indices and dengue transmission: a systematic review of the evidence","volume":"8","author":"Bowman","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"106523","DOI":"10.1016\/j.actatropica.2022.106523","article-title":"Effectiveness of environmental interventions to reduce entomological indices of dengue, Zika, and chikungunya vector","volume":"233","author":"Tortosa-La Osa","year":"2022","journal-title":"Acta Trop"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.actatropica.2018.09.003","article-title":"A scoping review of chikungunya virus infection: epidemiology, clinical characteristics, viral co-circulation complications, and control","volume":"188","author":"Silva","year":"2018","journal-title":"Acta Trop"},{"key":"ref18","year":""},{"key":"ref19","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.idm.2023.01.004","article-title":"A follow up study of cycle threshold values of SARS-CoV-2 in Hunan Province, China","volume":"8","author":"Abudurusuli","year":"2023","journal-title":"Infect Dis Model"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"7","DOI":"10.19871\/j.cnki.xfcrbzz.2025.04.002","article-title":"Clinical characteristics analysis of 213 adult chikungunya fever patients in Foshan City in 2025","volume":"10","author":"Zhang","year":"2025","journal-title":"Electronic J Emerg Infectious Dis"},{"key":"ref21","first-page":"539","article-title":"Epidemiological characteristics of imported chikungunya cases in China, 2010\u20132019","volume":"36","author":"Chen","year":"2021","journal-title":"Dis Surveillance"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.46234\/ccdcw2025.172","article-title":"An outbreak of chikungunya fever in China - Foshan City, Guangdong Province, China, July 2025","volume":"7","author":"Li","year":"2025","journal-title":"China CDC Wkly"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"23997","DOI":"10.1038\/srep23997","article-title":"Evaluating the effectiveness of localized control strategies to curtail chikungunya","volume":"6","author":"Ndeffo-Mbah","year":"2016","journal-title":"Sci Rep"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e0011610","DOI":"10.1371\/journal.pntd.0011610","article-title":"Reporting delays of chikungunya cases during the 2017 outbreak in Lazio region, Italy","volume":"17","author":"Manica","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"100087","DOI":"10.1016\/j.soh.2024.100087","article-title":"Advancing knowledge of one health in China: lessons for one health from China\u2019s dengue control and prevention programs","volume":"3","author":"Feng","year":"2024","journal-title":"Science in One Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e1002322","DOI":"10.1371\/journal.ppat.1002322","article-title":"ISG15 is critical in the control of chikungunya virus infection independent of UbE1L mediated conjugation","volume":"7","author":"Werneke","year":"2011","journal-title":"PLoS Pathog"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e2004","DOI":"10.1371\/journal.pntd.0002004","article-title":"Chikungunya fever: a clinical and virological investigation of outpatients on Reunion Island, south-West Indian Ocean","volume":"7","author":"Thiberville","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.16505\/j.2095-0136.2025.0078","article-title":"Chikungunya fever diagnosis and treatment guidelines","year":"2025","journal-title":"Chin J Viral Dis"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"744164","DOI":"10.3389\/fmicb.2021.744164","article-title":"Overview on chikungunya virus infection: from epidemiology to state-of-the-art experimental models","volume":"12","author":"Constant","year":"2021","journal-title":"Front Microbiol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e0211036","DOI":"10.1371\/journal.pone.0211036","article-title":"Virus load and clinical features during the acute phase of chikungunya infection in children","volume":"14","author":"B","year":"2019","journal-title":"PLoS One"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.46234\/ccdcw2025.182","article-title":"Viral load dynamics of chikungunya virus in human specimens - Foshan City, Guangdong Province, China, 2025","volume":"7","author":"Wan","year":"2025","journal-title":"China CDC Wkly"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1093\/infdis\/jiq042","article-title":"Persistent arthralgia induced by chikungunya virus infection is associated with interleukin-6 and granulocyte macrophage colony-stimulating factor","volume":"203","author":"Chow","year":"2011","journal-title":"J Infect Dis"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed6010012","article-title":"Chikungunya manifestations and viremia in patients who presented to the fever clinic at Bangkok Hospital for Tropical Diseases during the 2019 outbreak in Thailand","volume":"6","author":"Imad","year":"2021","journal-title":"Trop Med Infect Dis"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.3390\/v14081805","article-title":"Virological, serological and clinical analysis of chikungunya virus infection in Thai patients","volume":"14","author":"Tun","year":"2022","journal-title":"Viruses"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2567","DOI":"10.1111\/j.1537-2995.2012.03960.x","article-title":"Viremic profiles in asymptomatic and symptomatic chikungunya fever: a blood transfusion threat?","volume":"53","author":"Appassakij","year":"2013","journal-title":"Transfusion"},{"key":"ref36","year":"2025"},{"key":"ref37","year":"2025"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s40249-025-01364-y","article-title":"Epidemiological characteristics and transmission dynamics of the early stage chikungunya fever outbreak in Foshan City, Guangdong Province, China in 2025","volume":"14","author":"Zhang","year":"2025","journal-title":"Infect Dis Poverty"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1002\/jmv.27302","article-title":"Epidemiological and clinical characteristics of the chikungunya outbreak in Ruili City, Yunnan Province, China","volume":"94","author":"Liu","year":"2022","journal-title":"J Med Virol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e0010244","DOI":"10.1371\/journal.pntd.0010244","article-title":"Estimating chikungunya virus transmission parameters and vector control effectiveness highlights key factors to mitigate arboviral disease outbreaks","volume":"16","author":"Jourdain","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"2429","DOI":"10.3201\/eid2610.190957","article-title":"Basic reproduction number of chikungunya virus transmitted by Aedes mosquitoes","volume":"26","author":"Haider","year":"2020","journal-title":"Emerg Infect Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1895402\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:34:30Z","timestamp":1785216870000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1895402\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":41,"alternative-id":["10.3389\/fpubh.2026.1895402"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1895402","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"article-number":"1895402"}}