From folding in half to swollen hands – the 8 signs of killer virus in China sparking global outbreak fears

HEALTH chiefs in China have reimposed strict, Covid-like restrictions in a desperate bid to contain a deadly virus.

More than 7,000 people have been struck down by the mosquito-borne chikungunya virus in China’s biggest ever outbreak of the crippling disease, experts have warned.

The majority of cases have been reported in Foshan, a city in southern Guangdong province.

It’s here officials have rolled out Covid-style lockdowns in a bid to stop the virus from spiralling out of control.

At least 12 other cities in the southern Guangdong province have also reported infections.

On Monday, Hong Kong reported its first case – a 12-year-old boy who developed symptoms after travelling to Foshan in July.

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Here is what you need to know about the disease.

What is chikungunya and what are the symptoms?

Although rare in China, chikungunya outbreaks are common across South and South East Asia and parts of Africa.

The virus, which is spread by the Aedes mosquito – also known as the tiger mosquito – was first identified in Tanzania in 1952 and has since been reported in over 110 countries.

Most people who get bitten by an infected bug will develop symptoms within three to seven days.

Dr César López-Camacho, from the Jenner Institute at the University of Oxford, said: “Although chikungunya rarely causes death, it can be extremely uncomfortable and disabling.”

Typical symptoms include:

Excruciating joint pain, which can leave victims hunched or folded over in agony
High fever
Headache
Muscle aches
Nausea
Fatigue
Red, bumpy rash
Swelling in the joints, particularly the hands and feet

In severe cases, the joint pain can mimic arthritis, leaving sufferers temporarily disabled for months or even years.

The virus gets its name from a word meaning “that which bends up” or “doubled-up”, in reference to the stooped posture of victims hunched over in pain.

Most people recover within a week, but some may require hospital care, especially if complications like organ damage arise.

The virus can attack vital organs including the brain, heart, liver, and kidneys, triggering dangerous inflammation and tissue damage.

Its intense inflammatory response can also harm the lungs, skin, and joints, worsening symptoms and increasing the risk of serious complications.

Those most at risk of severe illness include newborn babies, older adults, and people with underlying conditions such as heart disease or diabetes.

Is there a treatment or vaccine?

There is no specific treatment for chikungunya, but medics can treat the symptoms by giving medicines to lower fevers or ease muscle pain.

Two chikungunya vaccines have recently been approved for use in the UK – although one is under safety review for older people.

Those are mostly targeted at travellers and are not widely available in the countries most affected by chikungunya.

Once someone has recovered from chikungunya, there is evidence to suggest they have lifelong immunity.

Unlike malaria-carrying mosquitoes, called Anopheles, tiger mozzies are most active during the day, especially in the early morning and late afternoon.

Experts warn that the best way to prevent their spread is to eliminate pools of stagnant water where mosquitoes breed, according to the World Health Organisation (WHO).

Brits travelling to China amidst the outbreak should “be cautious”, Dr César added.

He continued: “The US Centre for Disease Control and Prevention has issued a Level 2 travel alert, recommending travellers use insect repellent, wear long sleeves, and stay in screened or air-conditioned accommodation.

“Travellers returning from affected areas who develop fever and joint pain should seek medical attention and mention their recent travel.”

People travelling to high-risk areas where outbreaks of the virus often occur can get vaccinated against chikungunya at a travel clinic.

Is chikungunya in Europe?

The WHO warned last month that chikungunya could soon affect billions across the globe as it tears through parts of the Indian Ocean and edges closer to Europe.

The health watchdog said it was seeing the same warning signs as in the last major outbreak two decades ago, when nearly half a million were infected worldwide.

Dr Diana Rojas Alvarez, WHO’s technical lead on the virus, said the bug is now spreading from Indian Ocean islands into Africa, Asia and Europe, and urged countries to act now to avoid billions falling ill.

“We are seeing history repeating itself,” Dr Diana explained.

“Chikungunya is not a disease that is widely known, but it has been detected and transmitted in 119 countries globally, putting 5.6 billion people at risk,” she said.

In Europe, officials are especially concerned about a spike in imported cases, and signs of the virus being transmitted locally.

Since May 1, there have been around 800 imported chikungunya cases in mainland France, Dr Diana revealed.

Even more worrying, there have been 12 local transmission episodes in several regions of southern France – meaning people were infected by mosquitoes in Europe, not while travelling.

A case has also been detected in Italy, while the WHO says suspected cases have cropped up in other parts of the continent.

Last year, Europe saw a sharp surge in mosquito-borne diseases – including dengue, West Nile, and malaria – with some infections doubling in just 12 months.

In places where people have little or no immunity, up to three-quarters of the population can become infected, the WHO warned.

“The case fatality rate is less than one per cent, but when you start counting millions of cases, that one per cent can be thousands,” Dr Diana said.

How concerning is this outbreak?

Though tactics adopted by authorities in China hark back to lockdown measures five years ago, chikungunya “does not pose the same level of pandemic threat as a virus like Covid-19”, according to Prof Tom Solomon, director of The Pandemic Institute in Liverpool.

Dr César López-Camacho, from the Jenner Institute at the University of Oxford, added: “It is extremely unlikely to cause a pandemic in the traditional sense, as chikungunya does not spread from person to person.

“However, it can cause large regional outbreaks, especially when introduced to mosquito-rich, low-immunity settings, like what we are probably seeing in China.”

The risk to the UK from this outbreak is “currently low” as Aedes mosquitoes, which tend to carry the virus, aren’t widespread here.

“But we do need to watch closely, as climate change and global travel are expanding the range of these mosquitoes, and with it, the viruses they carry,” Dr López-Camacho warned.

“It is also important that genetic sequencing of the virus in this outbreak is carried out.

“In past outbreaks, mutations have helped chikungunya adapt to new mosquito species.

“If the virus has changed, we need to ensure current vaccines still offer protection.”

Brits travelling to China amidst the outbreak should “be cautious”, the disease expert said.

“Travellers returning from affected areas who develop fever and joint pain should seek medical attention and mention their recent travel.”

People travelling to high-risk areas where outbreaks of the virus often occur can get vaccinated against chikungunya at a travel clinic.

But Prof Solomon noted: “There have been reports of serious side effects in people over the age of 65.

“As such, the vaccine is currently recommended for travellers under 65 visiting high-risk areas.”

Folding in half among 8 signs of virus in China sparking global outbreak fears