What changes are there in the "Chikungunya Fever Diagnosis and Treatment Plan (2025 Edition)" released?
Release time：2025.08.01
On July 31, to further guide medical institutions at all levels and types in the treatment of chikungunya fever and improve standardized and homogeneous diagnosis and treatment levels, General Office of the National Health Commission and Comprehensive Department of the National Administration of Traditional Chinese Medicine Based on the chikungunya fever diagnosis and treatment plan issued in 2008, organized the formulation and release of Chikungunya Fever Diagnosis and Treatment Plan (2025 Edition) 。
Changes in the new edition
1. Etiology
Clarified virus diameter 60~70nm , genome length about 11.8kb 。
Added Transmission characteristics of the Indian Ocean lineage (IOL) 。
Added Inactivation conditions , disinfectant list more specific (added peracetic acid, glutaraldehyde, povidone-iodine, quaternary ammonium compounds ).
2. Epidemiology
Source of infection: emphasized infectious from the day of onset to within 7 days. 具传染性。
Transmission routes: added mother-to-child transmission, blood transfusion transmission explanation, removed possible aerosol transmission.
Epidemic characteristics: updated 119 countries and regions worldwide epidemic (as of June 2025), added cases in China (such as the imported epidemic in Foshan, Guangdong in 2025) 。
3. Pathogenesis
Clarified viremia peaks within 3 days of onset, disappears in 5-7 days 。
Added mechanism of chronic arthritis (persistent T cell activation).
Simplified description of pathological changes, removed animal experiment details (such as liver and spleen lesions in mice).
4. Clinical manifestations
Joint pain: emphasized symmetrical involvement of distal small joints (ankle, fingers, wrist) , may be accompanied by joint effusion.
Rash: added may involve the face , accompanied by itching.
Added Clinical manifestations in children/newborns. 临床表现。
Deleted description of "biphasic fever", emphasized fever duration 1-7 days 。
5. Laboratory tests
Serology: clarified IgM antibodies detectable 3-4 days after onset ， IgG antibodies detectable 5-8 days after onset 。
Added Imaging examinations (joint synovitis, effusion, etc.).
6. Diagnosis
Adopted three-level diagnosis system (suspected cases, clinical diagnosis cases, confirmed cases).
7. Differential diagnosis
Dengue fever: added need for nucleic acid testing to differentiate in high-risk dengue epidemic areas, dengue testing is also recommended.
Added Zika virus disease differentiation 。
Deleted differentiation from O’nyong-nyong virus and other alphaviruses.
8. Severe cases, high-risk groups for severe disease, and severe warning indicators
New section added.
9. Treatment
Avoid using non-steroidal anti-inflammatory drugs (NSAIDs) recommended acetaminophen Added avoid salicylates in children 。
Added Severe case treatment 。
Added Traditional Chinese medicine treatment 。
10. Case detection and reporting
Clearly required within 24 hours network direct reporting. 网络直报。
11. Hospital infection control and isolation release criteria
Added Hospital infection control 。
Added Isolation release criteria : normal body temperature >24 hours + negative nucleic acid test or disease course >7 days.
12. Prevention
Added raising awareness of prevention when traveling to epidemic areas.
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