The “Chikungunya Diagnosis and Treatment Protocol (2025 Edition)” has been released—what changes have been made?

On July 31, in order to further guide medical institutions at all levels and of all types in providing effective medical care for chikungunya fever and to enhance the standardization and uniformity of diagnosis and treatment, General Office of the National Health Commission and Comprehensive Department of the State Administration of Traditional Chinese Medicine Building on the 2008 guidelines for the diagnosis and treatment of chikungunya, an organization has developed and issued… Chikungunya Diagnosis and Treatment Protocol (2025 Edition) 。

I. Etiology
 

Determine the virus diameter. 60~70 nm , genome length Approximately 11.8 kb 。

New addition Propagation Characteristics of the Indian Ocean Branch (IOL) 。

New addition Inactivation conditions , the list of disinfectants is more detailed (newly added Peracetic acid, glutaraldehyde, povidone-iodine, quaternary ammonium compounds ).

II. Epidemiology

Source of infection: emphasized From the day of onset to within 7 days It is contagious.

Transmission route: New case Mother-to-child transmission, blood transfusion transmission The explanation states that it may be transmitted via aerosols.

Trend characteristics: Update 119 countries and regions worldwide Trending (as of June 2025), new additions China’s epidemic cases (e.g., the imported case in Foshan, Guangdong, in 2025) 。

III. Pathogenesis

Clear Viremia peaks within 3 days of onset and resolves by days 5 to 7. 。

New addition Mechanisms of chronic arthritis (T-cell persistent activation).

Simplify the description of pathological changes and omit details of animal experiments (e.g., hepatic and splenic lesions in mice).

IV. Clinical Manifestations

Joint pain: emphasized Symmetrical involvement of distal small joints (ankle, fingers, and wrist) , which may be accompanied by joint effusion.

Rash: New onset May involve the face. , accompanied by itching.

New addition Children/Newborns Clinical manifestations.

Remove the description of “biphasic fever” and emphasize the fever course. 1–7 days 。

V. Laboratory Tests

Serology: Clarified IgM antibodies can be detected 3 to 4 days after the onset of illness. ， IgG antibodies can be detected between days 5 and 8. 。

New addition Imaging examination (Joint synovitis, effusion, etc.).

VI. Diagnosis

Adopt Three-tier diagnostic system (Suspected cases, clinically diagnosed cases, confirmed cases).

VII. Differential Diagnosis

Dengue fever: Increase Nucleic acid testing is required for differential diagnosis. In areas with a high risk of dengue fever transmission, it is also recommended to test for dengue.

New addition Zika virus disease Identification 。

Identification and differentiation of alphaviruses, including the O’nyong-nyong virus.

VIII. Severe Cases, High-Risk Groups for Severe Disease, and Early Warning Indicators for Severe Disease

New chapter added.

IX. Treatment

Avoid using Nonsteroidal anti-inflammatory drugs (NSAIDs) , recommended Acetaminophen . Added Children should avoid using salicylate-containing medications. 。

New addition Critical care 。

New addition Traditional Chinese Medicine treatment 。

X. Case Detection and Reporting

Clearly require 24 hours Inside Online direct reporting.

XI. Hospital Infection Control and Criteria for Release from Isolation

New addition Hospital Infection Control 。

New addition Criteria for Release from Isolation : Normal body temperature for >24 hours + negative nucleic acid test or disease course >7 days.

XII. Prevention

Travel to newly designated epidemic areas should heighten vigilance.