2026年 · 第06卷第01期

China released updated national plans for dengue (2024) and chikungunya (2025) to standardize clinical management amid expanding Aedes-borne risk, recurrent importations with episodic local amplification, and heterogeneous diagnostic capacity. This article synthesizes the clinical and operational content of these documents, situates them within China’s epidemiologic context, and appraises areas of alignment and nuance relative to World Health Organization (WHO) and Pan American Health Organization (PAHO) recommendations. The revised plans recalibrate case stratification and advise against routine corticosteroids/Immunoglobulin therapy(IVIG) for chikungunya. Infection prevention and discharge criteria are operationalized by coupling defervescence with time- and/or virologic-based thresholds. Compared with WHO and PAHO, China converges on core principles—supportive care, early recognition, and judicious fluids management—while adding pragmatic features for arbovirus-endemic settings, notably an explicit dual-testing trigger for febrile arthralgia (simultaneous dengue and chikungunya testing) and more prescriptive discharge and precaution language. Implementation rests on a hub-and-spoke diagnostic model: frontline nonstructural protein 1 antigen testing with reflex Nucleic Acid Amplification Test via prefecture or provincial CDC laboratories, supported by external quality assessments for dengue, chikungunya, and Zika. Domestic evidence strengthens the plans’ real-world clinical applicability: field epidemiology with genotyping demonstrates importation-seeded local transmission; hospital cohorts validate the use of warning-sign-guided escalation, window-based testing, and risk stratification for frail patients; and health-economic analyses inform preseason capacity planning. The remaining gaps are practical rather than conceptual, but they matter because they directly affect patient outcomes and system readiness: pathways for chronic chikungunya arthropathy, pediatric- and pregnancy-specific operational details, tier-appropriate diagnostic turnaround standards, and numeric thresholds linked to time-bound escalation. Overall, China’s 2024-2025 plans harmonize with international norms while translating them into implementable routines for mixed-transmission environments, offering a replicable model for regions facing overlapping arboviral threats.

Influenza is a common acute respiratory infectious disease in China, characterized by pronounced seasonality, rapid transmission, and a high risk of severe illness among high-risk populations. These features pose a substantial threat to public health. Historically, recommendations for influenza treatment and prophylaxis have largely relied on expert consensus in China, with a lack of systematic, evidence-based guidelines. In recent years, accumulating evidence on traditional antiviral agents such as neuraminidase inhibitors, as well as emerging agents targeting RNA polymerase, has expanded therapeutic options for influenza, underscoring the need to systematically update and refine existing treatment recommendations. Accordingly, a multidisciplinary panel of Chinese experts developed the "Clinical practice guidelines for the treatment and prophylaxis of influenza in China (2025 edition)" following established guideline methodology. This guideline focuses on antiviral therapy, adjunctive treatment, and prophylaxis, systematically summarizing and updating treatment indications, drug selection, dosing regimens, duration, and safety management across different populations. Specific recommendations are provided for key groups such as children and pregnant women. The guideline culminates in a series of evidence-based recommendations, providing structured and actionable guidance for the clinical management and prevention of influenza in China.

Background: Severe coronavirus disease 2019 is associated with extensive syncytia formation, a process driven by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein-mediated cell-cell fusion in infected pneumocytes. This study aims to identify compounds to prevent S-mediated fusion, which may represent a potential therapeutic strategy to limit disease progression. Methods: We developed a bimolecular multicellular complementation assay using NanoLuc binary technology to quantitatively detect cell-cell fusion. A high-throughput screen was conducted against a compound library comprising 16,520 molecules. Candidate inhibitors were classified based on their bioactivities, and selected hits were further assessed for their ability to inhibit infection using pseudotyped virus and authentic SARS-CoV-2 infection in the cell cultures. Results: The screening identified 62 compounds that suppressed S protein-mediated fusion. These included inhibitors of cellular proteases involved in S protein cleavage, ATPase inhibitors linked to endosomal acidification, and modulators of hormone receptors, neurotransmitter receptors, calcium channels, and transmembrane protein 16F. Calcium ions emerged as a common regulatory element across these pathways. However, most hits did not show significant antiviral activity against pseudotyped or authentic SARS-CoV-2 infection. Interestingly, a natural compound trigothysoid N exhibited cell-type-dependent effects, inhibiting fusion in Vero-E6 (half maximal inhibitory concentration (IC50) = 1.70 nM) and HeLa-ACE2 cells (IC50 = 0.65 nM) but enhancing it in A549-ACE2/TMPRSS2 and 293T-ACE2 cells. Conclusion: The identification of fusion inhibitors helps delineate the complex network of events and signaling pathways involved in S-mediated fusion and supports the development of therapeutics targeting this process. Our findings provide valuable insights for the development of therapeutics targeting syncytia formation. Moreover, the opposite effects of trigothysoid N observed across different cell lines highlight the need for careful evaluation of host-targeted fusion inhibitors, as they may exhibit divergent efficacy among patients.

Vector-borne diseases (VBDs), primarily transmitted through the bites of vectors such as mosquitoes, ticks, and sandflies, have been recognized as a critical global public health priority. This systematic review summarizes the pivotal role of geospatial technologies, including geographic information systems (GIS), remote sensing (RS), and advanced spatial statistical methodologies, in enhancing disease surveillance systems. We conducted a comprehensive literature screening across the PubMed and OVID Medline databases, identifying 652 relevant studies published between 2015 and 2024. These studies were analyzed to evaluate the application of geospatial approaches to several critical VBDs such as malaria, dengue fever, yellow fever, and other VBDs. The integration of GIS and RS enables high-resolution mapping of vector habitats and disease hotspots by analyzing environmental factors. Advanced spatial statistical models effectively quantify the influence of environmental and socioeconomic variables, predict transmission risk, and detect significant spatial clusters. Phylogeographic analyses elucidate pathogen origins and transmission pathways, while animal migration tracking reveals the role of long-distance vector and host dispersal in disease spread. These approaches have facilitated the development of actionable risk maps that support targeted interventions, optimize resource allocation, and underpin early warning systems for diseases such as malaria, dengue fever, yellow fever, and Zika virus disease. In summary, geospatial epidemiology plays a critical role in VBD control by providing evidence-based insights into transmission dynamics. Future efforts should prioritize interdisciplinary collaboration and the development of integrated, real-time surveillance platforms that combine multisource data and predictive modeling.

Mosquito-borne viruses (MBVs) are a group of arboviruses belonging to diverse families and genera. Transmitted through mosquito bites, MBVs are a significant public health concern. These pathogens can cause a spectrum of mosquito-borne viral diseases (MBVDs) ranging from rashes, mild fever, and arthralgia to severe conditions, such as shock, encephalitis, microcephaly, hemorrhagic fever and even death. MBVDs are primarily endemic in tropical and subtropical regions, putting half of the global population at risk. Evolutionarily, these viruses are highly adapted to both mosquito and mammalian hosts, efficiently exploiting multiple characteristics of both hosts to facilitate the infection and transmission cycle. In this study, we review the current knowledge of the infection and transmission of major pathogenic MBVs, the underlying mechanisms thereof, and recent advances in preventing and controlling these viruses. We also highlight key challenges in MBV control, infection, and transmission while discussing prospective directions for future research.

Chikungunya fever (CHIKF) is an arthropod-borne viral disease caused by the chikungunya virus (CHIKV). Patients typically present with fever and symmetric distal polyarthralgia, which may progress to chronic joint sequelae. This review was conducted to systematically examine CHIKF’s virological characteristics, immunopathogenic mechanisms, global and regional epidemiology, and clinical manifestations as well as diagnostic approaches and treatment options. CHIKV may be present in areas previously considered nonendemic, as increased international travel, high urban population densities, and favorable vector ecology facilitate viral transmission. Effective CHIKF control requires the implementation of enhanced surveillance, targeted vector control measures, and standardized clinical management protocols. Considering CHIKV’s genomic diversity and immune-driven pathogenesis and the wide spectrum of acute and chronic disease conditions, continuous monitoring and adaptive control measures tailored to specific settings are required.

The emergence of HKU5-CoV-2, a novel lineage in the Merbecovirus subgenus, represents a potential zoonotic threat with significant implications for global health. This bat-derived virus, which is phylogenetically similar to the Middle East respiratory syndrome coronavirus and severe acute respiratory syndrome coronavirus 2, has demonstrated the ability to use the human angiotensin-converting enzyme 2 receptor to enter human cells. Although no human infections have been reported, its zoonotic potential raises the possibility of spillover events, which could lead to widespread transmission and, under certain conditions, pandemics. This study explores the virological characteristics, epidemiological risks, and clinical implications of HKU5-CoV-2, emphasizing its capacity to cross species barriers and cause severe respiratory diseases. To address the potential for a future pandemic, we propose a theoretical response framework based on the Chemical, Biological, Radiological, Nuclear, and Explosive approach traditionally employed for high-consequence biological threats. This strategy integrates early detection through advanced genomic surveillance, rapid containment measures, the development of targeted medical countermeasures, effective risk communication, and international collaboration. By leveraging lessons from previous coronavirus outbreaks, this framework aims to mitigate the impact of a potential HKU5-CoV-2 spillover and to ensure a coordinated and efficient global response. This study underscores the importance of preparedness in the face of emerging zoonotic viruses and provides a roadmap for managing future biological threats of pandemic potential.

Scrub typhus is a bacterial infection caused by Orientia tsutsugamushi and transmitted by chigger bites. It presents as an acute febrile illness and can lead to serious complications, including liver and kidney dysfunction. Although neurological involvement is rare, cases have been reported. We describe the case of a 59-year-old male from a scrub typhus endemic region with a history of seizure disorder who had experienced a fever for the last two days, multiple headaches, and seizures. Laboratory tests confirmed scrub typhus, low platelet levels, and elevated liver enzymes. The patient responded well to doxycycline and supportive care. This case highlights the need to identify scrub typhus in febrile patients with neurological symptoms to enable early diagnosis and treatment and prevent severe complications. The occurrence of scrub typhus with seizures is rare, making this case clinically significant in broadening differential diagnoses in endemic regions.