In the southern Chinese city of Foshan, officials are engaged in an all-out battle against chikungunya, a painful, mosquito-borne viral disease that could spread across the country.
Soldiers wearing masks are fogging parks and streets with insecticide. Drones have been deployed to identify mosquito breeding sites. Researchers have introduced giant “elephant mosquitoes,” whose larvae prey on the virus-carrying mosquitoes, and thousands of mosquito-eating fish have been released into city ponds.
A virus transmitted by the bites of infected mosquitoes, chikungunya is rarely fatal, but it does cause fever and severe joint pain. It has infected about 8,000 people in China in four weeks, mostly in Foshan, and is the country’s
largest outbreak of its kind
since the virus first emerged in the country in 2008. Experts say rising global temperatures have led to warmer and wetter weather there, allowing mosquitoes to thrive.
To fight the outbreak, the authorities are also drawing on a familiar playbook honed during the Covid-19 pandemic – mobilising the city of 10 million in a “patriotic public health campaign.” For some, that is evoking unhappy memories.
At building entrances in the city, workers spray residents with mosquito repellent before allowing them in. Community workers in red vests go door to door, inspecting homes and ordering residents to dump any stagnant water. Those who don’t cooperate could be fined or, in serious cases, face criminal charges for “obstructing the prevention of infectious diseases,” according to an illustrated government explainer.
At least five households have had their electricity cut for not cooperating, according to a notice issued by a neighbourhood committee in the district of Guicheng.
When Covid-19 spread in China, the country imposed some of the world’s strictest measures – the much-hated zero Covid policy that involved mass testing, citywide lockdowns, mandatory quarantines and the constant tracking of people’s movements.
On RedNote, a popular social media platform, residents say they are being ordered by community workers to empty all containers of water, including water bowls for their dogs. Some complained that the policing was excessive.
Two residents who were reached by message on RedNote and did not want to be identified out of fear of retaliation told The New York Times that workers entered their homes without their consent to search for stagnant water. Two others said their plants had been taken away or destroyed in front of them. Faxes to the Foshan city government’s line could not go through Aug 5, and emails were not returned.
In Foshan and other cities in Guangdong province, just north of Hong Kong, infected residents are being sent to “quarantine wards” where they stay behind mosquito nets and screens. Some who had been infected said they were given no choice but to go to the hospital at their own expense. (During an outbreak, mosquitoes can quickly spread the virus, picking it up from a sick person and infecting healthy others.)
Carried by the Aedes mosquito, which also transmits dengue and Zika, the chikungunya virus was first detected in southern Tanzania in the 1950s. (Its name comes from the Kimakonde language and means “that which bends up,” a reference to the contorted posture of those in pain.)
After an imported case of chikungunya was detected in Foshan on July 8, infections quickly spread. Now, citizens have been urged to spend at least three minutes every morning cleaning out all sources of standing water. Employees at government agencies should not go home until they have thoroughly checked plant holders, tea trays, unfinished drinks and roof awnings for water.
To breed, mosquitoes “don’t actually need a lot of water or even a lake. They can spread and reproduce in even the smallest pool of water, like a Coke bottle cap,” said Dr Ren Chao, a professor at the University of Hong Kong researching the impact of climate change on the spread of mosquito-borne diseases in urban areas.
The most extreme steps, such as mandatory quarantine for those infected, have not been implemented, but experts say China’s pandemic measures are designed to be ratcheted up quickly if deemed necessary.
“Essentially you raise the spectre of the zero Covid strategy, with its zero-tolerance approach, the mass mobilisation, the surveillance and testing,” said Professor Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.
There are similarities, Prof Huang said, with even earlier mobilisations. In the late 1950s, the infamous “four pests” campaign to eradicate rats, flies, mosquitoes and sparrows led to the mass extermination of sparrows in China and a surge in locusts that contributed to famine.
“It’s fundamentally no different from the Maoist-style public health campaigns,” Prof Huang said. “It involves the mass mobilisation of the people. It’s targeting a particular threat to public health and potentially could lead to unintentional consequences.”
The virus poses real risks. Experts say it can cause serious illness in older patients, newborns and people with preexisting health conditions. Most people recover within a week, but joint pain can last for months.
The outbreak has raised concerns abroad. The US Centres for Disease Control and Prevention on Aug 1
issued a “Level 2” travel advisory
for Guangdong, urging travellers to avoid mosquito bites and to get vaccinated before arrival. (There are two approved vaccines for the virus in the United States, but they are not available in China.)
Responding to reports about the US travel warning, Guo Jiakun, a Chinese Foreign Ministry spokesperson, said last week that the infections in China were “under control.”
Cases spreading from Indian Ocean islands to Europe and other regions prompted the World Health Organization in July to call on countries to act to prevent a large-scale outbreak. According to the European Centre for Disease Prevention and Control, there have been about 240,000 cases of chikungunya and 90 deaths related to the virus globally this year; South American countries are hardest hit.
Outside Foshan, about 200 infections have since been detected in 12 other cities in Guangdong. An unspecified number of cases also have been reported in neighbouring Hunan province. A handful have been reported as well in Macao and Hong Kong, which are about 170km south of Foshan.
Mr Wang Weizhong, the governor of Guangdong, on Aug 2 ordered all officials to help mobilise the masses to clean out rooftops and courtyards and to light mosquito coils, install window screens and hang nets over their beds.
“We must make every effort to win the battle against the epidemic,” he said.
Pharmacies in Foshan have started tracking who buys medications for fever, rash or joint pain, prompting concern online that the data would be used to identify potential infections. Skyscrapers in Foshan light up at night with messages reminding residents to burn mosquito coils and to empty out standing water. One community worker, surnamed Chen, said in an interview that she spends about 10 hours a day inspecting public places and homes, walking up and down flights of stairs.
For some residents, there is little point in resisting the campaign. Ms Cy Chen, 22, a recent graduate living in Foshan, was told to stay in the hospital isolation ward after testing positive instead of returning home.
“I was already infected, so there was no use in getting upset. I might as well cooperate,” she said. NYTIMES
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Additional reporting by Apoorva Mandavilli
