A mosquito-borne virus that can leave infected people debilitated for years is spreading to more regions of the world, as climate change creates new habitats for the insects that carry it.

随着气候变化为携带病毒的昆虫创造了新的栖息地，一种通过蚊子传播的病毒正扩散到世界更多地区。感染该病毒的人可能会多年身体虚弱。

More than 240,000 cases of the virus, chikungunya, have been reported around the world so far this year, including 200,000 cases in Latin America and 8,000 in China, the first cases ever reported there. Chinese authorities have launched an urgent effort to try to stifle the virus with public health measures that evoke the response to Covid-19.

今年到目前为止，全球已报告超过24万例基孔肯雅热病例，其中拉丁美洲20万例，中国有8000例——这是中国首次报告此类病例。中国有关部门已启动紧急行动，采取让人联想到应对新冠疫情的公共卫生措施，试图遏制该病毒。

Chikungunya is not circulating in the United States or Canada, but cases have been reported in France and Italy. The disease is endemic in Mexico.

目前基孔肯雅热尚未在美国和加拿大传播，但法国和意大利已报告病例。在墨西哥已经形成流行病疫情。

The World Health Organization is warning that current transmission patterns resemble a global outbreak that infected 500,000 people 20 years ago, contributing to a surge of new disabilities.

世界卫生组织警告称，当前的传播模式与20年前的全球疫情相似，那次疫情感染了50万人，导致新的残疾人数激增。

Although it is rarely fatal, chikungunya causes excruciating and prolonged joint pain and weakness.

虽然很少致命，这种病毒会引发剧烈且持续的关节疼痛和身体虚弱。

“You have people who were working, with no disabilities, and from one day to the next, they cannot even type on a phone, they can’t hold a pen, a woman cannot even hold a knife to be able to cook for her family,” said Dr. Diana Rojas Alvarez, who leads chikungunya work at the W.H.O. “It really impacts quality of life and also the economy of the country.”

“有些人原本在工作，没有任何残疾，一夜之间连能用手机打字、拿笔都不行了，女性甚至无法拿起菜刀为家人做饭，”世卫组织基孔肯雅热工作负责人戴安娜·罗哈斯·阿尔瓦雷斯博士说，“这确实会影响生活质量，也会对国家经济造成影响。”

What is chikungunya, and how dangerous is it?

什么是基孔肯雅热？它有多危险？

Chikungunya is a virus from the same family as Zika and dengue fever. Two different species of mosquitoes, Aedes aegypti and Aedes albopictus, transmit chikungunya. Between four and eight days after a bite, a person can develop symptoms including fever, joint pain and a rash.

基孔肯雅病毒与寨卡病毒、登革热病毒同属一个家族。埃及伊蚊和白纹伊蚊这两种不同种类的蚊子都会传播基孔肯雅病毒。被叮咬后四至八天内，人可能会出现发烧、关节疼痛和皮疹等症状。

Unlike dengue and Zika infections, the majority of which are asymptomatic, chikungunya sickens most people it infects. In rare instances, chikungunya can kill young children and older adults.

大多数感染基孔肯雅病毒的人都会发病，这与多数为无症状感染的登革热和寨卡病毒感染不同。在极少数情况下，基孔肯雅热可能导致幼儿和老年人死亡。

“Fatality levels are low, but we really care about chikungunya because it leaves people with months or potentially years of debilitating pain,” said Scott Weaver, an expert and the scientific director of the Galveston National Laboratory in Texas.

“死亡率较低，但我们之所以高度关注基孔肯雅热，是因为它会让患者遭受数月甚至数年的虚弱性疼痛，”这方面的专家、得克萨斯州加尔维斯顿国家实验室科学主任斯科特·韦弗说。

He added: “That has not only an individual toll but also a social one, with strain on health care systems, economic impact, the demand on caregivers, a lot of things.”

他还说：“这不仅会给个人带来损失，还会产生社会影响，比如给医疗系统带来压力，造成经济影响，增加护理人员的负担等等。”

Chikungunya is often misdiagnosed as dengue, which causes the same symptoms at first.

基孔肯雅热常被误诊为登革热，因为两者初期症状相同。

布宜诺斯艾利斯寄生虫和病媒研究中心实验室里的埃及伊蚊，这是传播基孔肯雅病的两种蚊子之一。

Dengue symptoms usually clear up in a week or two; chikungunya symptoms become chronic in as high as 40 percent of people infected, with debilitating joint pain lasting for months or years.

登革热症状通常在一两周内消退；而在40%的基孔肯雅热感染者中，症状会转为慢性，剧烈的关节疼痛会持续数月甚至数年。

Between 2005 and 2007, more than two-thirds of all the disabilities — including that caused by cancer, arthritis and diabetes — reported in India was the result of a chikungunya outbreak that was sweeping through the country.

2005至2007年间，印度报告的所有残疾病例中（包括由癌症、关节炎和糖尿病引起的残疾），有超过三分之二是由当时席卷全国的基孔肯雅热疫情导致的。

Who is at risk?

哪些人面临风险？

By the end of 2024, transmission of the virus had been reported in 199 countries, on every continent except Antarctica.

截至2024年底，已有199个国家报告了该病毒的传播，涉及除南极洲以外的所有大洲。

The W.H.O. estimates that 5.6 billion people live in areas where the mosquitoes that transmit the virus can live. These mosquitoes are daytime biters, feeding on people who are at work, at school or on a bus.

世卫组织估计，有56亿人生活在传播病毒的蚊子可以生存的地区。这些蚊子在白天叮咬人类，目标包括上班、上学或乘坐大巴的人。

Climate change is driving the spread of chikungunya-carrying mosquitoes in two ways. A warmer, wetter world provides more suitable habitat. And extreme weather events can cause more breeding in floods — or displace people, who cluster in areas with poor water and sanitation supply.

气候变化通过两种方式推动携带基孔肯雅病毒的蚊子扩散。气候变暖、湿润为蚊子提供了更适宜的栖息地。极端天气事件可能带来洪水，从而导致蚊子更多繁殖，或者使人们流离失所，聚集在供水和卫生设施较差的地区。

The Aedes albopictus mosquito has markedly expanded its presence in Europe in recent years: The insect has been found in Amsterdam and Geneva. In South America, Aedes aegypti carries the virus and thrives in low-income neighborhoods in rapidly growing cities with patchy water systems.

近年来，白纹伊蚊在欧洲的活动范围显著扩大：在阿姆斯特丹和日内瓦都发现了这种蚊子。在南美洲，埃及伊蚊携带该病毒，在供水系统不完善、快速发展的城市的低收入社区大量滋生。

“In the U.S. I don’t think we’re going to see massive outbreaks of chikungunya” because people in warm areas use air-conditioning and spend a lot of time indoors, Dr. Weaver said. “But in places like China and the Southern Cone of South America, the warming temperatures are going to have a big impact because people don’t stay inside with air-conditioners in their houses or their workplaces. They don’t even like to screen their windows in many parts of Asia and South America.”

“在美国，我认为不会出现大规模的基孔肯雅热疫情，”韦弗说，因为温暖地区的人们使用空调，大量时间是在室内度过。“但在像中国和南美洲的南锥体地区，气温升高将产生重大影响，因为这些地方的人不是一直待在有空调的家宅或工作场所里。在亚洲和南美洲的许多地方，人们甚至不喜欢给窗户装纱窗。”

People seem to become immune to chikungunya after an infection and so, if it sweeps through an area, it can be a couple of decades before there are enough immunologically vulnerable people to sustain another outbreak. But in places such as India and Brazil, populations are so large that the virus is circulating constantly.

感染基孔肯雅热后似乎会产生免疫力，因此，如果病毒席卷某个地区，可能需要几十年才会有足够多的易感人群再次引发疫情。但在印度和巴西等人口众多的国家，该病毒一直在持续传播。

Many countries in Africa that did not have circulating chikungunya, such as Chad and Mali, have reported cases in the past few years.

过去几年，乍得和马里等许多原本没有基孔肯雅热传播的非洲国家也报告了病例。

一剂基孔肯雅疫苗。

Is there a vaccine?

有疫苗吗？

There are two vaccines for chikungunya, but they are produced in limited quantities for use mainly by travelers from industrialized countries. The newest vaccine, made by Bavarian Nordic, sells for about $270 per shot in the United States, a price well beyond the reach of a country such as Paraguay, which has had huge chikungunya outbreaks and would ideally vaccinate much of the population. Brazil’s Butantan Institute is working on making a lower-cost version of another vaccine.

目前有两种基孔肯雅热疫苗，但产量有限，主要供工业化国家的旅行者使用。由巴伐利亚北欧公司生产的最新疫苗在美国每剂售价约270美元，这个价格远远超出了像巴拉圭这样国家的承受能力——该国爆发了大规模的基孔肯雅热疫情，理想情况下需要为大部分人口接种疫苗。巴西的布坦坦研究所正致力于研发另一种更便宜的疫苗。

Neither vaccine currently has the kind of W.H.O. recommendation that might lead to accelerated development of an affordable product. Doing a clinical trial of the kind the agency requires is difficult: Chikungunya outbreaks happen so fast that they’re over before the research can begin. Dr. Rojas said the W.H.O.’s vaccine committee was reviewing chikungunya outbreak data to consider options for a possible recommendation.

这两种疫苗目前都没有获得世卫组织的推荐，而这样的推荐本可以加速研发价格亲民的产品。开展世卫组织要求的那种临床试验很困难：基孔肯雅热疫情暴发得太快，往往在研究开始前就已经结束了。罗哈斯表示，世卫组织疫苗委员会正在审查基孔肯雅热疫情数据，以考虑可能的推荐方案。

What else can be done?

还能采取哪些措施？

The best protection against chikungunya is not to get bitten.

预防基孔肯雅热的最佳方法是避免被蚊子叮咬。

The next step is to reduce mosquito breeding sites. In China, public health officials are going house to house to look for stagnant water.

其次是减少蚊子的滋生地。在中国，公共卫生官员正在挨家挨户排查积水。

Surveillance for chikungunya is still weak. Dr. Rojas said the W.H.O. was trying to untangle how much of the current surge was new cases and how much was transmission that was already occurring but poorly tracked or reported. There is a molecular diagnostic test that screens for Zika, dengue and chikungunya at the same time, but more countries need to adopt it.

基孔肯雅热的监测工作仍然薄弱。罗哈斯说，世卫组织正试图弄清楚当前的病例激增中有多少是新增病例，有多少是已经存在但跟踪或报告不力的传播病例。有一种分子诊断测试可以同时筛查寨卡、登革热和基孔肯雅热病毒，但需要更多国家采用这种测试。

Disease surveillance globally has been weakened by the abrupt cuts in funding from the U.S. government, which was supporting much of this work in low-income countries.

美国政府突然削减了对低收入国家相关工作的大部分资金支持，削弱了全球的疾病监测能力。

Is this a new virus?

这是一种新病毒吗？

No. Chikungunya was first identified in Tanzania in the 1950s, and caused sporadic outbreaks in Africa and Asia in the next decades.

不是。基孔肯雅热病毒于20世纪50年代在坦桑尼亚首次被发现，在接下来的几十年里，在非洲和亚洲引发过零星疫情。

But the virus didn’t attract much attention from public health specialists until 2004. That year, an outbreak in Kenya spread to La Réunion, a French territory in the Indian Ocean. There, chikungunya raged through the population: A third of the people on the island were infected.

但直到2004年，这种病毒才引起公共卫生专家的广泛关注。那一年，肯尼亚的一场疫情蔓延到了印度洋上的法国属地留尼汪岛。在那里，基孔肯雅热肆虐，岛上三分之一的人被感染。

That same strain of the virus made its way to South Asia, and caused huge outbreaks in India from 2005 to 2007. And from there travelers took chikungunya around the world.

同一毒株的病毒传播到了南亚，并在2005至2007年间在印度引发了大规模疫情。从那以后，旅行者将基孔肯雅热带到了世界各地。

By late 2013, the virus had made its way to the Caribbean and once again began to tear through a population that lacked immunity. There were 1.8 million reported infections in the region by the end of 2015. Chikungunya then made its way down through South America — and a new strain from Angola was introduced to Brazil at the same time — and the two have been circulating since then. Chikungunya cases in South America have risen steadily since 2023, alongside a surge in dengue cases.

到2013年底，该病毒传入加勒比地区，再次在缺乏免疫力的人群中肆虐。截至2015年底，该地区报告的感染病例达180万例。随后，基孔肯雅热向南蔓延至南美洲——同时，一种来自安哥拉的新毒株传入巴西，从那以后，这两种毒株一直在当地传播。2023年以来，南美洲的基孔肯雅热病例稳步上升，登革热病例也同时激增。