From the ECDC (European Centre for Disease Prevention and Control) Weekly Communicable Disease Threats Report, the US CDC, and the WHO:
Chikungunya:
Since the beginning of 2025, approximately 317,000 CHIKVD (Chikungunya virus disease) cases have been reported in 16 countries/territories in the Americas, Africa, Asia, and Europe.
As reported last month, South America still accounts for the highest cumulative number of cases reported worldwide, with an ongoing outbreak in Bolivia in a region far from La Paz, and cases in Brazil and Argentina. In Europe, just last week, two countries reported new locally-acquired cases of chikvd: 45 in France and 22 in Italy.
The situation has been evolving in Asia now with an outbreak in China’s southeastern coastal province of Guandong (see US CDC map) – a total of 830 new cases were reported in the period 10-16 August. Since the start of the outbreak in July, at least 9,933 cases have been reported, mostly in the city of Foshan. Other nearby territories, such as Macao and Honk Kong have reported locally acquired CHIKVD cases associated with imported cases from Guangdong. According to the Chinese CDC, so far, cases have been mild with no deaths. Containment measures have been put in place, such as drones to identify sources of standing water, larvae-eating fish and community isolation for infected individuals.
CHIKVD is widely distributed in tropical and subtropical regions. It is predominantly transmitted by the Aedes aegypti and Aedes albopictus mosquitoes. Ambient temperature is critical for the mosquitoes, their activity (including biting, flight, and breeding) peaking somewhere between 22 and 32 ºC. Ae. albopictus is present in non-endemic areas, including parts of Europe (see previous update) and has been shown to be able to transmit CHIKVD at temperatures as low as 20 ºC. If an individual acquires CHIKVD in an endemic region or during an outbreak, say from being bitten by Ae aegypti, and then returns to a non-endemic region while still viraemic (i.e. with virus circulating in their blood, regardless of symptoms), local transmission may occur if Ae. albopictus is established in that area.
Here is a summary of the clinical features of CHIKVD based on the US CDC and the ECDC:
Most people infected with chikungunya virus develop some symptoms. Symptoms of chikungunya usually begin 3–7 days after a bite by an infected mosquito. The most common symptoms are fever and joint pain. Most people get better within a week; however, some can have severe joint pain for months to years following acute illness. People at risk for more severe disease include newborns, adults 65 years or older, and people with medical conditions such as diabetes or heart disease. Death from chikungunya is rare. There is no specific treatment for chikungunya - treatment focuses on managing the symptoms with pain relievers and anti-inflammatory medicines. After recovering from chikungunya, a person is likely to have lifelong immunity.
Individual measures against mosquito bites are recommended for those who travel to affected areas. Since Aedes is a diurnal mosquito, measures should be applied all day, especially during the hours of highest mosquito activity - mid-morning and late afternoon to twilight. There are currently two vaccines for CHIKVD, one made of live attenuated virus and another of virus-like particles. Currently, the WHO has not issued recommendations for the use of these vaccines. In any case an individualised risk-benefit assessment is essential for vaccination decisions, including individual risk factors for serious adverse reactions, duration of travel, risk of actual places to be visited and measures put in place locally, etc.
More about Chikungunya here: https://www.who.int/health-topics/chikungunya#tab=tab_1
A selection of other publications of interest:
ICAO 2024 Global Aviation Safety Report
Here:https://www.icao.int/sites/default/files/sp-files/safety/Documents/ICAO_SR_2025.pdf
“The global passenger traffic continued to grow in 2024 with around 4.528 billion passengers transported worldwide, up from 4.17 billion passengers in 2023 and surpassed the pre-pandemic (2019) level of 4.5 billion passengers.”
On page 43 you will find a section on “The Role of Health Promotion and Mental Wellbeing in Enhancing Aviation Safety”, including:
The ICAO Medical Provisions Study Group (MPSG) recommendation to consider migrating from a prescribed pilot upper age limit to an individualized, risk-based and performance-based standard, irrespective of chronological age;
The key outcomes of the ICAO Review of the Upper Age Limit for Pilots Engaged in Commercial Air Transport Operations survey.
Highlights of the work undertaken by the ICAO Mental Health Working Group (MHWG), including a review which has resulted in a new ICAO Manual of Health Promotion and Mental Wellbeing in Aviation Personnel, scheduled for publication this year.
The value of health promotion, mental well-being advocacy and the application of individualized risk management.
AI turbulence
Japan’s ANA has adopted a deep-learning turbulence prediction system with claims of an 86% accuracy rate: https://www.flightglobal.com/safety/japans-ana-adopts-deep-learning-turbulence-prediction-system-after-successful-trials/164153.article
In-flight turbulence from a health and safety perspective was one of the topics discussed at the 2022 Aviation Health Conference. For more discussion, networking, sharing and learning opportunities on matters of practical airline medical interest with medical and non-medical colleagues from around the world, register for this year’s Conference:
Aviation Health Conference 2025, London, September 23rd-24th
Programme and registration here: https://quaynote.com/conference/aviation-health-conference-2025/
Dr Rui Pombal
IATA Medical Advisor