Warning! You Might Not be Able to Enter China!

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Recently, my friend Eric planned to travel to China. When he got to customs, a Chinese officer stopped him from passing through. Annoying, yes, but it was with good reason. We recently discovered a viral infection has become widespread around the world within the past few months. China Customs recently released two documents on increasing border inspections, in an attempt to prevent Nipah and Dengue from going viral within the country through infected travelers.

Dengue Symptoms

In some cases, Dengue fever is asymptomatic – infected people may not exhibit symptoms. Those with symptoms get ill between 4 to 7 days after the bite. The infection is characterized by flu-like symptoms which include a sudden high fever coming in separate waves, pain behind the eyes, muscle, joint, and bone pain, severe headache, and a skin rash with red spots. Treatment includes supportive care of symptoms. There is no antiviral treatment available. 

Eric is from India - since May 2018, India has faced an outbreak of the Nipah virus. 17 people have died and a total of 43 patients tested positive so far, with no known cure or vaccine for Nipah. 

 Here is the announcement on the prevention of Nipah entering China from India released by China Custom. If travelers feel illness when passing through customs, they should declare it, and doctors can offer is supportive treatment while the victim’s immune system attempts to fight off the virus, which causes brain damage. 

A few weeks later, China Customs released a document about 28 countries (regions) that previously reported cases on Dengue fever.

On the list, travelers or goods entering China from these countries may face a health quarantine inspection. Chinese customs will take strict action to inspect patients with suspected infections. Travelers with symptoms like fever, headache, or joint pain are required to make a declaration at the border and accept the relevant health inspection. After passing through customs, if within 45 days they show Dengue fever symptoms, they should go to the doctor right away!

List of 28 countries(regions) reported Dengue Infections in 2018

               No.                      Country                  Case of Dengue 

Containers, goods, baggage, mail, and shipments from the above countries (regions) must pass quarantine inspection and related cargo carriers, agents, or shippers should accept the health and quarantine inspection as well. 

According to reported data from World Health Organization, the risk of Dengue exists in tropical and subtropical areas of Central America, South America, Africa, Asia, and Oceania. All travelers are at risk during outbreaks. Long-term travelers and humanitarian workers going to areas where Dengue is endemic are at higher risk. Dengue fever occurs in urban and suburban settings with higher transmission rates happening during the rainy season. Please pay attention if you have travel plans to these countries. 

Dengue is a mosquito-borne tropical disease, In China, its outbreak season is in summer. Over the past few years, a series of Dengue fever outbreaks occurred in Guangdong, Yunnan, Fujian, and Guangxi during the period from May-September. 

It is suggested that if you are bitten by the mosquitos or feel sick, think about staying at home, as if you try to come to China, China customs may repatriate you back your own country or insulate you in the hospital.

However, these methods appear not to be sufficiently effective, as the frequency of outbreaks appears to be increasing in some areas. The viruses are transmitted through the bite of infected Aedes aegypti and Aedesalbopictus female mosquitoes that feed both indoors and outdoors during the daytime (from dawn to dusk). These mosquitoes thrive in areas with standing water, including puddles, water tanks, containers and old tires. Lack of reliable sanitation and regular garbage collection also contribute to the spread of the mosquitoes. The range of the disease appears to be expanding possibly due to climate change.

Prevention

Travellers should take meticulous measures to prevent mosquito bites during the daytime. 

1. Use a repellent containing 20%-30% DEET or 20% Picaridin on exposed skin. Re-apply according to manufacturer's directions.

2. Wear neutral-coloured (beige, light grey) clothing. If possible, wear long-sleeved, breathable garments.

3. If available, pre-soak or spray outer layer clothing and gear with permethrin.

4. Get rid of water containers around dwellings and ensure that door and window screens work properly.

5. Apply sunscreen first followed by the repellent (preferably 20 minutes later).

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