Risk assessment of public health emergencies concerned in China, November 2025

Objective  To assess the risk of public health emergencies that may occur or be imported from abroad in China (except Hong Kong and Macao Special Administrative Regions and Taiwan region, the same below) in November 2025.

Methods  Based on the reports of domestic and foreign public health emergencies and surveillance results of key infectious diseases or notifications from relative agencies and departments, the expert consultation conference was hold and experts from provincial (autonomous region and municipal) centers for disease control and prevention attended this conference through video terminal.

Results  It is predicted that the incidence of public health emergencies in November 2025 may increasing compared with October 2025, driven primarily by infectious diseases. Currently, the acute respiratory infectious diseases are trending upward. Influenza virus positivity rates in both southern and northern Chinese provinces have risen rapidly to moderate levels. In November, Aedes mosquito vectors remain active in four Class I provinces (Guangdong, Guangxi, Hainan, Fujian) and southern regions such as Xishuangbanna Prefecture in Yunnan province. Consequently, the risk of local transmission following imported chikungunya fever cases remains relatively high, and the potential for local outbreaks persists. While dengue fever activity is entering a declining phase, the risk of local transmission in the aforementioned Class I areas and southern regions remains elevated, posing a continued threat of clustered cases. Class II areas continue to face the risk of case importation from abroad and other provinces, though the risk of sustained local transmission is low. Hand, foot and mouth disease (HFMD) is in the late stage of its autumn peak, and reported cases are predicted to gradually decrease. In November, norovirus enteritis outbreaks were expected to continue showing a slight increase. Crowded settings, particularly schools and kindergartens, are identified as high-risk environments for epidemic transmission. In the short term, the risk of imported mpox sublineage Ib outbreak from abroad and local secondary transmission within China will persist. Meanwhile, mpox sublineage IIb is expected to maintain low-level transmission among key populations. Lassa fever remains endemic in West Africa; Chinese personnel traveling to or working in field settings in endemic areas face a risk of infection if they come into contact with rodents or rodent-contaminated items. Furthermore, the risk of sporadic human infections with novel influenza subtypes persists. Finally, non-occupational carbon monoxide poisoning has entered its high-incidence seasonal period, particularly in northern China due to colder weather and improper heating methods.

Conclusion  Attention should be paid to influenza, multiple acute respiratory infectious diseases, chikungunya fever, dengue fever, HFMD, norovirus enteritis, mpox, Lassa fever, human infections with novel influenza subtypes and non-occupational carbon monoxide poisoning.