Chikungunya fever (CHIKF) is an emerging global health threat caused by the chikungunya virus (CHIKV), whose main symptoms include fever, rash and severe joint pain. The disease is characterized by acute febrile illness and chronic arthralgia, resulting in significant morbidity and economic burden, and posing a significant and growing global public health challenge. CHIKV has spread to over 119 countries, with recent outbreaks in the Americas and Asia. Two vaccines, VLA1553 (live-attenuated) and PXVX0317 (virus-like, particle-based), have been approved and have shown high immunogenicity, although their accessibility remains limited. Pathogenesis involves matrix remodeling-associated protein 8-mediated viral entry and immune dysregulation contributing to chronic arthritis. Traditional Chinese medicine approaches emphasize the removal of dampness and heat as well as the activation of collaterals, which have a potential adjunctive value in chronic phase management of CHIKF. Despite advances in vaccine development for CHIKF, challenges remain in terms of global coverage, research on chronic disease pathways and comprehensive treatment. Multidisciplinary collaboration will be needed to curb the public health impact of CHIKF in the future. Please cite this article as: Yu XL, Zhou RY, Xie XY, Zhang Y, Jia J. Chikungunya fever-What we know and have done in the face of a new global public health threat. J Integr Med. 2026; Epub ahead of print.

Heat-related illnesses encompass a spectrum of disorders resulting from exposure to high temperatures and the body's inability to efficiently dissipate heat. These syndromes range from mild illnesses, such as heat edema, heat rash, and heat cramps, to more concerning manifestations such as exercise-associated collapse, heat exhaustion, and exertional rhabdomyolysis. The most severe and potentially life-threatening heat-related illnesses include exercise collapse associated with sickle cell trait, severe exercise-associated hyponatremia, and heat stroke. Common risk factors of heat-related illness are physical activity in high ambient temperatures, behavioral factors, lack of acclimatization, deconditioning, recent illness, inadequate hydration, predisposing medical conditions, use of certain drugs and supplements, and excessive clothing or equipment. Treatment of mild heat-related illness includes cessation of activity, removal of the patient from high temperatures, and oral hydration. Symptoms of heat exhaustion are nonspecific and may include the inability to continue physical activity, weakness, fatigue, headache, nausea, and vomiting. Management includes rest, hydration, and basic cooling measures. Heat stroke is a medical emergency requiring immersion in ice-cold water within 30 minutes to prevent significant morbidity and mortality. Diagnosis of severe exercise-associated hyponatremia and exercise collapse associated with sickle cell trait require a high index of suspicion because they can mimic heat stroke but require different treatments. Heat-related illnesses are largely preventable with proper acclimatization, adequate hydration, avoidance of physical activity in extreme temperatures, and promotion of population-based intervention programs, particularly during anticipated heat waves.

Global warming is escalating occupational health risks worldwide, with outdoor workers in hot and humid regions facing disproportionate exposure to extreme heat. In such climates, the synergistic effects of high temperature and humidity critically impair thermoregulation, increasing susceptibility to heat stress-related disorders (HSRDs) a growing concern in low- and middle-income countries where adaptive capacity is limited. This study analyzed the six-year trend (2018-2023) in the HSRDs among outdoor workers in a hot, humid petrochemical industry in southern Iran. This retrospective longitudinal study collected health data on HSRDs alongside concurrent Wet-Bulb Globe Temperature (WBGT) index values. Additive time-series decomposition was used to analyze trends. Analyses were conducted using R and SPSS (p < 0.05). The mean WBGT index showed a significant, consistent increasing trend over the 6-year period (from 27.73 to 29.75 °C, p < 0.001). Exposure for site workers was highest, and summer critical (Sweltering) heat stress levels increased markedly from near zero to approximately 55% of the recorded time. General heat-related disorders showed the strongest association with elevated WBGT. A major challenge was identified in predictive modeling: only the model for general heat-related disorders showed relative accuracy (R[2] = 0.692). Other specific disorders (e.g., headache, cramp, rash) exhibited unpredictable patterns with high error rates (44% to 147% MAPE). Heat stress exposure is intensifying continuously in these work environments. While the WBGT index trend is predictable, the incidence of specific HSRDs follows complex, unpredictable patterns, making prediction based solely on WBGT challenging. The results underscore the necessity for robust, continuous preventive interventions considering all individual and environmental factors.

We present the case of a 25-year-old male who attended a dermatological online consultation due to a whiplash-shaped, pruritic rash. The lesions in the form of well-demarcated linear erythematous papules, located mainly on the trunk and arms, had first appeared four days prior to the consultation. Chronic disease history was negative and similar symptoms never appeared previously. After reviewing the clinical images and excluding dermatographism, flagellate dermatitis was suspected. The diagnosis was subsequently confirmed when the patient reported having consumed undercooked shiitake mushrooms two days prior to the onset of the lesions. Topical corticosteroids and oral antihistamines were recommended, and the patient was informed about the necessity of high-temperature preparation of shiitake mushrooms in the future. Flagellate dermatitis is a rare entity speculated to be a hypersensitivity reaction to lentinan, a heat-labile polysaccharide found in shiitake mushrooms (Lentinus edodes). Symptoms include characteristic papular or vesicular lesions erupting in a linear pattern resembling whiplash marks, usually on the trunk and extremities. While the condition is self-limiting, the awareness of its manifestation is important in order to prevent unnecessary biopsies. Patients should be educated to avoid further exposure to lentinan, as instances of severe reactions following repeated contact have been described.

We present a genome assembly from an individual male Xyphosia miliaria (tephritid fruit fly; Arthropoda; Insecta; Diptera; Tephritidae). The assembly contains two haplotypes with total lengths of 806.98 megabases and 799.90 megabases. Most of haplotype 1 (97.34%) is scaffolded into 7 chromosomal pseudomolecules, including the X and Y sex chromosomes. Most of haplotype 2 (83.09%) is scaffolded into 5 chromosomal pseudomolecules. The mitochondrial genome has also been assembled, with a length of 19.41 kilobases. This assembly was generated as part of the Darwin Tree of Life project, which produces reference genomes for eukaryotic species found in Britain and Ireland.

Erythema ab igne (EAI), also known as "hot water bottle rash" or "toasted skin syndrome", is a benign cutaneous condition caused by chronic exposure to low-level infrared heat. It typically begins as transient erythema and evolves into a reticulated brown pigmentation with telangiectasias. A skin biopsy, ideally taken from the central area of the hyperpigmented lesion, is recommended to exclude differential diagnoses. Although usually benign, EAI has been associated with rare malignant transformations, supported only by low-level evidence. Elimination of the heat source is essential, and topical treatments such as hydroquinone or retinoids may be considered, while agents like 5-fluorouracil or imiquimod are reserved for dysplastic lesions. Women with endometriosis frequently use heating devices to alleviate dysmenorrhea and chronic pelvic pain. However, prolonged or inappropriate heat application can lead to chronic thermal injury, including EAI, and may delay medical consultation. While controlled trials confirm short-term analgesic efficacy of heat therapy, extrapolating these findings to unrestricted home use without standardized safety recommendations can be misleading. EAI illustrates the broader impact of chronic pain in endometriosis, linking cutaneous manifestations with neuroplastic alterations and psychiatric comorbidities. A nuanced approach combining patient education on safe use of heat, close dermatologic monitoring, and multidisciplinary pain management is warranted.

Scrub typhus, caused by Orientia tsutsugamushi, is a mite-borne zoonotic disease endemic to many parts of Asia. Although traditionally associated with rural environments, cases of urban transmission are increasingly being reported, possibly due to ecological changes such as urban heat islands, which may expand the habitats of vector mites. Recognizing these emerging patterns is important, as scrub typhus often presents with non-specific clinical features, making diagnosis challenging and potentially delaying appropriate treatment, thereby worsening patient outcomes. We report a case of an 84-year-old woman who presented with a seven-day history of anorexia, malaise, and headache. Physical examination revealed mild altered consciousness, an eschar on the left eyelid, and a maculopapular rash on the trunk. Laboratory findings included thrombocytopenia, elevated liver enzymes, and increased C-reactive protein (CRP). Despite no known exposure to grasslands or brush fields, and with no recent travel, animal contact, or other potential exposure routes identified, scrub typhus was suspected based on clinical findings. She was treated with intravenous minocycline for 14 days, following which the fever resolved and laboratory abnormalities improved. The antibody test for Orientia tsutsugamushi was positive. Her clinical course was favorable, and she was discharged in good condition. Although scrub typhus is traditionally associated with rural environments, urban transmission is becoming more recognized, possibly due to ecological changes such as urban heat islands, where temperatures are higher than in surrounding rural areas, potentially expanding the habitats of vector mites. This case highlights that scrub typhus should be considered in patients presenting with fever, rash, and eschar, even when no clear environmental exposure is identified.

Erythema ab igne is a cutaneous rash characterized by a reticulated pattern of erythema and hyperpigmentation. This dermatosis is caused by repeated exposure of direct heat or infrared radiation to a person’s skin, often from occupational exposures or use of heating pads. While the rash is most often benign, its presence can be an indication of chronic inflammation or, less commonly, systemic illness and should prompt further investigation. Furthermore, careful inspection of the rash may yield evidence of possible pre-malignant transformation and should prompt referral for biopsy, if indicated.