The Chinese Center for Disease Control and Prevention has issued health advisories for the 2021 National Day holiday.

As the National Day holiday approaches, many regions are poised to enter a peak period for travel and visits to family and friends. To ensure a safe and healthy enjoyment of the crisp, pleasant autumn weather and cherished moments with loved ones, the Chinese Center for Disease Control and Prevention offers the following advice: During this year’s National Day holiday, prioritize prevention and control measures against COVID‑19, norovirus gastroenteritis, hand, foot and mouth disease, zoonotic diseases, and foodborne illnesses.

Key Reminder

1. COVID-19 Prevention:

Avoid traveling to areas with medium- or high-risk COVID-19 outbreaks, and refrain from non-essential cross-border travel.

Continue to practice self-protection by consistently wearing masks, maintaining social distance, practicing good personal hygiene, and ensuring adequate ventilation in indoor spaces.

Before traveling, familiarize yourself in advance with the destination’s epidemic prevention and control policies and measures, and make sure to bring adequate personal protective equipment.

Avoid crowded places, enclosed spaces, and areas with poor ventilation. Continue to monitor your health closely, and if you develop any suspicious symptoms, seek medical attention promptly while taking appropriate precautions to prevent infecting others.

2. Prevention of Norovirus Gastroenteritis:

Wash your hands frequently.

Do not eat food that has not been thoroughly cooked or milk that has not been pasteurized.

Do not drink raw water.

Do not eat fruits and vegetables that are not clean.

Avoid contact with patients, their vomitus and excreta, as well as contaminated items and environments.

3. Prevention of Hand, Foot, and Mouth Disease:

Pay attention to personal hygiene, especially hand hygiene.

Do not share personal items with others, avoid contact with patients, contaminated objects, or contaminated environments, and refrain from swimming or playing in swimming pools that have not been properly disinfected.

During outbreaks of hand, foot, and mouth disease, try to avoid taking your child to group activities.

4. Prevention of Animal-Transmitted Diseases:

Avoid entering habitats of wild birds, marmots, and other animals, and refrain from touching or consuming wild animals.

Avoid direct contact with any animals, especially those of unknown origin, and do not handle dead or diseased animals on your own.

Do not purchase live poultry from live-poultry markets, live-poultry stalls in farmers’ markets, or mobile vendors.

Do not consume animal products that have not been thoroughly cooked.

Choose fresh, safe animal food ingredients, and keep raw and cooked foods separate during preparation.

5. Food Poisoning Prevention:

Choose reputable restaurants or dining establishments with good hygiene standards.

Do not consume food of unknown origin.

Do not collect or consume unidentified wild mushrooms or wild plants.

Characteristics of Relevant Risks and Specific Preventive Measures

1. Novel Coronavirus Pneumonia

China continues to experience imported cases of COVID‑19, while the domestic epidemic remains largely sporadic, with occasional cluster outbreaks in certain local areas. Globally, the pandemic is currently at a high plateau during its third wave, and many countries and regions outside China are still experiencing sustained transmission. During the 2021 National Day holiday, the overseas epidemic is expected to persist at a high level, and the risk of imported cases and subsequent local transmission within China will remain.

The primary sources of COVID‑19 transmission are confirmed cases and asymptomatic carriers. The disease is mainly spread through respiratory droplets and close contact; infection can also occur via contact with virus‑contaminated objects. In relatively enclosed settings, exposure to high concentrations of aerosols may facilitate aerosol‑borne transmission. The general population is universally susceptible. Following infection or vaccination against SARS‑CoV‑2, a degree of immunity can be acquired.

The clinical manifestations are primarily fever, dry cough, and fatigue; in some patients, olfactory or gustatory impairment or loss may be the initial symptom. A small number of patients also present with nasal congestion, rhinorrhea, sore throat, conjunctivitis, myalgia, and diarrhea.

Main preventive measures

At present, many countries abroad are experiencing severe outbreaks, and the risk of infection for individuals traveling overseas is high. In accordance with local prevention and control measures, inbound travelers must provide strict proof of two negative test results (those with a history of vaccination need only a negative nucleic acid test), and upon arrival, they are required to undergo 14 days of medical quarantine followed by an additional 7 days of home-based health monitoring. It is recommended that individuals carefully weigh the timing and necessity of travel and avoid non-essential cross-border trips.

The COVID-19 risk levels across China can be checked in real time on the State Council’s dedicated website (http://bmfw.www.gov.cn/yqfxdjcx/risk.html), the “State Council Client” mobile app, or the WeChat mini-program.

During holidays, strengthen personal protection by consistently wearing masks, maintaining social distance, practicing good personal hygiene, and ensuring adequate ventilation. Avoid visiting crowded places, enclosed spaces, or areas with poor ventilation.

Before traveling, familiarize yourself in advance with the COVID‑19 prevention and control policies and measures at your destination, and bring along personal protective items such as masks, hand sanitizer, and disinfecting wipes. Information on COVID‑19 prevention and control policies across China can be accessed in real time via the dedicated section on the State Council website (http://www.gov.cn/zhuanti/2021yqfkgdzc/index.htm), the “State Council Client” mobile app, or the WeChat mini‑program.

During your travels, when using airplanes, trains, buses, ships, or other modes of transportation, please observe order and comply with the instructions of onboard staff. Wear a mask at all times, practice good hand hygiene, and keep your tickets safely for itinerary verification. If you develop symptoms such as fever, dry cough, fatigue, or a reduced or lost sense of smell or taste during your trip, take appropriate precautions to prevent infecting others, seek medical attention immediately at the nearest healthcare facility, and cancel or suspend your travel plans.

Upon returning from travel, you should monitor yourself for 14 days. If any suspicious symptoms develop, take appropriate precautions to prevent infecting others, seek medical attention promptly, and proactively inform your healthcare provider of your travel history.

During holidays, you should still get vaccinated as scheduled and avoid letting travel interfere with your vaccination schedule.

2. Norovirus gastroenteritis

Norovirus gastroenteritis can occur throughout the year, with a marked seasonal peak during the winter and spring in China. It readily causes outbreaks involving multiple cases within a short period in densely populated settings such as schools, childcare facilities, and hospitals. Travel groups, cruise ships, and resort centers are also frequent sites of outbreaks; in recent years, China has reported several cluster outbreaks among domestic and international tour groups.

People typically become infected through the following routes: consuming food or drinking water contaminated with norovirus; putting fingers in the mouth after touching objects or surfaces contaminated with the virus; or coming into contact with an infected person, such as by caring for a patient, sharing food with them, or using shared utensils. Shellfish like oysters, as well as raw fruits and vegetables, are also common sources of infection.

Norovirus gastroenteritis is predominantly mild, with vomiting and diarrhea being the most common clinical symptoms, followed by nausea, abdominal pain, headache, fever, chills, and muscle aches. Most patients recover within 2–3 days. A small number of cases may progress to severe illness or result in death; the high-risk groups for severe disease or mortality are elderly individuals and young children.

Main preventive measures

Be sure to wash your hands frequently, especially before meals and after using the restroom, as well as before handling food.

Do not drink raw water;

Do not consume food that has not been thoroughly cooked or milk that has not been pasteurized; oysters and other shellfish should be thoroughly processed before consumption.

Fruits and vegetables should be thoroughly washed before consumption, and unclean fruits and vegetables should not be eaten.

Avoid contact with patients, their vomitus and excreta, as well as contaminated items and environments.

Patients with norovirus gastroenteritis should be isolated from the onset of illness until three days after recovery. Mild cases may be isolated at home or on-site at the facility where the outbreak occurred, while severe cases must be transferred to a medical institution for isolation and treatment.

Environmental surfaces or objects contaminated by a patient’s vomitus or excreta should be cleaned and disinfected by trained personnel using a chlorine‑based disinfectant or another effective disinfectant. Contaminated clothing, bed linens, and other items should be removed and washed immediately. During disinfection and laundering, wear a mask and rubber or disposable gloves, and thoroughly clean and disinfect your hands afterward.

3. Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease is a common infectious illness among children, with the majority of cases occurring in children aged five years and younger. In China, the peak season for this disease runs from April to June each year, and in some regions—particularly in the south—a secondary autumnal surge may occur in October and November.

Hand, foot, and mouth disease is primarily transmitted through close contact with a patient’s feces, vesicle fluid, nasopharyngeal secretions, saliva, or by touching objects or environments contaminated by these substances, such as hands, towels, handkerchiefs, tooth cups, toys, tableware, baby bottles, and bedding.

Hand, foot, and mouth disease is usually mild and self-limiting, with complete recovery typically occurring within 7 to 10 days. At the onset, affected children often present with fever, loss of appetite, fatigue, or sore throat. One to two days after the fever develops, vesicles appear in the oral cavity—on the tongue, gums, and/or the inner cheeks—causing significant pain; these vesicles initially manifest as small red spots before evolving into ulcers. Additionally, most children develop a rash on the palms of the hands and soles of the feet, which is usually non‑itchy; some rashes may contain blisters. Rashes can also occur on other sites, such as the buttocks, knees, elbows, and trunk. A subset of cases may be febrile, while a small number of patients may experience severe complications, including encephalitis, brainstem encephalitis, acute flaccid paralysis, pulmonary edema, pulmonary hemorrhage, and cardiopulmonary failure.

Main preventive measures

Pay attention to personal hygiene, especially hand hygiene.

Wash your hands with clean water, hand sanitizer, or soap before touching your mouth or nose, before meals and after using the toilet, before handling food, after contact with herpes lesions or respiratory secretions, and after changing diapers or handling items contaminated with feces.

Cover your mouth and nose with a handkerchief or tissue when you sneeze or cough, then wrap the used tissue securely and dispose of it in a lidded trash bin.

Do not share towels or other personal items with others;

Do not come into contact with patients, contaminated items, or contaminated environments.

Do not swim or play in swimming pools that have not been properly disinfected.

Regularly clean and disinfect frequently touched items and surfaces, such as toys and furniture. After cleaning, wipe or soak these surfaces with a chlorine-based disinfectant, allow it to act for 30 minutes, then wipe or rinse thoroughly with clean water.

Nasopharyngeal secretions, vomitus, feces, as well as contaminated items and environments, should be cleaned and disinfected by trained personnel.

During outbreaks of hand, foot, and mouth disease, try to avoid taking your child to group activities.

4. Animal-Transmitted Diseases

Humans can contract zoonotic diseases such as avian influenza, plague, rabies, brucellosis, and anthrax through contact with animals—such as feeding, petting, slaughtering, skinning, or processing them—by consuming undercooked animal products—including meat, eggs, and milk—or by coming into contact with animal habitats and environments.

Main preventive measures

Avoid entering habitats of wild birds, marmots, and other animals, and refrain from touching or consuming wild animals.

Avoid direct contact with any animals, especially those of unknown origin, and do not handle dead or diseased animals on your own.

Do not purchase live poultry from live‑poultry markets, live‑poultry stalls in agricultural markets, or street vendors. Instead, opt for chilled or frozen poultry that has been slaughtered and processed at centralized facilities.

Do not consume animal products such as meat, eggs, and dairy that have not been thoroughly cooked.

Choose fresh, safe animal food ingredients, and be sure to keep raw and cooked foods separate during preparation.

5. Food poisoning

May through October are the peak months for foodborne illnesses in China. During holidays, opportunities for group meals and dining out increase, thereby raising the risk of food poisoning. In mainland China, microbial foodborne illnesses are the most common, though cases of poisoning from wild mushrooms, wild plants, and other sources also occur from time to time. Poisoning from wild mushrooms can cause functional or structural damage to the human body and may even be life‑threatening.

Food poisoning typically manifests acutely within a short time after eating, with symptoms such as nausea, vomiting, abdominal pain, and diarrhea. Abdominal pain is most commonly persistent or cramping in the upper and mid‑abdomen, and vomitus often consists of the ingested food. Vomiting usually precedes diarrhea.

Main preventive measures

Pay attention to food safety.

When dining out, be sure to choose reputable restaurants or eateries with good sanitary conditions.

Do not consume foods of unknown origin, and do not collect or eat wild mushrooms or wild plants whose edibility is uncertain.

Do not eat food that has not been thoroughly cooked or milk that has not been pasteurized.

Do not eat fruits and vegetables that are not clean.

Choose fresh, safe food ingredients, and be sure to keep raw and cooked foods separate during preparation.