白喉是一种急性传染病,由白喉棒状杆菌定植黏膜后释放的外毒素驱动[1][2]。病原体主要靶向上呼吸道,在此处毒素介导的组织破坏促进了局部病变及潜在的全身播散[2]。该病被归类为疫苗可预防的细菌性疾病,其严重程度和致死率直接取决于菌株特异性毒素的产生[1]。
疾病概览
细菌性白喉
Diphtheria
白喉是由产毒型白喉棒状杆菌引起的传染性细菌感染[1][2]。尽管许多感染呈无症状或轻症过程,但重症病例具有显著的死亡风险,尤其在未接种疫苗的人群中[1][2]。该病在20世纪30年代前曾广泛流行,目前在全球范围内持续存在,当代疫情爆发日益与免疫覆盖率下降及卫生系统中断有关[2]。持续的疫苗接种计划仍是实现人群层面控制的基础策略[2]。
阅读完整临床与流行病学资料7
症状通常在暴露后两至七天出现并逐渐进展[1][2]。初始表现常包括发热、咽痛、声音嘶哑、颈部淋巴结肿大及全身乏力[1][2]。在两至三天内,坏死的呼吸道上皮会凝结成致密的灰白色假膜,可能机械性阻塞气道并影响吞咽功能[1][2]。全身性毒素吸收可能引发心肌炎、周围神经病变、肾功能损害及血小板减少症,在未治疗的可感人群中病死率接近百分之三十[2]。
白喉在引入疫苗之前曾是全球范围内儿童发病和死亡的主要原因,自20世纪30年代广泛接种白喉类毒素疫苗以来,发病率大幅下降[2]。据估计,1980—2000年间含白喉成分的联合疫苗预防了90%以上的病例[2]。然而,由于疫苗接种不足,近年来各地区疫情再次增多;目前没有世卫组织区域完全没有白喉,免疫覆盖率低的地区为细菌传播提供了条件,使所有未接种和未全程接种者面临更高的暴发风险[2]。白喉的基本再生数估计在1.7–4.3之间,在暴发环境中仅靠疫苗接种能在约28%的情境中阻断传播,提示需要结合其他干预措施[3]。
白喉是一种由产毒细菌引起的传染性疾病,可通过人际传播途径扩散。感染者咳嗽或打喷嚏时产生的呼吸道飞沫是主要的传播方式,细菌也可通过人与人之间的直接接触进行传播[2][3]。除了呼吸道传播外,人们还可能通过接触被感染者的开放性溃疡或伤口而感染。值得注意的是,部分感染者虽未表现出临床症状,但仍可将细菌传播给他人;无症状携带者在其感染期内所导致的续发病例数量比有症状病例少约76%。在密切接触者中,家庭成员、暴露于患者分泌物者以及与感染者频繁密切接触者感染风险更高。未经治疗的病例平均带菌时间约为18.5天,95%的病例在48天内可清除白喉杆菌。疫苗接种虽能显著降低传播风险(接种3剂百日咳类毒素疫苗可使传播减少60%),但接种者仍可能发生细菌定植并继续传播,因此单靠疫苗接种不足以在大多数暴发环境中阻断传播。
本章节暂无经来源支持的信息。
通过将白喉类毒素疫苗常规纳入国家免疫规划来维持群体免疫力[2]。标准程序要求在婴儿早期启动三剂基础免疫系列,并在儿童期和青春期补充多次加强接种,以维持持久的保护力[2]。公共卫生操作优先加强初级保健服务网络建设,快速识别并接种免疫不足人群,以及部署针对性暴发响应以切断传播途径[2]。
- 1Wikipedia contributors. Diphtheria - Wikipedia [Internet]. Wikipedia. cited 3 Sept 2026.Available from: https://en.wikipedia.org/wiki/Diphtheria
- 2World Health Organization. Diphtheria [Internet]. cited 3 Sept 2026.Available from: https://www.who.int/news-room/fact-sheets/detail/diphtheria
- 3Truelove SA et al. Clinical and Epidemiological Aspects of Diphtheria: A Systematic Review and Pooled Analysis. Clin Infect Dis. 2020 Jun 24. PMID: 31425581. doi: 10.1093/cid/ciz808.PubMed: https://pubmed.ncbi.nlm.nih.gov/31425581/
- 4World Health Organization. Diphtheria [Internet]. cited 3 Sept 2026.Available from: https://www.who.int/health-topics/diphtheria
- A36
- 1C15
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官方数据来源机构、频率与说明61
Austria AGES Radar for Infectious Diseases
Austria
AGES Radar monthly national source. Internal ingestion retains native categories; public release is disabled pending licence review.
Australia NINDSS
Australia
Australian national notifiable diseases surveillance dashboard.
Australia NINDSS — Australian Capital Territory
Australian Capital Territory, Australia
Australian NINDSS monthly state/territory notifications for Australian Capital Territory, kept separate from the Australia national aggregate.
Australia NINDSS — New South Wales
New South Wales, Australia
Australian NINDSS monthly state/territory notifications for New South Wales, kept separate from the Australia national aggregate.
Australia NINDSS — Northern Territory
Northern Territory, Australia
Australian NINDSS monthly state/territory notifications for Northern Territory, kept separate from the Australia national aggregate.
Australia NINDSS — Queensland
Queensland, Australia
Australian NINDSS monthly state/territory notifications for Queensland, kept separate from the Australia national aggregate.
Australia NINDSS — South Australia
South Australia, Australia
Australian NINDSS monthly state/territory notifications for South Australia, kept separate from the Australia national aggregate.
Australia NINDSS — Tasmania
Tasmania, Australia
Australian NINDSS monthly state/territory notifications for Tasmania, kept separate from the Australia national aggregate.
Australia NINDSS — Victoria
Victoria, Australia
Australian NINDSS monthly state/territory notifications for Victoria, kept separate from the Australia national aggregate.
Australia NINDSS — Western Australia
Western Australia, Australia
Australian NINDSS monthly state/territory notifications for Western Australia, kept separate from the Australia national aggregate.
ECDC Surveillance Atlas — Belgium Annual Baseline
Belgium
Belgium annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Brazil DATASUS SINAN
Brazil
Brazil Ministry of Health DATASUS/SINAN public DBC microdata aggregated to national monthly notification counts.
Canada PHAC CNDSS Annual
Canada
Canada is the national jurisdiction; subdivision feeds are registered separately.
Switzerland FOPH IDD
Switzerland
Switzerland FOPH/BAG IDD mandatory reporting API normalized to national case rows. Monthly series may use the dashboard CHFL aggregate where CH-only monthly series are not exposed.
China CDC Weekly
China
Monthly notifiable infectious disease reports published by China CDC.
National Disease Control and Prevention Administration
China
Official China public health bulletin and query portal.
PubMed
China
Biomedical literature discovery feed used as supplementary context.
Public Health Science Data Center
Anhui, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Anhui, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Chongqing, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Chongqing, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Guangdong, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Guangdong, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Gansu, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Gansu, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Henan, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Henan, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Jiangsu, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Jiangsu, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Sichuan, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Sichuan, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Shandong, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Shandong, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Shanghai, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Shanghai, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Xinjiang, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Xinjiang, China
Province-level statutory infectious disease report published by the responsible health authority.
Public Health Science Data Center
Zhejiang, China
Chinese province-level historical monthly observations; this higher-priority source overlays overlapping official monthly reports.
Provincial statutory infectious disease monthly report
Zhejiang, China
Province-level statutory infectious disease report published by the responsible health authority.
ECDC Surveillance Atlas — Czechia Annual Baseline
Czechia
Czechia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Germany RKI SurvStat 2.0
Germany
RKI SurvStat national weekly notification export; raw ZIP exports are retained and recent weeks are overwritten for revisions.
ECDC Surveillance Atlas — Spain Annual Baseline
Spain
Spain annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Finland THL Infectious Diseases Register
Finland
Finland THL Infectious Diseases Register national monthly case counts. The current month is ingested as provisional and the latest three months are refreshed for source revisions.
ECDC Surveillance Atlas — France Annual Baseline
France
France annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — United Kingdom Annual Baseline
United Kingdom
United Kingdom annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Hong Kong, China CHP Notifiable Diseases
Hong Kong, China
Hong Kong, China CHP annual notifiable infectious disease CSVs normalized to national monthly totals
冰岛卫生署年度传染病看板
Iceland
冰岛全国分病种年度病例通报;历史值可能追溯修订,并保持年度总量口径。
冰岛卫生署性病监测看板
Iceland
实验室与登记监测的月度性病诊断事实;官方看板按季度发布。
冰岛卫生署呼吸道感染周度看板
Iceland
按 ISO 周记录的呼吸道疾病诊断数;住院、样本和疫苗指标不计入诊断数。
冰岛卫生署历史传染病登记
Iceland
1997—2021 年官方历史登记表,年度与月度事实按原始粒度保留。
冰岛卫生署历史 ICD 临床月报
Iceland
Saga 电子病历 ICD 就诊数;与登记通报不可比并保持独立。
ECDC Surveillance Atlas — Italy Annual Baseline
Italy
Italy annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
日本 NIID/JIHS 周报
Japan
日本 NIID/JIHS 周度传染病监测数据。
Korea KDCA EID
South Korea
Korea KDCA notifiable infectious disease OpenAPI or portal/KOSIS downloads aggregated to national monthly notification counts.
ECDC Surveillance Atlas — Luxembourg Annual Baseline
Luxembourg
Luxembourg annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Latvia Annual Baseline
Latvia
Latvia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Netherlands Annual Baseline
Netherlands
Netherlands annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Norway FHI MSIS Statistics Bank
Norway
Norway FHI MSIS national monthly notifications from the official Allvis frontend API; adapter contract checks guard the unversioned endpoint.
Sweden Public Health Agency SmiNet
Sweden
Sweden SmiNet national monthly reported cases from the official Public Health Agency statistics pages; public release is enabled with closed-month publication and revisable recent-month refreshes.
Singapore CDA Weekly Infectious Diseases Bulletin
Singapore
Singapore national weekly case notifications, combining the official data.gov.sg 2012–2022 CSV history with CDA annual workbooks from 2023 onward; 2023 weekly PDFs are retained as a source fallback.
ECDC Surveillance Atlas — Slovakia Annual Baseline
Slovakia
Slovakia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.