土拉菌病是由土拉弗朗西斯菌引起的一种细菌性人畜共患疾病，病原体可经多种途径感染宿主并累及几乎任何部位[1][3]。该病临床表现多样，组织学上可表现为以单核细胞样B淋巴细胞和肉芽肿形成为特征的化脓性肉芽肿性淋巴结炎，常累及腋窝及颈部淋巴结[4]。
疾病概览
细菌性土拉菌病
Tularemia
有证据支持的资料英文 5/7 个适用章节 · 中文 5/7 个适用章节更新于 2026年9月3日
土拉菌病（也称为兔热病）是由革兰阴性菌土拉弗朗西斯菌（Francisella tularensis）引起的人畜共患疾病，可经节肢动物、空气以及食物和水传播，呈现多种临床综合征并可在未经治疗时造成高病死率[1]。该病近年在北半球特别是欧洲出现再发趋势，加之其可通过气溶胶高效传播，已被列为生物恐怖A类病原体，公共卫生意义重大[1][2]。诊断延误可显著升高死亡风险，因此临床识别与及时抗菌治疗至关重要[1]。目前尚无安全且全面获批的人用疫苗，预防依赖环境与动物控制、实验室生物安全及暴露后预防[1][2]。
阅读完整临床与流行病学资料6
由于感染途径的多样性，土拉菌病可表现为六种典型临床类型：溃疡腺型、腺型、眼腺型、口咽型、伤寒型及肺型，并可出现其他少见表现而累及全身任何部位[1]。在孕妇中，口咽型和溃疡腺型最为常见，感染多发生于妊娠中期，可引起淋巴结穿刺或切除、母亲出血、自发流产、宫内胎死及早产等并发症，未经治疗时可能出现经胎盘传播[3]。肺型土拉菌病属于非典型肺炎，常伴有特征性肺外表现，构成系统性感染的一部分[5]。
土拉菌病近年来在北半球尤其是欧洲呈现再发趋势，被认为是一种再发传染病[1]。该病为人畜共患、节肢动物媒介、空气传播及食源性和水源性传播的疾病，多种传播途径决定了其广泛的地理与人群分布[1]。
土拉弗朗西斯菌可通过节肢动物叮咬、空气吸入以及污染的食物和水传播给人类，是少数几种可通过气溶胶高效感染的细菌之一[1][2]。这种易于空气传播的特性使其被列为生物恐怖A类制剂，并提示其在公共卫生应急中的潜在重要性[1][2]。
土拉菌病的预防策略以环境和动物控制措施为核心，包括管理宿主动物和媒介节肢动物、避免接触病死动物以及保障食物和水源安全[1]。由于尚无安全且全面获批的人用疫苗，及时向实验室通报临床怀疑以保障生物安全，并对高风险暴露者实施暴露后抗菌药物预防也至关重要[1][2]。
- 1Antonello RM et al. Tularemia for clinicians: An up-to-date review on epidemiology, diagnosis, prevention and treatment. Eur J Intern Med. 2025 May. PMID: 40107886. doi: 10.1016/j.ejim.2025.03.013.PubMed: https://pubmed.ncbi.nlm.nih.gov/40107886/
- 2Putzova D et al. Tularemia vaccines. Folia Microbiol (Praha). 2016 Nov. PMID: 27194547. doi: 10.1007/s12223-016-0461-z.PubMed: https://pubmed.ncbi.nlm.nih.gov/27194547/
- 3Cunha BA et al. The atypical pneumonias: clinical diagnosis and importance. Clin Microbiol Infect. 2006 May. PMID: 16669925. doi: 10.1111/j.1469-0691.2006.01393.x.PubMed: https://pubmed.ncbi.nlm.nih.gov/16669925/
- 4Fleck-Derderian S et al. Systematic Review of Tularemia During Pregnancy. Clin Infect Dis. 2024 Jan 31. PMID: 38294114. doi: 10.1093/cid/ciad686.PubMed: https://pubmed.ncbi.nlm.nih.gov/38294114/
- 5Asano S et al. Granulomatous lymphadenitis. J Clin Exp Hematop. 2012. PMID: 22706525. doi: 10.3960/jslrt.52.1.PubMed: https://pubmed.ncbi.nlm.nih.gov/22706525/
数据覆盖
报告国家和地区
各报告国家的趋势
月度变化趋势
研究雷达
近期相关研究
PCR-Based Detection of Priority Bacterial Biological Threat Agents: Advances in Diagnosis of Anthrax, Tularemia and Brucellosis
One Health Journal
Tularemia: a re-emerging zoonosis.
Medicina clinica
Macular serpiginous chorioretinitis associated with Francisella tularensis: A case report.
Retinal cases & brief reports
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本页面数据索引，含来源链接和更新信息。
官方数据来源机构、频率与说明51
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.
ECDC Surveillance Atlas — Bulgaria Annual Baseline
Bulgaria
Bulgaria 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.
Canada PHAC CNDSS Annual
Canada
Canada is the national jurisdiction; subdivision feeds are registered separately.
Public Health Ontario IDTO Monthly
Ontario, Canada
Ontario-level current-year preliminary monthly case counts from Public Health Ontario's IDTO report.
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.
ECDC Surveillance Atlas — Cyprus Annual Baseline
Cyprus
Cyprus 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 — 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 — Estonia Annual Baseline
Estonia
Estonia 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 — 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.
ECDC Surveillance Atlas — Greece Annual Baseline
Greece
Greece 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 — Croatia Annual Baseline
Croatia
Croatia 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 — Hungary Annual Baseline
Hungary
Hungary 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.
Ireland HPSC Notifiable Diseases Hub
Ireland
Ireland HPSC national weekly notifiable-disease totals from the official ArcGIS FeatureServer. Internal ingestion is enabled; public release remains disabled pending written redistribution permission.
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 — Liechtenstein Annual Baseline
Liechtenstein
Liechtenstein 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 — Lithuania Annual Baseline
Lithuania
Lithuania 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 — 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 — Malta Annual Baseline
Malta
Malta 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.
ECDC Surveillance Atlas — Poland Annual Baseline
Poland
Poland 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 — Portugal Annual Baseline
Portugal
Portugal 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 — Romania Annual Baseline
Romania
Romania 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.
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.
ECDC Surveillance Atlas — Slovenia Annual Baseline
Slovenia
Slovenia 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 — 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.
Taiwan, China CDC NIDSS
Taiwan, China
Taiwan, China monthly notifiable infectious disease open-data CSV feed.
US CDC NNDSS
United States
CDC National Notifiable Diseases Surveillance System provisional data.
US CDC NHSS HIV
United States
CDC NNDSS weekly data plus NHSS annual national HIV diagnoses