Magdei M, Melnic A, Benes O, Bukova V, Chicu V, Sohotski V, Bass A
Director General's Office, Ministry of Health,National Scientific and Practical Center for Preventive Medicine, Chisinau, Moldova.
J Infect Dis. 2000 Feb;181 Suppl 1:S47-54. doi: 10.1086/315538.
In 1994-1996, the Republic of Moldova was stricken with an epidemic of diphtheria after >30 years of routine diphtheria immunization and the near absence of the disease for nearly 20 years. The intensity of the epidemic gradually grew, reaching a peak in 1994-1995. The epidemiology of diphtheria in Moldova during this period is described along with laboratory findings and control measures. Pharyngeal diphtheria was the predominant clinical form of the disease (97% of cases), and it most often developed in a localized form (70%), with 20% in the toxic form. The clinical diagnosis of diphtheria was bacteriologically confirmed in 91% of cases: Of the cases tested for biotype, 91.3% were gravis, 8.5% were mitis, and 0. 2% were intermedius. Of 494 toxigenic isolates from cases and carriers at the beginning of the epidemic, 47% were nonphagotypeable strains, and 25.7% were phagotype VI strains. Aggressive population-based diphtheria control measures, a mass immunization campaign, rapid case identification, antibiotic prophylaxis and supplemental immunization of close contacts in clusters of infection, and high coverage with routine immunization rapidly controlled the epidemic within Moldova.
1994年至1996年期间，摩尔多瓦共和国在经历了30多年的白喉常规免疫接种且近20年几乎没有白喉病例之后，暴发了白喉疫情。疫情强度逐渐增加，在1994年至1995年达到高峰。本文描述了这一时期摩尔多瓦白喉的流行病学情况、实验室检查结果及防控措施。咽白喉是该疾病的主要临床类型（占病例的97%），最常见的表现形式为局限性（占70%），20%为中毒型。91%的白喉临床诊断病例经细菌学确诊：在检测生物型的病例中，91.3%为重型，8.5%为轻型，0.2%为中间型。在疫情初期从病例和携带者中分离出的494株产毒株中，47%为不可分型菌株，25.7%为VI型菌株。基于人群的积极白喉防控措施、大规模免疫接种运动、快速病例识别、抗生素预防以及对感染聚集区密切接触者的补充免疫接种，加上常规免疫接种的高覆盖率，迅速控制了摩尔多瓦境内的疫情。
