Nielsen P B, Scherling B, Scheibel J H, Frederiksen W
Statens Seruminstitut, København.
Ugeskr Laeger. 1991 Mar 11;153(11):769-72.
The public immunization program against diphtheria, established in 1941, has almost eradicated the disease in Denmark, and 1956 became the first year without any notified cases. Since then, toxigenic strains have only been isolated five times--three cases of clinical diphtheria due to Corynebacterium diphtheriae biovar. mitis and two cases of tonsillitis/pharyngitis due to Corynebacterium ulcerans. The source of the infection was not identified in any of the cases. The first case of diphtheria in 1968 was imported from abroad. The following two cases in 1983 and 1985 were due to strains of the same phage type and peptide profile as the strains isolated during the epidemic in Sweden in 1984-1986. This indicates that the Danish cases and the Swedish epidemic derived from the same source. The diphtheria immunity of the Danish population is decreasing, and the level of protection is approaching the Swedish level. The impact is that a situation like that in Sweden may be anticipated with diphtheria epidemic in the lowest socio-economical groups--the skid row dwellers, alcoholics and drug abusers--if the immunization program against diphtheria is not intensified.
1941年建立的白喉公共免疫计划几乎已在丹麦根除了这种疾病，1956年成为没有任何病例报告的第一年。从那时起，产毒株仅被分离出5次——3例由轻型白喉棒状杆菌引起的临床白喉病例，以及2例由溃疡棒状杆菌引起的扁桃体炎/咽炎病例。在任何病例中均未确定感染源。1968年的首例白喉病例是从国外输入的。1983年和1985年的以下两例病例是由与1984 - 1986年瑞典疫情期间分离出的菌株具有相同噬菌体类型和肽谱的菌株引起的。这表明丹麦的病例和瑞典的疫情源自同一来源。丹麦人群的白喉免疫力正在下降，保护水平正在接近瑞典的水平。影响是，如果不加强白喉免疫计划，可能会在社会经济地位最低的群体——贫民窟居民、酗酒者和吸毒者中预见到类似瑞典那样的白喉疫情情况。
