Gauvreau L, Breton J P, Bergeron M G, Dorval J, Martineau G, Frenette G
Can Med Assoc J. 1977 Jun 4;116(11):1279-83.
An outbreak of diphtheria occurred on the North Shore of the St. Lawrence River at the beginning of September 1974. It started with the death of an 18-year-old forest worker Sept. 5, spread over a vast area of the North Shore and lasted until the end of October that year. Eleven strains of toxigenic Corynebacterium diphtheriae intermedium, type K were isolated. Eleven of the 12 patients had characteristic diphtheritic pharyngitis with pseudomembranes. Preventive measures, set forth immediately after the third case was declared, included the following: (a) daily surveillance of all contacts, (b) isolation or preventive hospitalization of persons with all types of pharyngitis, (c) mass vaccination of all susceptible persons and (d) search for healthy carriers of the germ. No strains of toxigenic C. diptheriae were isolated from patients preventively hospitalized or from the 1235 individuals among whom carriers were sought. Among the main characteristics of this epidemic, the mean age of the patients (17 years), their mobility and their habits are factors that could have made it almost uncontrollable. It is also remarkable that this outbreak occurred in such a scattered population of adolescents, in 82% of whom the Schick test was negative.
1974年9月初，圣劳伦斯河北岸爆发了白喉疫情。疫情始于9月5日一名18岁森林工人的死亡，蔓延至北岸的大片地区，一直持续到当年10月底。从中分离出11株产毒中间型白喉棒状杆菌K型菌株。12名患者中有11人患有伴有假膜的典型白喉性咽炎。在第三例病例确诊后立即采取的预防措施包括：（a）对所有接触者进行每日监测；（b）对所有类型咽炎患者进行隔离或预防性住院治疗；（c）对所有易感人群进行大规模疫苗接种；（d）寻找病菌的健康携带者。在预防性住院治疗的患者或在其中寻找携带者的1235人中，均未分离出产毒白喉棒状杆菌菌株。在这次疫情的主要特征中，患者的平均年龄（17岁）、流动性和习惯等因素可能使其几乎无法控制。同样值得注意的是，这次疫情发生在如此分散的青少年人群中，其中82%的人锡克试验呈阴性。
