白喉(Diphtheria，来源于希腊语διφθερα
dipther' “pair of leather scrolls”)是一种上
呼吸道疾病，临床症状为咽炎，低烧and an adherent membrane (a
pseudo-membrane) on the
扁桃体,
咽部,或鼻。一种比较轻度的白喉只会病发於皮肤上。致病菌为
[白喉棒状杆菌', a
facultatively anaerobic Gram-positive bacterium.
白喉拥有极高的传染性﹔它能透过直接身体接触或呼吸带菌者的气体分泌物而散播。Once quite common, diphtheria has largely been eradicated in developed nations through wide-spread
vaccination. In the
United States for instance, between 1980 and 2004 there have been 57 reported cases of diptheria as the
DPT (Diphtheria-
Pertussis-
Tetanus) vaccine is given to all school children. Boosters of the vaccine are recommended for adults since the benefits of the vaccine decrease with age; they are particularly recommended for those traveling to areas where the disease has not been eradicated.
历史
白喉被法国物理学家
1826年Pierre Bretonneau命名。The name alludes to the leathery,
sheath-like membrane that grows on the
扁桃体,
throat, and in the nose. The pronunciation
/?dip?θi??i.?/ was originally considered incorrect, but has become the most common way of saying the word, and is accepted as a correct form. While many writers today use the spelling "diptheria" which fits the modern pronunciation, this spelling is rarely found in dictionaries.
白喉曾经是大规模频繁爆发的恐怖疾病。一段发生1735年－1740年的流行，在新英格兰某些城镇据说导致10岁一下儿童80%死亡。
1920年代美国每天有10-20万患者，死亡人数约1万3千－1万5千人。
One of the first effective treatments for diphtheria was discovered in the 1880s by U.S. physician
Joseph O'Dwyer (1841-1898). O'Dwyer developed
tubes that were inserted into the throat, and prevented victims from suffocating due to the membrane sheath that grows over and obstructs airways.1890年代,德国医师
Emil von Behring开发出一种抗生素，并不杀死白喉病毒，而是抑制它释放毒素到患者体内。他因为发现和研制出抗白喉血清获得第一个
诺贝尔医学奖。(美国的
William H. Park，
Anna Wessels Williams和
Pasteur Institute的科学家
Emile Roux，
Martin Chaillou同期也独立研制出白喉抗生素)。首度成功地白喉疫苗于1923年研制成功。但是抗生素并未用于治疗白喉直到
二战后开发出
磺胺药。
机理
白喉病毒促进ADP-核糖基化，阻止
eEF-2活性。 这样真核蛋白合成期间抑制传输移动。
标志和症状
The respiratory form has an
潜伏期 of 2-5 days. The onset of disease is usually gradual. Symptoms include fatigue, fever, a mild sore throat and problems swallowing. Children infected have symptoms that include nausea, vomiting, chills, and a high fever, although some do not show symptoms until the infection has progressed further. In 10% of cases, patients experience neck swelling. These cases are associated with a higher risk of death.
In addition to symptoms at the site of infection (sore throat), the patient may experience more generalized symptoms, such as listlessness, pallor, and fast heart rate. These symptoms are caused by the
毒素 released by the bacterium.
低血压 may develop in these patients. Longer-term effects of the diphtheria toxin include
心肌症 and
周围神经 (sensory type).
The cutaneous form of diphtheria is often a
继发性传染 of a preexisting skin disease. Signs of cutaneous diphtheria infection develop an average of seven days after the appearance of the primary skin disease.
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