Syphilis Percentage Increased in USA, Europe, Canada, China and Several Developing Countries Recently
Did Columbus and his men introduce the syphilis pathogen into Renaissance Europe after contracting it during their voyage to the New World? While it is generally agreed that the first recorded epidemic of syphilis occurred in Europe in 1495, controversy has raged ever since over the origin of the pathogen.
Sadly, our national silence may be related to our difficulty discussing the roles that race and poverty play in these trends. In 2005, for example, the rate of gonorrhea (a curable STD) among African Americans was 18 times greater than the rate among whites. The contrast in rates for HIV-AIDS, syphilis and chlamydial infection among blacks and whites is only slightly less dramatic. These diseases cost tens of billions of dollars each year, but with the exception of HIV infection, STDs remain the elephant in the room when it comes to the national conversation about health and health care.
Syphilis is caused by the bacterium Treponema pallidum. An estimated 36,000 cases of the disease were reported in the United States in 2006. The germ is passed from person to person through direct contact with a syphilis sore, with sores mainly occurring on the external genitals, vagina, anus, or in the rectum, according to the CDC.
Early stages of infection are easily cured with the antibiotic penicillin. Late stages of the disease can develop in about 15 percent of people who have not been treated. Untreated syphilis can eventually damage internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. The damage can be serious enough to cause death, according to the CDC.
Syphilis is a sexually transmitted infection (STI) that can also be transmitted through needle sharing or passed from mother to infant during birth. The first stage of syphilis is characterized by a painless sore known as a chancre, which may disappear on its own even though the person remains infected. Untreated, syphilis can progress through three stages.
Once the infection reaches the last stage, it can spread to the organs and brain.
For the seventh year in a row, rates of syphilis infection have increased in the United States, driven largely by cases among gay and bisexual men, according to a new federal report (March 12, 2008).
"CDC's preliminary 2007 data indicate that the rate of primary and secondary syphilis -- the earliest and most infectious stages of the disease -- increased by 12 percent between 2006 and 2007," Dr. Hillard Weinstock, of the U.S. Centers for Disease Control and Prevention's Division of STD Prevention, said during a Wednesday teleconference. Weinstock spoke at the CDC-sponsored 2008 National STD Prevention Conference in Chicago.
The number of reported cases of syphilis increased from 9,756 in 2006 to 11,181 in 2007, Weinstock said. "This is the seventh consecutive annual increase in national syphilis rates," he said.
Continuing with recent trends, 2007 statistics showed that men who have sex with men accounted for the majority of syphilis cases in the United States and contributed significantly to the overall increase in the disease among men, Weinstock said.
"The syphilis rate among men increased 14 percent from 2006. It was six times higher than the rate among women. Men who have sex with men comprised approximately 64 percent of reported syphilis cases in 2007," he said.
The increase in the syphilis rates among gay and bisexual men is a significant health concern, Weinstock said. "Syphilis, like other STDs [sexually transmitted diseases], can increase the likelihood of HIV transmission two- to five-fold. For individuals already infected with HIV, syphilis can increase viral load, which can accelerate HIV disease progression and the potential for HIV transmission," he said.
The CDC recommends that gay and bisexual men be tested for syphilis and other STDs at least once a year. However, several other studies presented at the meeting found that the rates of STD screening among gay and bisexual men remain low.
Although the majority of new cases of syphilis are among gay and bisexual men, syphilis is also increasing among women and African-Americans, officials said.
"The syphilis rate among women increased between 2006 and 2007 for the third consecutive year after a decade of decline," Douglas said. "The rate of syphilis among women increased 10 percent from 2006."
And, syphilis rates increased last year among African-Americans for the fourth consecutive year after more than a decade of decline. The rate of syphilis among African-Americans increased 22 percent from 2006 to 2007, Weinstock said.
Although the rate of syphilis infections among whites and African-Americans is narrowing, there is still a disparity. "In 2007, the syphilis rate among African-Americans was seven times higher than among whites. This represents a substantial decline from 1999 when the syphilis rate among African-Americans was 29 times that of whites," Weinstock said.
This decline represents a drop in cases among African-Americans and an increase in infections among white gay and bisexual men, Weinstock noted.
A study by Carnegie Mellon University came from a survey of 300 adolescent girls in the Pittsburgh area. The researchers gave the girls a test to gauge their knowledge of eight STDs: HIV/AIDS, chlamydia, gonorrhea, genital herpes, genital warts, hepatitis B, trichomoniasis and syphilis. Girls who reported having been diagnosed with a sexually transmitted disease knew more about that particular disease than other girls, but did not know more about the other diseases. On average, with the exception of HIV/AIDS, the teens did not know many basic facts about STDs.
Syphilis was a major killer in Europe during the Renaissance. Syphilis is sexually transmitted, but yaws and endemic syphilis are tropical diseases that are transmitted through skin-to-skin or oral contact. It could be argued that syphilis is one of the important early examples of globalization and disease, and globalization remains an important factor in emerging diseases.
"Syphilis has returned to China with a vengeance. The data demonstrates a syphilis epidemic of such scope and magnitude that it will require terrific effort to intervene," said Dr. Myron S. Cohen, the J. Herbert Bate distinguished professor of medicine, microbiology and immunology, and public health, and director of the Center for Infectious Diseases at the University of North Carolina at Chapel Hill School of Medicine.
Also alarming is the rate of congenital syphilis, Cohen said, which has increased from 0.01 cases per 100,000 live births in 1991 to 19.68 cases in 2005 - an average yearly rise of 71.9 percent. Congenital syphilis occurs when a pregnant woman with syphilis passes the infection to her baby in the womb. Many cases result in miscarriage or stillbirth, and surviving babies may have serious problems of the brain, liver, and other organs.
Armed with more than a decade's worth of statistics, researchers are sounding a new alarm about growing rates of syphilis among gay and bisexual men. The syphilis rate rose by 19 percent between 2000 and 2003. During that period, the rates among women continued to slide -- by 53 percent -- while rates among men jumped by 62 percent. Nevertheless, gay men have seen their rates rise significantly in this decade. In addition, officials worry that gay men will get syphilis and become more susceptible to HIV infection, although statistics have not made it clear if that is actually happening. There were 8,724 new cases of syphilis recorded in 2005.
This year cases of sexually transmitted infections (STIs) have risen by 2% in the UK, in spite of a small drop in the incidence of syphilis and gonorrhea, according to scientists speaking 28 November 2007 at the Federation of Infection Societies Conference 2007 at the University of Cardiff, UK, which runs from 28-30 November 2007.
"The key message here is that syphilis is again on the rise in several developing countries. In many of these countries we are seeing very high rates in men who have sex with men," said Dr. Kevin Fenton of the U.S. Centers for Disease Control and Prevention, whose study appears in the journal Lancet.
Since 1997, the incidence of syphilis infections in Canada has increased ninefold, according to a new report (19 March 2008). Data from the Public Health Agency of Canada (PHAC) found the rate of infection rose to 3.5 per 100,000 in 2004 from 0.4 per 100,000 in 1997.
According to a publication, assured by The Lancet magazine stated that diagnosis increased in Denmark in 50 percent from 1999 to 2002 while in Belgium it exceeded that period in three times more. Canada, United States, Australia and New Zealand have also registered an important upturn of the disease. The research pointed out also interaction between syphilis and HIV-AIDS, big disorders that could be acquired through non-safety sexual practices that could deteriorate the situation of patients.
Warren Jimenez, executive director of National Native American AIDS Prevention Center (NNAAPC), said [Mar 20, 2008] infection rates among native populations are probably higher than the CDC figures indicate. Increases in rates of drug and alcohol abuse, as well as in rates of sexually transmitted infections such as gonorrhea, chlamydia and syphilis, suggest that HIV/AIDS rates are likely increasing for the group. NNAAPC and more than 55 American Indian, Native Hawaiian and Alaska Native community organizations.
This first sign of syphilis will show up about three weeks after you have sex with someone who has it. Four to 10 weeks later, you may notice a rash on your body, palms and soles of your feet. The rash will also go away on its own.
The late stage of syphilis usually happens 10 to 20 years later. It can occur much earlier if you also have HIV. Late stage syphilis can cause serious heart, brain and bone disease.