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Sample records for syphilis

  1. Syphilis

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Syphilis KidsHealth > For Teens > Syphilis Print A A A ... Symptoms? Syphilis happens in several different stages: Primary Syphilis In the first stage of syphilis, red, firm, ...

  2. Syphilis

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Syphilis KidsHealth > For Teens > Syphilis A A A What's ... Symptoms? Syphilis happens in several different stages: Primary Syphilis In the first stage of syphilis, red, firm, ...

  3. Syphilis

    MedlinePlus

    Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or ... of both men and women. You usually get syphilis from sexual contact with someone who has it. ...

  4. Syphilis

    MedlinePlus

    ... baby. Treatment Most often, syphilis is treated with penicillin given by a shot. This treatment has been ... Is The Prognosis? The treatment of syphilis with penicillin can resolve the infection. Patients should have blood ...

  5. Syphilis

    MedlinePlus

    ... to the second stage. What happens during the second (secondary) stage of syphilis? The second stage can start as the sore is healing ... syphilis starts when symptoms from the first and second stages go away. The latent stage can last ...

  6. Syphilis

    MedlinePlus

    ... kissing, hand contact, or other close personal contact. Pregnant women with syphilis can pass it on to their babies before birth. Am I at risk? Anyone having unprotected sexual contact with an infected person can get syphilis. Having more than one sexual partner increases ...

  7. Syphilis

    MedlinePlus

    ... tetracycline given to people who are allergic to penicillin) Penicillin G benzathine Length of treatment depends on how ... person's overall health. To treat syphilis during pregnancy, penicillin is the drug of choice. Tetracycline cannot be ...

  8. Syphilis

    MedlinePlus

    ... which look like symptoms from other diseases. The painless syphilis sore that you would get after you ... are usually (but not always) firm, round, and painless. Because the sore is painless, it can easily ...

  9. Syphilis

    MedlinePlus

    ... that antibiotic pills (azithromycin) are as effective as penicillin injections for curing early-stage syphilis. Azithromycin may ... important in settings where resources are limited because penicillin injections can cause allergic reactions and the drug ...

  10. Congenital syphilis

    MedlinePlus

    Congenital lues; Fetal syphilis ... which is passed from mother to child during fetal development or at birth. Nearly half of all ... Saunders; 2014:chap 143. Duff P. Maternal and fetal infections. In: Creasy RK, Resnik R, Iams JD, ...

  11. Treating Syphilis

    PubMed Central

    Colby, W. David

    1992-01-01

    Background information on treating syphilis indicates that some currently recommended approaches to therapy are not optimal. There is no perfect drug schedule available, but penicillin remains the drug of choice. The author's recommendations for treatment and follow up are presented. PMID:21221354

  12. Pregnancy Complications: Syphilis

    MedlinePlus

    ... Collaboratives Launch Prematurity research centers What is team science? More than 75 years of solving problems March ... sex. You can get syphilis by being in direct contact with someone’s syphilis sore. Sores usually are ...

  13. Gastric syphilis - Case report*

    PubMed Central

    Guimarães, Tais Ferreira; Novis, Camila Freitas Lobo; Bottino, Caroline Bertolini; D'Acri, Antonio Macedo; Lima, Ricardo Barbosa; Martins, Carlos José

    2016-01-01

    Gastric syphilis is an uncommon extracutaneous manifestation of syphilis, occurring in less than 1% of patients, presenting nonspecific clinical manifestations. In general, it occurs on secondary stage. The critical point is the recognition of the syphilitic gastric involvement, without which there may be incorrect diagnosis of malignancy of the digestive tract. In this report, a case of secondary syphilis with gastric involvement that had complete remission with benzathine penicillin will be described. PMID:27828649

  14. Early malignant syphilis*

    PubMed Central

    Ortigosa, Yara Martins; Bendazzoli, Paulo Salomão; Barbosa, Angela Marques; Ortigosa, Luciena Cegatto Martins

    2016-01-01

    Early malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by lesions, which can suppurate and be accompanied by systemic symptoms such as high fever, asthenia, myalgia, and torpor state. We report a diabetic patient with characteristic features of the disease showing favorable evolution of the lesions after appropriate treatment. PMID:28300925

  15. Syphilis: an unusual manifestation?

    PubMed Central

    Bezalely, Shai; Jacob, Giris; Flusser, Gideon; Ablin, Jacob

    2014-01-01

    Syphilis is a widely investigated infectious venereal disease with varied presentations frequently mimicking other diseases. It progresses in distinct, well-characterised stages: early (primary and secondary), latent, and late (tertiary), each stage having its own unique presentations. However, there has been increasing evidence of atypical presentations. We describe one such presentation of early syphilis in its secondary stage. A man in his late 20s presented with a rash (which is typical of the secondary stage) and with bone pain with multiple lytic lesions (which is rare in the secondary stage but more typical of the tertiary stage). The patient was successfully treated for secondary syphilis. On the basis of our case, and on analysis of other case reports and research of early-stage syphilitic bone involvement, we conclude that the true incidence of bone involvement in early-stage syphilis may be higher than has been previously appreciated, and thus may be under-recognised and underdiagnosed. PMID:25239989

  16. Brief History of Syphilis

    PubMed Central

    Tampa, M; Sarbu, I; Matei, C; Benea, V; Georgescu, SR

    2014-01-01

    Abstract Before the discovery of Treponema pallidum as the etiologic agent, the origins of syphilis have been the subject of several debates. Diverse therapeutic agents were employed in an attempt to cure the disease. Examining the milestones in the history of syphilis, the present article reviews the existing theories that tried to explain the origins of the disease, the approach in art, the cultural and the evolution of the treatments from the empiric means to the discovery of penicillin. PMID:24653750

  17. Endemic syphilis and yaws

    PubMed Central

    Grin, E. I.

    1956-01-01

    Endemic syphilis and similar conditions are compared in this paper with yaws. Both are non-venereal and endemic, and they have very similar epidemiological characteristics. There is also considerable similarity in the clinical manifestations at the various stages of yaws and endemic syphilis, the differences that do appear being mainly due to different environmental and living conditions. No antigenic or immunogenic differences between syphilis and yaws have yet been demonstrated, and the sensitivity of both to penicillin is the same. Control measures for both diseases may be based on similar principles. The author considers the treponematoses to be closely related infections, and stresses the “unitarian” view put forward by various writers. PMID:13404469

  18. Syphilis in pregnancy

    PubMed Central

    Genc, M.; Ledger, W.

    2000-01-01

    Syphilis can seriously complicate pregnancy and result in spontaneous abortion, stillbirth, non-immune hydrops, intrauterine growth restriction, and perinatal death, as well as serious sequelae in liveborn infected children. While appropriate treatment of pregnant women often prevents such complications, the major deterrent has been inability to identify the infected women and get them to undergo treatment. Screening in the first trimester with non-treponemal tests such as rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) test combined with confirmation of reactive individuals with treponemal tests such as the fluorescent treponemal antibody absorption (FTA-ABS) assay is a cost effective strategy. Those at risk should be retested in the third trimester. Treatment during pregnancy should be with penicillin. In determining a penicillin regimen, the clinician must consider the stage of the maternal infection and the HIV status of the mother. Patients who are allergic to penicillin should be desensitised before treatment. Despite appropriate treatment, as many as 14% will have a fetal death or deliver infected infants. Treatment may further be complicated by the Jarich–Herxheimer reaction, a complex allergic response to antigens released from dead micro-organisms, which can cause fetal distress and uterine contractions. Thanks to effective intervention strategies and inexpensive penicillin, syphilis rarely complicates pregnancy in the Western world today. In parts of the world where the traditional sexually transmitted diseases have not been controlled, the magnitude of problems associated with syphilis during pregnancy is reminiscent of that faced by the West during the early 1900s. Key Words: syphilis; pregnancy PMID:10858706

  19. Congenital syphilis: an unusual presentation.

    PubMed

    Dzebolo, N N

    1980-08-01

    Congenital syphilis was discovered in a neonate with the unusual radiographic presentation of unilateral involvement of three bones showing lytic lesions and periostitis. Congenital syphilis should be considered in a newborn infant with these radiographic manifestations, especially when a suggestive history is obtained.

  20. Syphilis returns to the suburbs.

    PubMed

    Hargrove, Anna; Curtis, Nigel

    2006-05-01

    Congenital syphilis is now rare in Australia, particularly in suburban areas. The disease is both preventable and treatable, however, missed or late diagnosis can lead to catastrophic effects. We report an infant who developed congenital syphilis after multiple opportunities for preventing this condition were missed.

  1. Syphilis and Scherlievo in Dalmatia.

    PubMed

    Gruber, Franjo; Lipozenčić, Jasna

    2010-01-01

    The authors describe the emergence of syphilis in Dalmatia, the coastal part of Croatia, at the very end of the 15(th) and the beginning of the 16(th) century, its presence up to the 20(th) century, making reference to the most important physicians that tried to cure the new disease. The archives of Dalmatian towns, their statutes, some literary works, travel writers, physician books, and articles by historians of medicine contain data on syphilis in Dalmatia. Syphilis was first observed in Zadar (1500), Trogir (1501) and Dubrovnik (1502). Among the first physicians who treated patients in Dubrovnik were Mariano Santo and Amatus Lusitanus. The latter was the first to make prosthesis for the palate defect to cure tertiary syphilis lesions. According to the statutes of Dalmatia towns, each had one or more paid physicians and pharmacists. The Ottoman travel writer Evlija Celebi gave an account of syphilis in Dalmatia in the 17(th) century. At the end of the 18(th) century and during the 19(th) century, endemic syphilis known as morbus de Scherlievo and morbus Brenensis appeared in Dalmatia. Because of the numerous cases observed in the region, new hospitals were opened in Dalmatian towns and the patients were hospitalized. Among the physicians who were engaged in the fight against syphilis in the 19th century, mention should be made of Giovanni Battista Cambieri, Nikola Selak and Božo Peričić. They all treated the affected patients and described syphilis and 'Scherlievo disease'in Croatian as well as in other languages. Syphilis was present in Dalmatia towns during the 15(th)-20(th) century, remaining a challenge and arousing the interest of current dermatovenereologists as well as other specialists.

  2. Atypical Cutaneous Manifestations in Syphilis.

    PubMed

    Ivars Lleó, M; Clavo Escribano, P; Menéndez Prieto, B

    2016-05-01

    Although the diversity of the clinical manifestations of syphilis is well-known, atypical presentations can also occur. Such atypical presentations are associated with a high risk of transmission as a result of diagnostic confusion and treatment delays owing to the disease's ability to mimic other common skin diseases, deviate from classic clinical presentations, and adopt unique forms. Cases of atypical syphilis have been described most frequently in patients with concomitant human immunodeficiency virus (HIV) infection. Because the incidence of syphilis has been growing over recent years -particularly in patients with HIV co-infection- dermatologists need to be familiar with the less well-known clinical presentations of this venereal disease.

  3. Maternal syphilis: pathophysiology and treatment.

    PubMed Central

    Berman, Stuart M.

    2004-01-01

    Despite the long history of medical interest in syphilis and its effects on pregnancy outcome, many fundamental questions about the pathophysiology and treatment of syphilis during pregnancy remain unanswered. However, understanding has been advanced by recent scientific reports such as those which delineate the complete sequence of the genome of the syphilis spirochaete, provide a more precise description of fetal and neonate infection by use of rabbit infectivity tests and describe the gestational age distribution of fetal death secondary to syphilis. It appears that fetal syphilitic involvement progresses in a rather predictable fashion, and although there is disagreement about the optimal prenatal treatment regimen, programmatic efforts to prevent fetal death must provide seropositive pregnant women with a recommended treatment early in pregnancy, and certainly before the third trimester. PMID:15356936

  4. Syphilis in the AIDS Era

    DTIC Science & Technology

    1987-06-18

    high risk of contracting syphilis, all HIV -infected patients should be screened for syphilis, and vice versa. The same holds true for other sexually...made to isolate the infecting organ- ism and no proved means of detecting T. pallidunt anti- gens exists. The antibody response in HIV -infected...patients, particulary in the later stages of AIDS, may be compromised, and thus the diagnosis may be ob- scuredShould all HIV -infected patients with neuro

  5. Syphilis: presentations in general medicine.

    PubMed

    Nyatsanza, Farai; Tipple, Craig

    2016-04-01

    Syphilis is caused by the spirochete bacteriumTreponema pallidumand can be transmitted both sexually and from mother to child.T pallidumcan infect any organ and produces a clinical disease with a relapsing and remitting course. It is not hard to see, therefore, why it is often described as the great mimic. In this review, we provide an update of modern syphilis epidemiology, clinical presentations, and testing and treatment strategies.

  6. Prevalence Estimates of Complicated Syphilis.

    PubMed

    Dombrowski, Julia C; Pedersen, Rolf; Marra, Christina M; Kerani, Roxanne P; Golden, Matthew R

    2015-12-01

    We reviewed 68 cases of possible neurosyphilis among 573 syphilis cases in King County, WA, from 3rd January 2012 to 30th September 2013; 7.9% (95% confidence interval, 5.8%-10.5%) had vision or hearing changes, and 3.5% (95% confidence interval, 2.2%-5.4%) had both symptoms and objective confirmation of complicated syphilis with either abnormal cerebrospinal fluid or an abnormal ophthalmologic examination.

  7. Sexually Transmitted Diseases Surveillance, 2014: Syphilis

    MedlinePlus

    ... states ( Table 27 ). P&S Syphilis by Metropolitan Statistical Area The overall rate of reported P&S syphilis cases in the 50 most populous metropolitan statistical areas (MSAs) was 8.7 cases per 100,000 ...

  8. Malignant syphilis in an immunocompetent female patient*

    PubMed Central

    Requena, Camila Bueno; Orasmo, Cínthia Rosane; Ocanha, Juliana Polizel; Barraviera, Silvia Regina Catharino Sartore; Marques, Mariangela Esther Alencar; Marques, Silvio Alencar

    2014-01-01

    Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient. PMID:25387504

  9. Syphilis soars in Russia.

    PubMed

    Ingram, M

    1995-07-08

    The number of adults with syphilis in Russia has increased 15-fold since the collapse of the Soviet Union. The rate in children is 20 times higher than it was 4 years ago. 126,500 cases were registered with the health ministry over the past year, while 7900 were in 1990. The number of cases in children increased from 38 in 1991 to 761 this year; most of these cases were acquired via sexual transmission. Lilia Tikhonova, the health ministry's chief specialist on sexually transmitted diseases (STDs), blamed the increases on "the complete perversion of our society's morals," the rapid growth of child prostitution, the influx of homeless people and refugees into the cities, and miracle cures that are used in place of seeing a specialist. In communist Russia, patients were required to register passport details and previous sexual contacts, and future sexual contact was forbidden for a period; anyone breaking these rules faced 5 years in jail. Current law only punishes those who knowingly infect their sexual partners. Health officials in the Ukraine, where a similar increase in the number of STDs has been noted, blame black market condoms. Over the past 5 years, cheap foreign condoms have flooded the market.

  10. Annular lichenoid syphilis: A rare entity.

    PubMed

    Khurana, Ananta; Singal, Archana; Gupta, Seema

    2014-01-01

    Syphilis is a disease known for centuries, but still continues to be a diagnostic challenge as the myriad manifestations of secondary syphilis can mimic a lot many dermatological disorders. Lichenoid syphilis is an uncommon entity, reported only occasionally in the penicillin era. We present the case of a 32-year-old woman presenting with localized annular lichenoid lesions on the neck.

  11. Nodular tertiary syphilis in an immunocompetent patient*

    PubMed Central

    Bittencourt, Maraya de Jesus Semblano; de Brito, Arival Cardoso; Nascimento, Bianca Angelina Macêdodo; Carvalho, Alessandra Haber; Drago, Marion Guimarães

    2016-01-01

    Acquired syphilis can be divided into primary, secondary, latent, and tertiary stages. About 25% of patients with untreated primary syphilis will develop late signs that generally occur after three to five years, with involvement of several organs. The authors present an immunocompetent female who developed a tertiary stage syphilis presenting with long-standing nodular plaques. PMID:27579755

  12. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  13. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  14. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  15. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  16. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  17. Annular lichenoid syphilis: A rare entity

    PubMed Central

    Khurana, Ananta; Singal, Archana; Gupta, Seema

    2014-01-01

    Syphilis is a disease known for centuries, but still continues to be a diagnostic challenge as the myriad manifestations of secondary syphilis can mimic a lot many dermatological disorders. Lichenoid syphilis is an uncommon entity, reported only occasionally in the penicillin era. We present the case of a 32-year-old woman presenting with localized annular lichenoid lesions on the neck. PMID:26396452

  18. Papulosquamous dermatitis. Syphilis: a forgotten disease?

    PubMed

    Konstantopoulou, M; Andrady, U; Lord, M G; Macfarlane, A W

    2006-12-10

    We report a case of secondary syphilis in a 54-year-old, bisexual, HIV positive man. Although syphilis is a well-known sexually-transmitted infection, it is not widely seen nowadays. However, a possible diagnosis of syphilis should not be overlooked in any individual, irrespective of HIV status.

  19. Congenital syphilis: The continuing scourge

    PubMed Central

    Agrawal, Prachi G.; Joshi, Rajesh; Kharkar, Vidya D.; Bhaskar, M. V.

    2014-01-01

    Congenital syphilis is a severe, disabling infection that occurs due to the transmission of Treponema pallidum across the placenta during pregnancy or from contact with an infectious genital lesion during delivery. However, its early diagnosis is often difficult because more than half of the affected infants are asymptomatic, and the signs in symptomatic infants may be subtle and nonspecific. Although its incidence is declining, this long-forgotten disease continues to affect pregnant women, resulting in considerable perinatal morbidity and mortality. We hereby report a case of a 2-month-old infant with early congenital syphilis presenting with joint swellings and Parrot's pseudoparalysis, a comparative rarity in the present scenario. The report also stresses upon the importance of implementing the Centres for Disease Control and Prevention recommendation that all the pregnant women should be screened for syphilis in the first antenatal visit in the first trimester and again in late pregnancy. PMID:26396451

  20. Did Adolf Hitler have syphilis?

    PubMed

    Retief, F P; Wessels, A

    2005-10-01

    The evidence that Adolf Hitler might have suffered from incapacitating syphilis is reviewed. Rumors that he acquired syphilis from a prostitute at the age of 20 years, with possible re-infection during World War I, can no longer be verified. Evidence is that he was sexually rather inactive throughout his life. Suggestions that Hitler's cardiac lesion and complaints such as transitory blindness, tremor of his left arm and leg, recurring abdominal pain and a skin lesion of the leg were of syphilitic aetiology cannot be supported. Hitler's progressive mental and physical deterioration after 1942, his growing paranoia, fits of rage, grandiosity and symptoms of possible dementia would fit in neurosyphilis. There are, however, also other explanations for his terminal syndrome, and evidence that repeated clinical examinations did not show the characteristic signs of dementia paralytica or tabes dorsalis, swings the balance of probability away from tertiary syphilis.

  1. Congenital syphilis after treatment of maternal syphilis with a penicillin regimen exceeding CDC guidelines.

    PubMed Central

    Conover, C S; Rend, C A; Miller, G B; Schmid, G P

    1998-01-01

    BACKGROUND: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported. CASE: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines. CONCLUSION: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasional treatment failures and the importance of adequate follow-up of infants at risk for congenital syphilis. PMID:9785110

  2. Secondary Syphilis With Hepatitis and Nephrotic Syndrome: A Rare Concurrence.

    PubMed

    Makker, Jasbir; Bajantri, Bharat; Nayudu, Suresh Kumar

    2016-07-01

    Syphilis, a chronic multisystem disease, is caused by a spirochete, Treponema pallidum. Clinical presentation may expand to several stages including primary, secondary and latent syphilis, which may present as early or late syphilis. Nephrotic syndrome and acute hepatitis are well-known complications of secondary syphilis. To the best of our knowledge, secondary syphilis with coexisting renal and hepatic complications has rarely been reported. Here we present a rare case of concurrent nephrotic syndrome and acute hepatitis in a patient with secondary syphilis.

  3. Periungual Lesion due to Secondary Syphilis

    PubMed Central

    Noriega, Leandro; Gioia Di Chiacchio, Nilton; Cury Rezende, Flávia; Di Chiacchio, Nilton

    2017-01-01

    Several countries experience a new epidemic of syphilis, mainly due to the changes in risk behaviors. Dermatologists play an important role in the diagnosis, since cutaneous manifestations are frequent during disease progression. We report a rare case of secondary syphilis with periungual involvement. Syphilis, especially in the secondary form, may present with different clinical features, affecting different organs, and mimicking many diseases. Although nail apparatus lesions are more common in the primary form of the disease, they may also be present in the secondary and tertiary forms. Therefore, a comprehensive knowledge of the diverse forms of syphilis presentation is important for an early diagnosis and timely treatment. PMID:28232918

  4. Periungual Lesion due to Secondary Syphilis.

    PubMed

    Noriega, Leandro; Gioia Di Chiacchio, Nilton; Cury Rezende, Flávia; Di Chiacchio, Nilton

    2017-01-01

    Several countries experience a new epidemic of syphilis, mainly due to the changes in risk behaviors. Dermatologists play an important role in the diagnosis, since cutaneous manifestations are frequent during disease progression. We report a rare case of secondary syphilis with periungual involvement. Syphilis, especially in the secondary form, may present with different clinical features, affecting different organs, and mimicking many diseases. Although nail apparatus lesions are more common in the primary form of the disease, they may also be present in the secondary and tertiary forms. Therefore, a comprehensive knowledge of the diverse forms of syphilis presentation is important for an early diagnosis and timely treatment.

  5. OCULAR SYPHILIS IN A KIDNEY TRANSPLANT RECIPIENT

    PubMed Central

    ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel

    2016-01-01

    We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748

  6. Alopecia as the Presenting Symptom of Syphilis.

    PubMed

    Ornelas, Jennifer; Agbai, Oma N; Kiuru, Maija; Sivamani, Raja K

    2015-07-15

    Alopecia can be one of the many symptoms of secondary syphilis and the clinical presentations include essential syphilitic alopecia or symptomatic syphilitic alopecia. In this report, we present a case of a patient with essential syphilitic alopecia whose sole presenting symptom of syphilis was alopecia. Despite an initial negative rapid plasma reagin (RPR) test, he was ultimately found to have syphilis on scalp biopsy. His alopecia improved following treatment with benzathine penicillin. This presentation serves as a reminder to clinicians to be cognizant of alopecia as a presenting sign of syphilis. A review of the specificity and sensitivity of the typical tests used for the diagnosis is presented.

  7. Analytical and clinical comparison of Elecsys syphilis (Roche(®)) - Architect syphilis TP and reformulated Architect syphilis TP (Abbott(®)) assay.

    PubMed

    De Keukeleire, Steven; Desmet, Stefanie; Lagrou, Katrien; Oosterlynck, Julie; Verhulst, Manon; Van Besien, Jessica; Saegeman, Veroniek; Reynders, Marijke

    2017-03-01

    The performance of Elecsys Syphilis was compared to Architect Syphilis TP and Reformulated Architect Syphilis TP. The overall sensitivity and specificity were 98.4% and 99.5%, 97.7% and 97.1%, and 99.2% and 99.7% respectively. The assays are comparable and considered adequate for syphilis screening.

  8. [Injury by skull osteolytic secundary syphilis].

    PubMed

    Alessandro, Lucas; Camporro, Julieta Piar; Arakaki, Naomi; Orellana, Nora; Mora, Claudia Andrea

    2016-04-01

    Bone involvement of syphilis can be observed in tertiary and congenital syphilis. It is infrequent during the secondary stage. The skull is the most affected bone in secondary syphilis, and its most frequent form of presentation is proliferative osteitis. If the skull is affected, headache is usual and can be as intense as in meningitis. Osteolyitic lesions may be seen in complimentary imaging studies, with a moth eaten aspect. These lesions raise concern over a number of differential diagnoses, among which are infectious, inflammatory and neoplastic diseases. The definitive diagnosis is made by bone biopsy of the compromised bone. Molecular techniques in the affected tissues increases diagnostic performance. There is no standardized treatment protocol for syphilis since there are no guidelines available. We report a case of a 19 year old female, presenting with a unique osteolytic lesion in the skull due to secondary syphilis.

  9. Should all pregnant women be screened for syphilis?

    PubMed

    Buvé, Anne

    2007-09-01

    In industrialized countries, the incidence of syphilis has decreased dramatically since the discovery of penicillin in the 1940s. However, syphilis and congenital syphilis are far from eradicated, especially in low- and middle-income countries. Syphilis in pregnant women is a cause of adverse pregnancy outcomes that can be prevented by screening for syphilis and early treatment in pregnancy. Several studies have found screening of pregnant women for syphilis to be a highly cost-effective intervention, even if the prevalence of syphilis is low. Obstacles to universal screening of pregnant women include low awareness of syphilis and low quality of antenatal care and healthcare in general in many low- and middle-income countries. For these settings, we need simpler and more reliable serological tests for syphilis, but we also need to strengthen health services in general to ensure sustainable antenatal care services to ensure sustainability of syphilis screening programmes.

  10. [Syphilis: a STD back to us].

    PubMed

    Flagothier, C; Arrese, J E; Piérard-Franchimont, C; Piérard, G E

    2004-01-01

    Sexually transmitted diseases (STD) show frequent epidemiological changes. We report a case of secondary syphilis diagnosed in a 32-year old woman during post-partum. The disease, although showing a typical presentation, raises the problem of dating with precision the contamination time. This is of importance for treating the newborn at risk of congenital syphilis. We highlight the constant attention that should be brought to disclose this venereal disease that shows so variable clinical and histological presentations. Syphilis seems on the rise in the Mosan valley and in some cities where prostitution is imported from Eastern Europe and Africa.

  11. The Tuskegee Syphilis Study and women's health.

    PubMed

    Gamble, V N

    1997-01-01

    In May 1997, President Bill Clinton apologized for the Tuskegee Syphilis Study. The President's action underscores that in the 25 years since its public revelation, the study has moved from a singular historical event to a powerful metaphor that symbolizes racism in medicine, misconduct in human research, the arrogance of physicians, and government abuse of black people. The Tuskegee Syphilis Study also has implications for women's health. Discussion of the study usually ignores its impact on the wives of the victims. In addition, African-American women may be more reluctant to participate in clinical trials because of the shadow cast by the syphilis study and other incidents of medical abuse. Finally, the Tuskegee Syphilis Study reminds us that the battle against racism must be an integral part of the campaign to improve women's health.

  12. Can HIV Drugs Boost Syphilis Risk?

    MedlinePlus

    ... 17, 2017 MONDAY, Jan. 16, 2017 (HealthDay News) -- Gay and bisexual men taking antiretroviral drugs to treat ... why new and repeat cases of syphilis in gay and bisexual men have risen sharply compared to ...

  13. Oral syphilis: a series of 5 cases.

    PubMed

    Hertel, Moritz; Matter, Daniel; Schmidt-Westhausen, Andrea M; Bornstein, Michael M

    2014-02-01

    Syphilis is an infectious, usually sexually transmitted, disease caused by Treponema pallidum, subspecies pallidum. Because of the increasing prevalence in Europe during the past few years, dentists could be confronted with patients with oral manifestations of syphilis. Because oral lesions are highly contagious, it is vital to make the correct diagnosis quickly to initiate the proper therapy and to interrupt the chain of infection. We present the cases of 5 patients with syphilis-related oral lesions. These cases are representative because of their clinical presentation, age, and gender distribution and the diagnostic approach. The aim of the present report is to emphasize the importance of the dentist knowing and identifying syphilis in different stages to diagnose the disease and institute treatment at an early stage.

  14. Secondary Syphilis With Hepatitis and Nephrotic Syndrome: A Rare Concurrence

    PubMed Central

    Makker, Jasbir; Bajantri, Bharat; Nayudu, Suresh Kumar

    2016-01-01

    Syphilis, a chronic multisystem disease, is caused by a spirochete, Treponema pallidum. Clinical presentation may expand to several stages including primary, secondary and latent syphilis, which may present as early or late syphilis. Nephrotic syndrome and acute hepatitis are well-known complications of secondary syphilis. To the best of our knowledge, secondary syphilis with coexisting renal and hepatic complications has rarely been reported. Here we present a rare case of concurrent nephrotic syndrome and acute hepatitis in a patient with secondary syphilis. PMID:27298666

  15. Neuro syphilis: Portrayals by Sir Arthur Conan Doyle.

    PubMed

    Somasundaram, O

    2009-01-01

    The developments in neuro syphilis in the 19 th century are integral parts of the history of psychiatry. The delineation of various aspects of neuro syphilis by Sir Arthur Conan Doyle in three of his stories is discussed in brief.

  16. Syphilis and MSM (Men Who Have Sex with Men)

    MedlinePlus

    ... syphilis is linked to an increased risk of transmission of HIV infection. How could I get syphilis? ... English, en Español Resources: CDC National Prevention Information Network (NPIN) P.O. Box 6003 Rockville, MD 20849- ...

  17. Syphilis on the rise: A prolonged syphilis outbreak among HIV-infected patients in Northern Greece

    PubMed Central

    Tsachouridou, Olga; Skoura, Lemonia; Christaki, Eirini; Kollaras, Panagiotis; Sidiropoulou, Eleni; Zebekakis, Pantelis; Vakirlis, Efstratios; Margariti, Apostolia; Metallidis, Symeon

    2016-01-01

    Introduction Sexually transmitted diseases (STDs) are a major public health issue in Europe. Numerous outbreaks of syphilis have been described recently and an increased prevalence of high-risk sexual practices has raised concern about the transmission of HIV and other STDs. Similarly, an increase in sexually transmitted infections has been recorded in Northern Greece. Methods This report describes a recent outbreak of syphilis in people living with HIV. The demographic, clinical, and serologic data of HIV patients diagnosed with syphilis were recorded and analyzed. Data on syphilis incidence from the general population was also compared to HIV patients’ data. Results Fifty-eight HIV-patients of the Infectious Diseases Unit of a tertiary hospital (5.2%) were diagnosed with syphilis during a three-year period (2008-2010). Highly active antiretroviral therapy (HAART) and coexistence of other STDs were independent predictors of syphilis (OR: 2.4, 95CI%: 1.26, 4.63, p=0.008; OR: 9.4, 95%CI: 4.49, 19.64, p<0.001, respectively). Origin from a country other than Greece (p=0.005), and homosexual contact (p=0.003), were separate risk factors for syphilis in the general population in the same area. Conclusion Diagnosis of a sexually transmitted disease in an HIV patient is a crucial clinical event that should trigger the clinician’s suspicion for high-risk sexual behavior. Sexual health assessments should be a routine process for HIV patients. PMID:27622160

  18. Syphilis hospitalisations in Portugal over the last decade.

    PubMed

    Sousa-Pinto, B; Freitas, A; Lisboa, C

    2016-02-01

    Although several studies have reported an increase of syphilis incidence over the last decade in Western Europe, information concerning syphilis epidemiology in Portugal remains scarce. Therefore, we sought to characterise acquired syphilis-associated hospitalisations in Portugal according to demographic and clinical data. We used a database containing all hospitalisations that occurred in mainland Portugal public hospitals with discharges between 2000 and 2014. We analysed all hospitalisations associated with ICD-9-CM codes 091-097.x (corresponding to acquired syphilis diagnosis) concerning inpatients' gender, age and comorbidities. The median length of stay and in-hospital mortality rates were also studied. Between 2000 and 2014, there were a total of 8974 syphilis-related hospitalisations in mainland Portugal. The rate of acquired syphilis hospitalisations per 100,000 inhabitants increased by 33 % during the studied period. Syphilis hospitalisation rates increased by 70 % in males and 139 % among patients aged over 55 years. On the other hand, they declined by 10 % in females and 20 % among patients younger than 55 years old. The percentage of syphilis episodes presenting cardiovascular and neuropsychiatric comorbidities increased, while the percentage of syphilis episodes presenting HIV co-infection decreased by 69 %. A fatal outcome was reported in 5 % of episodes; 4.6 % of them had acquired syphilis as the main reason for hospitalisation. This study illustrates that, despite being a preventable infection, syphilis remains a public health problem. The analysis of hospitalisation and administrative data helps to understand syphilis epidemiology and provides a supplement to traditional case notifications.

  19. Shakespeare's chancre: did the bard have syphilis?

    PubMed

    Ross, John J

    2005-02-01

    Shakespeare's obsessive interest in syphilis, his clinically exact knowledge of its manifestations, the final poems of the sonnets, and contemporary gossip all suggest that he was infected with "the infinite malady." The psychological impact of venereal disease may explain the misogyny and revulsion from sex so prominent in the writings of Shakespeare's tragic period. This article examines the possibility that Shakespeare received successful treatment for syphilis and advances the following new hypothesis: Shakespeare's late-life decrease in artistic production, tremor, social withdrawal, and alopecia were due to mercury poisoning from syphilis treatment. He may also have had anasarca due to mercury-related membranous nephropathy. This medical misadventure may have prematurely ended the career of the greatest writer in the English language.

  20. Cross-reactivity between Lyme and syphilis screening assays: Lyme disease does not cause false-positive syphilis screens.

    PubMed

    Patriquin, Glenn; LeBlanc, Jason; Heinstein, Charles; Roberts, Catherine; Lindsay, Robbin; Hatchette, Todd F

    2016-03-01

    Increased rates of Lyme disease and syphilis in the same geographic area prompted an assessment of screening test cross-reactivity. This study supports the previously described cross-reactivity of Lyme screening among syphilis-positive sera and reports evidence against the possibility of false-positive syphilis screening tests resulting from previous Borrelia burgdorferi infection.

  1. Bone lesions in early congenital syphilis.

    PubMed

    Rosen, E U; Solomon, A

    1976-01-31

    A radiological study of bone changes in 112 children with congenital syphilis was undertaken. A similar number of normal children acted as a control group. Radiological examination of 5 syphilitic children showed that their bones were normal. Combined metaphyseal and periosteal lesions were the commonest bone disorders seen and are thus the most convincing radiological evidence of congenital syphilis. Transverse metaphyseal lucencies occur early in the disease, and with Wimburger's sign they are the prime evidence of pathology in syphilitic bone. Other radiographic changes are probably owing to minimal trauma in fragile disorganized bone. The occurrence of periosteal lesions alone has also been evaluated.

  2. Syphilis and HIV/Syphilis Co-infection Among Men Who Have Sex With Men (MSM) in Ecuador.

    PubMed

    Hernandez, Isabel; Johnson, Ayesha; Reina-Ortiz, Miguel; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M; Teran, Enrique; Izurieta, Ricardo

    2016-12-05

    There is a reemergence of syphilis in the Latin American and Caribbean region. There is also very little information about HIV/Syphilis co-infection and its determinants. The aim of this study is to investigate knowledge, attitudes, and practices regarding sexually transmitted infections (STIs), in particular syphilis infection and HIV/Syphilis co-infection, as well as to estimate the prevalence of syphilis among men who have sex with men (MSM) in a city with one of the highest HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 291 adult MSM. Questions included knowledge about STIs and their sexual practices. Blood samples were taken from participants to estimate the prevalence of syphilis and HIV/syphilis co-infection. In this population, the prevalence of HIV/syphilis co-infection was 4.8%, while the prevalence of syphilis as mono-infection was 6.5%. Participants who had syphilis mono-infection and HIV/syphilis co-infection were older. Men who had multiple partners and those who were forced to have sex had increased odds of syphilis and HIV/syphilis co-infection. A high prevalence of syphilis and self-reported STI was observed, which warrants targeted behavioral interventions. Co-infections are a cause for concern when treating a secondary infection in a person who is immunocompromised. These data suggest that specific knowledge, attitudes, and behaviors among MSM are associated with increased odds of STIs (including HIV/syphilis co-infections) in this region of Ecuador.

  3. Syphilis in the United States: on the rise?

    PubMed

    Peterman, Thomas A; Su, John; Bernstein, Kyle T; Weinstock, Hillard

    2015-02-01

    Syphilis rates and trends vary by population subgroup. Among men who have sex with men (MSM), rates of primary and secondary (P&S) syphilis are high throughout the USA (228.8 per 100,000 in 2013). P&S syphilis among women is much less common (0.9 per 100,000 in 2013) and occurs in isolated outbreaks plus in a few counties with persistent low levels of infection. Congenital syphilis trends closely follow P&S trends among women. These trends have implications for prevention. Routine screening among MSM can prevent tertiary syphilis, but despite interventions, rates of infection continue to rise among MSM and will soon approach those last seen in 1982 (estimate: 340.7 per 100,000). Control of syphilis among women is possible and important because it often leads to congenital syphilis. Outbreaks among heterosexuals can be halted by intensive screening, treatment and partner notification.

  4. [Maternal syphilis and congenital syphilis in Latin America: big problem, simple solution].

    PubMed

    Valderrama, Julia; Zacarías, Fernando; Mazin, Rafael

    2004-09-01

    From the data submitted to the Pan American Health Organization (PAHO) by nationwide programs against sexually transmitted diseases (STD), HIV infection, and AIDS (2002), one can estimate the overall prevalence of syphilis among pregnant women to be 3.1% and to range from 1.00% in Peru to 6.21% in Paraguay. According to these data, the incidence of congenital syphilis ranges from 1.4 per 1000 live births in El Salvador to 12.0 per 1000 live births in Honduras. Among men who engage in sex with other men, who often classify themselves as heterosexual, as well as in female sex workers, the prevalence of syphilis ranged from 5% to 15%. Factors that determine the persistence of congenital syphilis as public health problem include a lack of awareness of the seriousness of the problem among politicians, health officials, and health care providers, difficult access to prenatal care, and screening services, a low demand for the test among users, and the stigma and discrimination that surround sexually transmitted diseases (STD). This paper seeks to focus the attention of health professionals on maternal and congenital syphilis so they will undertake actions, using an interprogrammatic approach, to eliminate congenital syphilis from Latin America and the Caribbean. Eliminating congenital syphilis will only become possible if interventions targeting vulnerable groups are also implemented. PAHO's role in eliminating congenital syphilis includes determining the baseline situation in the Region as a whole and in each country, developing communication and procurement strategies, supporting nationwide programs, promoting operational research, and facilitating interprogrammatic coordination.

  5. Ocular Syphilis - Eight Jurisdictions, United States, 2014-2015.

    PubMed

    Oliver, Sara E; Aubin, Mark; Atwell, Leah; Matthias, James; Cope, Anna; Mobley, Victoria; Goode, Alexandra; Minnerly, Sydney; Stoltey, Juliet; Bauer, Heidi M; Hennessy, Robin R; DiOrio, Dawne; Fanfair, Robyn Neblett; Peterman, Thomas A; Markowitz, Lauri

    2016-11-04

    Ocular syphilis, a manifestation of Treponema pallidum infection, can cause a variety of ocular signs and symptoms, including eye redness, blurry vision, and vision loss. Although syphilis is nationally notifiable, ocular manifestations are not reportable to CDC. Syphilis rates have increased in the United States since 2000. After ocular syphilis clusters were reported in early 2015, CDC issued a clinical advisory (1) in April 2015 and published a description of the cases in October 2015 (2). Because of concerns about an increase in ocular syphilis, eight jurisdictions (California, excluding Los Angeles and San Francisco, Florida, Indiana, Maryland, New York City, North Carolina, Texas, and Washington) reviewed syphilis surveillance and case investigation data from 2014, 2015, or both to ascertain syphilis cases with ocular manifestations. A total of 388 suspected ocular syphilis cases were identified, 157 in 2014 and 231 in 2015. Overall, among total syphilis surveillance cases in the jurisdictions evaluated, 0.53% in 2014 and 0.65% in 2015 indicated ocular symptoms. Five jurisdictions described an increase in suspected ocular syphilis cases in 2014 and 2015. The predominance of cases in men (93%), proportion of those who are men who have sex with men (MSM), and percentage who are HIV-positive (51%) are consistent with the epidemiology of syphilis in the United States. It is important for clinicians to be aware of potential visual complications related to syphilis infections. Prompt identification of potential ocular syphilis, ophthalmologic evaluation, and appropriate treatment are critical to prevent or manage visual symptoms and sequelae of ocular syphilis.

  6. Forgotten but Not Gone! Syphilis Induced Tenosynovitis

    PubMed Central

    Brooks, David; Walton, Mollie; Nagabandi, Arun

    2016-01-01

    Objective. Tenosynovitis, inflammation of a tendon and its synovial sheath, is a rare manifestation of secondary syphilis and if diagnosed early is reversible. Background. A 52-year-old male with past medical history of untreated syphilis presented with gradual onset of swelling and pain of the right fourth metacarpophalangeal joint (MCP). He reported a history of painless penile lesions after having sexual intercourse with a new partner approximately five months ago which was treated with sulfamethoxazole/trimethoprim. An RPR done at that time came back positive with a high titer; however, patient was lost to follow-up. On examination, patient had an edematous, nonerythematous right fourth proximal interphalangeal (PIP) joint. Urgent irrigation, debridement, and exploration of the right hand into the tendon sheath were performed. With his history of syphillis, an RPR was done, which was reactive with a titer of 1 : 64. A confirmatory FTA-ABS test was completed, rendering a positive result. Based on his history of untreated syphilis, dormancy followed by clinical scenario of swelling of the right fourth finger, and a high RPR titer, he was diagnosed with secondary syphilis manifesting as tenosynovitis. PMID:28050292

  7. Primary syphilis cases in Guangdong Province 1995-2008: Opportunities for linking syphilis control and regional development

    PubMed Central

    2010-01-01

    Background Syphilis cases have risen in many parts of China, with developed regions reporting the greatest share of cases. Since syphilis increases in these areas are likely driven by both increased screening and changes in sexual behaviours, distinguishing between these two factors is important. Examining municipal-level primary syphilis cases with spatial analysis allows a more direct understanding of changing sexual behaviours at a more policy-relevant level. Methods In this study we examined all reported primary syphilis cases from Guangdong Province, a southern province in China, since the disease was first incorporated into the mandatory reporting system in 1995. Spatial autocorrelation statistics were used to correlate municipal-level clustering of reported primary syphilis cases and gross domestic product (GDP). Results A total of 52,036 primary syphilis cases were reported over the period 1995-2008, and the primary syphilis cases increased from 0.88 per 100,000 population in 1995 to 7.61 per 100,000 in 2008. The Pearl River Delta region has a disproportionate share (44.7%) of syphilis cases compared to other regions. Syphilis cases were spatially clustered (p = 0.01) and Moran's I analysis found that syphilis cases were clustered in municipalities with higher GDP (p = 0.004). Conclusions Primary syphilis cases continue to increase in Guangdong Province, especially in the Pearl River Delta region. Considering the economic impact of syphilis and its tendency to spatially cluster, expanded syphilis testing in specific municipalities and further investigating the costs and benefits of syphilis screening are critical next steps. PMID:21192782

  8. [A case of secondary syphilis with hepatitis].

    PubMed

    Tanyel, Esra; Taşdelen Fişgin, Nuriye; Sarikaya Genç, Hanife; Tülek, Necla

    2007-04-01

    Hepatitis is a rare clinical manifestation of syphilis. In this report a 50 years old male patient who was diagnosed as secondary syphilis presenting with hepatitis has been discussed. The patient was admitted to the hospital with high fever and skin rash, and his history revealed a suspected sexual contact. He indicated that he had been admitted to a health center eight months ago because of the presence of a penile wound, however VDRL (Venereal Disease Research Laboratory) test was negative at that time. Fever (39.5 degrees C), jaundice in skin and sclera, generalized macular and maculopapular skin rash including palms and soles, lymphadenopathy and hepatosplenomegaly were detected in physical examination. Laboratory tests yielded elevated erythrocyte sedimantation rate, high CRP levels and elevated liver enzyme levels, however viral hepatitis markers together with VDRL and TPHA (Treponema pallidum hemagglutination) tests were found negative. Ceftriaxone therapy was initiated because of the presence of high fever (40 degrees C) and 30 leukocyte/mm3 in urine, and the absence of bacteria in Gram staining of urine sample. However, the antibiotic therapy was discontinued since fever persisted. As the clinical signs and symptoms strongly indicated syphilis, the serological tests were repeated and VDRL positivity at 1/8 and TPHA positivity at 1/1280 titers were detected. Ceftriaxone therapy was restarted and continued for 14 days with complete cure. Since the spouse of the patient was also found VDRL and TPHA positive, she was treated with penicilin. The presentation of this case emphasized the importance of repeating the serological tests for syphilis since they might be negative in the early stages of infection. The case also indicates that syphilis should be considered in the differential diagnosis of hepatitis.

  9. THE IMMUNOPATHOBIOLOGY OF SYPHILIS: THE MANIFESTATIONS AND COURSE OF SYPHILIS ARE DETERMINED BY THE LEVEL OF DELAYED-TYPE HYPERSENSITIVITY

    PubMed Central

    Carlson, J. Andrew; Dabiri, Ganary; Cribier, Bernard; Sell, Stewart

    2013-01-01

    Syphilis has plagued mankind for centuries and is currently resurgent in the Western hemisphere. While there has been a significant reduction of tertiary disease, and recognition of facilitative interactions with HIV infection, the natural history of syphilis has remained largely unchanged; thus, new strategies are required to more effectively combat this pathogen. The immunopathologic features of experimental syphilis in the rabbit; the course, stages, and pathology of human syphilis; and a comparison of human syphilis with leprosy suggest that the clinical course of syphilis and its tissue manifestations are determined by the balance between delayed type hypersensitivity (DTH) and humoral immunity to the causative agent, Treponema pallidum. A strong DTH response is associated with clearance of the infecting organisms in a well-developed chancre, whereas a cytotoxic T-cell response or strong humoral antibody response is associated with prolonged infection and progression to tertiary disease. Many of the protean symptoms/appearances of secondary and tertiary human syphilis are manifestations of immune reactions that fail to clear the organism, due to a lack of recruitment and more importantly, activation of macrophages by sensitized CD4 T-cells. The Bacillus Calmette Guerin (BCG) vaccination can enhance DTH and has been shown to produce a low, but measurable beneficial effect in the prevention of leprosy, a disease that shows a disease spectrum with characteristics in common with syphilis. In the prevention of syphilis, a potential vaccine protective against syphilis should be designed to augment the DTH response. PMID:21694502

  10. Syphilis presenting as retinal detachment and orchitis in a young man with HIV.

    PubMed

    Yogo, Norihiro; Nichol, Aran Cunningham; Campbell, Thomas B; Erlandson, Kristine M

    2014-02-01

    Retinal detachment and testicular lesions are 2 rare presentations of syphilis. We describe a man with bilateral retinal detachment from ocular syphilis and syphilitic orchitis as a manifestation of syphilis and HIV coinfection.

  11. Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: Birth in Brazil study

    PubMed Central

    Domingues, Rosa Maria Soares Madeira; Szwarcwald, Celia Landmann; Souza, Paulo Roberto Borges; Leal, Maria do Carmo

    2014-01-01

    OBJECTIVE Determine the coverage rate of syphilis testing during prenatal care and the prevalence of syphilis in pregnant women in Brazil. METHODS This is a national hospital-based cohort study conducted in Brazil with 23,894 postpartum women between 2011 and 2012. Data were obtained using interviews with postpartum women, hospital records, and prenatal care cards. All postpartum women with a reactive serological test result recorded in the prenatal care card or syphilis diagnosis during hospitalization for childbirth were considered cases of syphilis in pregnancy. The Chi-square test was used for determining the disease prevalence and testing coverage rate by region of residence, self-reported skin color, maternal age, and type of prenatal and child delivery care units. RESULTS Prenatal care covered 98.7% postpartum women. Syphilis testing coverage rate was 89.1% (one test) and 41.2% (two tests), and syphilis prevalence in pregnancy was 1.02% (95%CI 0.84;1.25). A lower prenatal coverage rate was observed among women in the North region, indigenous women, those with less education, and those who received prenatal care in public health care units. A lower testing coverage rate was observed among residents in the North, Northeast, and Midwest regions, among younger and non-white skin-color women, among those with lower education, and those who received prenatal care in public health care units. An increased prevalence of syphilis was observed among women with < 8 years of education (1.74%), who self-reported as black (1.8%) or mixed (1.2%), those who did not receive prenatal care (2.5%), and those attending public (1.37%) or mixed (0.93%) health care units. CONCLUSIONS The estimated prevalence of syphilis in pregnancy was similar to that reported in the last sentinel surveillance study conducted in 2006. There was an improvement in prenatal care and testing coverage rate, and the goals suggested by the World Health Organization were achieved in two regions. Regional

  12. Scaling up syphilis testing in China: implementation beyond the clinic

    PubMed Central

    Hawkes, Sarah J; Yin, Yue-Pin; Peeling, Rosanna W; Cohen, Myron S; Chen, Xiang-Sheng

    2010-01-01

    Abstract China is experiencing a syphilis epidemic of enormous proportions. The regions most heavily affected by syphilis correspond to regions where sexually transmitted HIV infection is also a major public health threat. Many high-risk patients in China fail to receive routine syphilis screening. This missed public health opportunity stems from both a failure of many high-risk individuals to seek clinical care and a disconnect between policy and practice. New point-of-care syphilis testing enables screening in non-traditional settings such as community organizations or sex venues. This paper describes the current Chinese syphilis policies, suggests a spatiotemporal framework (based on targeting high-risk times and places) to improve screening and care practices, and emphasizes a syphilis control policy extending beyond the clinical setting. PMID:20539859

  13. The Tuskegee Syphilis Experiment: biotechnology and the administrative state.

    PubMed Central

    Roy, B.

    1995-01-01

    The central issue of the Tuskegee Syphilis Experiment was property: property in the body and intellectual property. Once removed from the body, tissue and body fluids were not legally the property of the Tuskegee subjects. Consequently, there was not a direct relationship between a patient and research that used his sera. The Public Health Service (PHS) was free to exercise its property right in Tuskegee sera to develop serologic tests for syphilis with commercial potential. To camouflage the true meaning, the PHS made a distinction between direct clinical studies and indirect studies of tissue and body fluids. This deception caused all reviews to date to limit their examination to documents labeled by the PHS as directly related to the Tuskegee Syphilis Experiment. This excluded other information in the public domain. Despite the absence of a clinical protocol, this subterfuge led each to falsely conclude that the Tuskagee Syphilis Experiment was a clinical study. Based on publications of indirect research using sera and cerebrospinal fluid, this article conceives a very history of the Tuskagee Syphilis Experiment. Syphilis could only cultivate in living beings. As in slavery, the generative ability of the body made the Tuskegee subjects real property and gave untreated syphilis and the sera of the Tuskegee subjects immense commercial value. Published protocols exploited the Tuskegee Syphilis Experiment to invent and commercialize biotechnology for the applied science of syphilis serology. PMID:7869408

  14. Syphilis: an atypical case of sepsis and multiple anogenital lesions in secondary syphilis

    PubMed Central

    Smith, Nichole; Dhillon, Sonu; Cotter, John G.; Ahmed, Zohair

    2016-01-01

    The incidence of syphilis has historically been cyclical in nature, often in relation to the rise and fall of public health initiatives directed toward eradication along with social attitudes toward sexual practices. The incidence of syphilis has increased by 15% in the last 6 years in the United States, with similar increases worldwide. Herein, we present an atypical case of syphilis presenting with severe septic shock and multiple anogenital lesions in an immunocompetent host. A 22-year-old male with no significant past medical history presented with fevers, chills, sore throat, diaphoresis, and diarrhea. He was febrile, tachycardic, hypotensive, and unresponsive to fluid resuscitation requiring short-term vasopressor support. Physical exam revealed diffuse lymphadenopathy; lower extremity macular rash involving the soles of the feet; papular non-pustular lesions on the scrotum; and a 0.5 cm non-tender irregular, healing lesion on the shaft of the penis. Laboratory analysis was significant for leukocytosis and elevated creatinine. Serum screening rapid plasma reagin was positive, and further testing revealed a titer of 1:32, with confirmation via fluorescent treponemal antibody absorption test. The patient was diagnosed with secondary syphilis, which was determined to be the underlying etiology of the sepsis as all other serological evaluations were negative. He was treated with penicillin G benzathine 2.4 million units intramuscular and supportive management, with improvement of symptoms. The patient engaged in high-risk sexual behaviors, including prior unprotected sexual contact with males. New research indicates that up to one-third of patients may present with atypical cutaneous manifestations, as demonstrated by this patient. It is important for physicians to familiarize themselves with the varied clinical presentations of syphilis, which include multiple anogenital lesions and tender primary lesions in primary or secondary syphilis. PMID:27802854

  15. Syphilis: Re-emergence of an old foe

    PubMed Central

    Stamm, Lola V.

    2016-01-01

    Syphilis is caused by infection with Treponema pallidum subsp. pallidum, a not-yet-cultivable spiral-shaped bacterium that is usually transmitted by sexual contact with an infected partner or by an infected pregnant woman to her fetus. There is no vaccine to prevent syphilis. Diagnosis and treatment of infected individuals and their contacts is key to syphilis control programs that also include sex education and promotion of condom use to prevent infection. Untreated syphilis can progress through four stages: primary (chancre, regional lymphadenopathy), secondary (disseminated skin eruptions, generalized lymphadenopathy), latent (decreased re-occurrence of secondary stage manifestations, absence of symptoms), and tertiary (gummas, cardiovascular syphilis and late neurological symptoms). The primary and secondary stages are the most infectious. WHO estimates that each year 11 million new cases of syphilis occur globally among adults aged 15-49 years. Syphilis has re-emerged in several regions including North America, Western Europe, China and Australia. Host-associated factors that drive the re-emergence and spread of syphilis include high-risk sexual activity, migration and travel, and economic and social changes that limit access to health care. Early, uncomplicated syphilis is curable with a single intramuscular injection of benzathine penicillin G (BPG), the first line drug for all stages of syphilis. Emergence of macrolide-resistant T. pallidum has essentially precluded the empirical use of azithromycin as a second-line drug for treatment of syphilis. Virulence attributes of T. pallidum are poorly understood. Genomic and proteomic studies have provided some new information concerning how this spirochete may evade host defense mechanisms to persist for long periods in the host. PMID:28357375

  16. 42 CFR 493.1207 - Condition: Syphilis serology.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Syphilis serology. 493.1207 Section 493.1207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES....1207 Condition: Syphilis serology. If the laboratory provides services in the subspecialty of...

  17. 42 CFR 493.1207 - Condition: Syphilis serology.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Syphilis serology. 493.1207 Section 493.1207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES....1207 Condition: Syphilis serology. If the laboratory provides services in the subspecialty of...

  18. 42 CFR 493.835 - Standard; Syphilis serology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Standard; Syphilis serology. 493.835 Section 493.835 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.835 Standard; Syphilis serology. (a) Failure to attain an overall testing event...

  19. 42 CFR 493.835 - Standard; Syphilis serology.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Syphilis serology. 493.835 Section 493.835 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.835 Standard; Syphilis serology. (a) Failure to attain an overall testing event...

  20. 42 CFR 493.835 - Standard; Syphilis serology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Standard; Syphilis serology. 493.835 Section 493.835 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.835 Standard; Syphilis serology. (a) Failure to attain an overall testing event...

  1. 42 CFR 493.835 - Standard; Syphilis serology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Standard; Syphilis serology. 493.835 Section 493.835 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.835 Standard; Syphilis serology. (a) Failure to attain an overall testing event...

  2. 42 CFR 493.1207 - Condition: Syphilis serology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition: Syphilis serology. 493.1207 Section 493.1207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES....1207 Condition: Syphilis serology. If the laboratory provides services in the subspecialty of...

  3. 42 CFR 493.1207 - Condition: Syphilis serology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition: Syphilis serology. 493.1207 Section 493.1207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES....1207 Condition: Syphilis serology. If the laboratory provides services in the subspecialty of...

  4. 42 CFR 493.835 - Standard; Syphilis serology.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Syphilis serology. 493.835 Section 493.835 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.835 Standard; Syphilis serology. (a) Failure to attain an overall testing event...

  5. 42 CFR 493.1207 - Condition: Syphilis serology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Condition: Syphilis serology. 493.1207 Section 493.1207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES....1207 Condition: Syphilis serology. If the laboratory provides services in the subspecialty of...

  6. Neuro syphilis: Portrayals by Sir Arthur Conan Doyle

    PubMed Central

    Somasundaram, O.

    2009-01-01

    The developments in neuro syphilis in the 19th century are integral parts of the history of psychiatry. The delineation of various aspects of neuro syphilis by Sir Arthur Conan Doyle in three of his stories is discussed in brief. PMID:19881059

  7. UK national guidelines on the management of syphilis 2015.

    PubMed

    Kingston, M; French, P; Higgins, S; McQuillan, O; Sukthankar, A; Stott, C; McBrien, B; Tipple, C; Turner, A; Sullivan, A K; Radcliffe, Keith; Cousins, Darren; FitzGerald, Mark; Fisher, Martin; Grover, Deepa; Higgins, Stephen; Kingston, Margaret; Rayment, Michael; Sullivan, Ann

    2016-05-01

    These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline.

  8. A patient with primary syphilis of the hand.

    PubMed Central

    De Koning, G A; Blog, F B; Stolz, E

    1977-01-01

    The case history of a man with primary syphilis of the right hand is described. This type of luetic condition nowadays is rare. The incidence of genital, anorectal, and extragenital primary syphilis in both men and women and in sailors presenting at the Venereological Outpatient Clinic of the Department of Dermatology of the University Hospital Rotterdam-Dijkzigt during a period of seven years was studied. In sailors and women only genital primary lesions were found, whereas in male civilians 6.3% of cases of primary syphilis had anorectal lesions. The primary lesions in this study were different from those reported in earlier literature. Images PMID:606335

  9. The footprint of old syphilis: using a reverse screening algorithm for syphilis testing in a U.S. Geographic Information Systems-Based Community Outreach Program.

    PubMed

    Goswami, Neela D; Stout, Jason E; Miller, William C; Hecker, Emily J; Cox, Gary M; Norton, Brianna L; Sena, Arlene C

    2013-11-01

    The impact of syphilis reverse sequence screening has not been evaluated in community outreach. Using reverse sequence screening in neighborhoods identified with geographic information systems, we found that among 239 participants, 45 (19%) were seropositive. Of these, 3 (7%) had untreated syphilis, 33 (73%) had previously treated syphilis infection, and 9 (20%) had negative nontreponemal test results.

  10. Syphilis: The Renaissance of an Old Disease with Oral Implications

    PubMed Central

    Carlos, Roman

    2009-01-01

    Syphilis is caused by Treponema pallidum an anaerobic filamentous spirochete. In recent years, striking outbreaks have occurred in USA, Canada, Russia, China and some areas of Central and Eastern Europe. Main epidemiology changes reflect sex industry, sexual promiscuity, decreasing use of barrier protection (i.e. condoms) due to false sense of security that nowadays sexually transmitted diseases are curable and lack of pertinent knowledge. Considering that the initial presentation of syphilis may be the oral cavity, it is of great relevance to include this disease in the differential diagnosis of unusual oral ulcerations and white patches. Primary syphilis is a highly infectious disease in which inappropriate treatment may be apparently curative while the patient remains highly infectious. It is then of pivotal importance that clinicians maintain a high clinical index of suspicion. At the present time, clinical-pathologic correlation together with serologic studies remain essential in establishing the diagnosis of syphilis. PMID:20596972

  11. Cannibalism and contagion: framing syphilis in counter-reformation Italy.

    PubMed

    Eamon, W

    1998-02-01

    The outbreak of syphilis in Europe elicited a variety of responses concerning the disease's origins and cure. In this essay, I examine the theory of the origins of syphilis advanced by the 16th-century Italian surgeon Leonardo Fioravanti. According to Fioravanti, syphilis was not new but had always existed, although it was unknown to the ancients. The syphilis epidemic, he argued, was caused by cannibalism among the French and Italian armies during the siege of Naples in 1494. Fioravanti's strange and novel theory is connected with his view of disease as corruption of the body caused by eating improper foods. His theory of bodily pollution, a metaphor for the corruption of society, coincided with Counter-Reformation concepts about sin and the social order.

  12. Syphilis and MSM (Men Who Have Sex with Men)

    MedlinePlus

    ... its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has ... a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There ...

  13. [Nodular secondary syphilis in a HIV patient mimicking cutaneous lymphoma].

    PubMed

    Baniandrés Rodríguez, O; Nieto Perea, O; Moya Alonso, L; Carrillo Gijón, R; Harto Castaño, A

    2004-05-01

    We report the case of a 61-year old man who, already for a month, had infiltrated plaques on the chest, back, neck and face as well as axilar lymphadenopathy, bearing a striking resemblance to lymphoma. During his stay in the hospital he had fever, sore throat, macules on the palms and soles and a depapilated plaque on the tongue and alopecia. A test for syphilis confirmed the diagnosis. The HIV serology was also positive. The nodular secondary syphilis is an unusual form that was first documented more than 20 years ago. Since then, only a few cases have been reported in which the first diagnosis included lymphoreticular malignancy. This form of secondary syphilis was found in the HIV-infected as well as non-infected patients. We discuss the atypical clinical course, the inappropriate serological reactions and the therapy in HIV infected patients with secondary syphilis.

  14. A report on syphilis control in Turkey

    PubMed Central

    Christiansen, Sven

    1954-01-01

    This report presents the results of a six-month survey of the nature and extent of venereal diseases in Turkey which was undertaken by the author, on behalf of WHO, at the request of the Turkish Government. The first part of the report outlines the present venereal-disease-control system and includes descriptions of the work undertaken by public authorities, hospitals and dispensaries, mobile venereal-disease-control teams, and laboratories; in the second part, the author enumerates certain recommendations for the intensification of the current control programme. These recommendations are particularly concerned with the control of syphilis (since the incidence of other venereal diseases in Turkey is of very secondary importance), and with the expansion, standardization, and co-ordination of serodiagnostic facilities and services. It is suggested that there might be a gradual intensification and reorientation of the present programme. A proposed plan of operations for an eight-year period is described. PMID:13182590

  15. Secondary syphilis presenting with aortitis and coronary ostial occlusion.

    PubMed

    Chadwick, John A; MacNab, Anita; Sarma, Jaydeep; Ray, Simon; Kadir, Isaac; Muldoon, Eavan G

    2016-03-01

    Aortitis is an established manifestation of tertiary syphilis. We report a rare case of aortitis with ostial occlusion and left ventricular failure in secondary syphilis. Her management required a true multidisciplinary approach from multiple specialities due to complications of concomitant psychosis and a history of anaphylaxis to penicillin. This case illustrates the complexities of diagnosing and managing a rare presentation of this increasingly prevalent infection.

  16. Primary and secondary syphilis - Jefferson county, Alabama, 2002-2007.

    PubMed

    2009-05-08

    In June 2006, the Alabama Department of Public Health (ADPH) requested assistance from CDC to investigate and control a multiyear epidemic of syphilis in Jefferson County. The county had experienced a decrease in primary and secondary (P&S) syphilis cases, from 279 in 1995 to nine in 2002. By 2005, the incidence had begun to rise substantially, culminating with 238 cases in 2006 and 166 in 2007. Beginning in August 2006, CDC assisted the Jefferson County Department of Health (JCDH) in investigating the increase in cases and in planning control measures. This report summarizes the results of that investigation, which found that the characteristics of cases during 2002-2004 differed substantially from cases during 2005-2007. Declines in U.S. syphilis rates, which reached their lowest point in 2000, led to optimism that syphilis elimination (defined as the absence of sustained syphilis transmission) in the United States was possible, and CDC's National Syphilis Elimination Plan was launched in 1999. Although increased U.S. syphilis rates in the early 2000s have been reported to be associated primarily with transmission among men who have sex with men (MSM), the findings from this investigation indicate reemergence of syphilis among women and heterosexual men in Jefferson County. Public health officials in other areas should remain alert for similar epidemiologic shifts. Public health departments should facilitate access to effective treatment in sexually transmitted disease (STD) clinics or other settings, consider selective screening in high-prevalence populations (e.g., in correctional settings), and ensure adequate partner notification and treatment.

  17. Towards the Elimination of Syphilis in a Small Developing Country

    PubMed Central

    Mungrue, Kameel; Edwards, Jeffrey; Fyzul, Azizah; Boodhai, Billy; Narinesingh, Adita; Nanlal, Shasta

    2015-01-01

    Objective. To describe the current epidemiological features of syphilis and congenital syphilis in Trinidad, 2009–2012. Methods. All laboratory confirmed syphilis cases diagnosed through a vertical program in the Ministry of Health, between 1/1/2009 and 31/12/2012, were identified. All relevant data were collected including address which was geocoded and mapped using ArcGIS 10.0 (Esri). Both spatial techniques and standardized incidence ratios were used to determine hot spots. Results. The annual cumulative incidence rate for syphilis remains high varying from 39 per 100 000 population in 2009 to 29 per 100 000 in 2012. We identified 3 “hot spots,” in urban areas of Trinidad. Young men and particularly young women in childbearing age 15–35 living in urban high density populations were commonly infected groups. Conclusion. The incidence of syphilis continues to be very high in Trinidad. New initiatives will have to be formulated in order to attain the global initiative to eradicate syphilis by 2015. PMID:26316981

  18. Social determinants of syphilis in South China: the effect of sibling position on syphilis and sexual risk behaviours

    PubMed Central

    Tucker, Joseph D; Young, Darwin; Yang, Ligang; Yang, Bin; Adimora, Adaora A

    2013-01-01

    Objective This study evaluated the relationship between sibling position and sexual risk based on behavioural and syphilis infection data from sexually transmitted infection (STI) patients in South China. Design A cross-sectional study examining sexual behaviours and syphilis infection. Setting 4 STI clinics in the Pearl River Delta of South China. Participants 1792 Chinese men and women attending STI clinics. Primary outcome measures STI history, syphilis infection defined as positive non-treponemal and treponemal tests. Results Among all clinic patients, 824 (46.3%) were first-born, 354 (19.9%) were middle-born and 602 (33.8%) were final-born. Middle-born individuals had a higher percentage of reported STI history (44.7% compared to 34.7%, p<0.001) and syphilis infection (9.7% compared to 4.9%, p=0.01) among men (n=1163) compared to other sibling positions in bivariate analyses, but not in the final multivariate model. The relationship between sibling position and syphilis was independent of income and education level. There was no trend observed between middle-born position and female sexual risk behaviours (n=626). Higher education was significantly associated with syphilis among women and men in respective multivariate models. Conclusions This study suggests that middle-born men in China may have an increased sexual risk compared to other sibling positions. As Chinese family and social structures change, a more thorough understanding of how demographic factors influence sexual risk behaviours is needed. PMID:23793689

  19. Syphilis at the Crossroad of Phylogenetics and Paleopathology

    PubMed Central

    de Melo, Fernando Lucas; de Mello, Joana Carvalho Moreira; Fraga, Ana Maria; Nunes, Kelly; Eggers, Sabine

    2010-01-01

    The origin of syphilis is still controversial. Different research avenues explore its fascinating history. Here we employed a new integrative approach, where paleopathology and molecular analyses are combined. As an exercise to test the validity of this approach we examined different hypotheses on the origin of syphilis and other human diseases caused by treponemes (treponematoses). Initially, we constructed a worldwide map containing all accessible reports on palaeopathological evidences of treponematoses before Columbus's return to Europe. Then, we selected the oldest ones to calibrate the time of the most recent common ancestor of Treponema pallidum subsp. pallidum, T. pallidum subsp. endemicum and T. pallidum subsp. pertenue in phylogenetic analyses with 21 genetic regions of different T. pallidum strains previously reported. Finally, we estimated the treponemes' evolutionary rate to test three scenarios: A) if treponematoses accompanied human evolution since Homo erectus; B) if venereal syphilis arose very recently from less virulent strains caught in the New World about 500 years ago, and C) if it emerged in the Americas between 16,500 and 5,000 years ago. Two of the resulting evolutionary rates were unlikely and do not explain the existent osseous evidence. Thus, treponematoses, as we know them today, did not emerge with H. erectus, nor did venereal syphilis appear only five centuries ago. However, considering 16,500 years before present (yBP) as the time of the first colonization of the Americas, and approximately 5,000 yBP as the oldest probable evidence of venereal syphilis in the world, we could not entirely reject hypothesis C. We confirm that syphilis seems to have emerged in this time span, since the resulting evolutionary rate is compatible with those observed in other bacteria. In contrast, if the claims of precolumbian venereal syphilis outside the Americas are taken into account, the place of origin remains unsolved. Finally, the endeavor of

  20. Recent Trends in the Serologic Diagnosis of Syphilis

    PubMed Central

    Singh, Ameeta E.

    2014-01-01

    Complexities in the diagnosis of syphilis continue to challenge clinicians. While direct tests (e.g., microscopy or PCR) are helpful in early syphilis, the mainstay of diagnosis remains serologic tests. The traditional algorithm using a nontreponemal test (NTT) followed by a treponemal test (TT) remains the standard in many parts of the world. More recently, the ability to automate the TT has led to the increasingly widespread use of reverse algorithms using treponemal enzyme immunoassays (EIAs). Rapid, point-of-care TTs are in widespread use in developing countries because of low cost, ease of use, and reasonable performance. However, none of the current diagnostic algorithms are able to distinguish current from previously treated infections. In addition, the reversal of traditional syphilis algorithms has led to uncertainty in the clinical management of patients. The interpretation of syphilis tests is further complicated by the lack of a reliable gold standard for syphilis diagnostics, and the newer tests can result in false-positive reactions similar to those seen with older tests. Little progress has been made in the area of serologic diagnostics for congenital syphilis, which requires assessment of maternal treatment and serologic response as well as clinical and laboratory investigation of the neonate for appropriate management. The diagnosis of neurosyphilis continues to require the collection of cerebrospinal fluid for a combination of NTT and TT, and, while newer treponemal EIAs look promising, more studies are needed to confirm their utility. This article reviews current tests and discusses current controversies in syphilis diagnosis, with a focus on serologic tests. PMID:25428245

  1. Rapid Syphilis Testing Uptake for Female Sex Workers at Sex Venues in Southern China: Implications for Expanding Syphilis Screening

    PubMed Central

    Chen, Xiang-Sheng; Yin, Yue-Ping; Shen, Crystal; Liu, Guo-Gu; Zhu, Zheng-Jun; Wei, Wan-Hui; Wang, Hong-Chun; Huang, Shui-Jie; Li, Jing; Tucker, Joseph D.; Mabey, David C.; Peeling, Rosanna W.

    2012-01-01

    Background Accessibility of syphilis testing services is critical in syphilis control programs for female sex workers (FSWs), but few FSWs attend public STI clinics or other testing sites. Introduction of free rapid syphilis testing (RST) into outreach programs for FSWs will help improve test uptake. Methods Commercial sex venues were identified in two cities in South China. In cooperation with health advocacy organizations, health outreach teams from local public health or medical facilities approached all types of sex venues in study areas to offer free RST. Acceptability and uptake of RST among FSWs were evaluated. Results A total of 2812 FSWs were offered RST and 2670 (95.0%) accepted syphilis testing. 182 (6.8%) FSWs had a positive RST result among whom 136 (74.7%) were willing to attend an STD clinic for confirmatory testing and treatment. More than half (89, 66.4%) of those with syphilis were not willing to notify their sex partners. Multivariate logistic analysis showed that syphilis test uptake was associated with residing in Jiangmen (AOR, 1.78; 95% CI, 1.15–2.77), older age (AOR, 2.11, 95% CI, 1.17–3.79 for age of 31 years or above), and not working at a service venue (AOR, 1.60; 95% CI, 1.10–2.34). Conclusions RST at sex venues is well accepted by FSWs when it is integrated into ongoing outreach services. Such programs provide excellent opportunities for expanding syphilis screening efforts among specific subgroups of FSW who are difficult to reach through clinic-based programs. PMID:23300709

  2. Syphilis in composers and musicians--Mozart, Beethoven, Paganini, Schubert, Schumann, Smetana.

    PubMed

    Franzen, C

    2008-12-01

    In the pre-antibiotics era, syphilis was an extremely common disease. The first well-recorded European outbreak of what is now known as syphilis occurred in 1494, when it appeared among French troops besieging Naples. Thereafter, the disease spread all over Europe and, in the 18th and 19th centuries, many artists became victims of syphilis, among them poets, painters, philosophers, and musicians and composers. This review presents biographies of several musicians and composers that probably suffered from syphilis.

  3. Histopathologic ear findings of syphilis: a temporal bone study.

    PubMed

    Hızlı, Ömer; Hızlı, Pelin; Kaya, Serdar; Monsanto, Rafael da Costa; Paparella, Michael M; Cureoglu, Sebahattin

    2016-09-01

    To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused on hydropic changes; so far, no such studies have investigated peripheral vestibular otopathology using differential interference contrast microscopy, in patients with syphilis. For this study, we examined 13 human temporal bone samples from 8 patients with a history of syphilis. Using conventional light microscopy, we performed qualitative histopathologic assessment. In addition, using differential interference contrast microscopy, we performed type I and type II vestibular hair cell counts on each vestibular sense organ with minimal autolysis; in which the neuroepithelium was oriented perpendicular to the plane of section. We then compared vestibular hair cell densities (cells per 0.01 mm² surface area) in the syphilis group vs. the control group. In the syphilis group, we observed precipitate in the endolymphatic or perilymphatic spaces in 1 (7.7 %) of the samples and endolymphatic hydrops in eight (61.5 %) of the samples. Hydrops involved the cochlea (four samples) and/or saccule (four samples). In addition, the syphilis group experienced a significant loss of type II vestibular hair cells in the maculae of the utricle and saccule, and in the cristae of the lateral and posterior semicircular canals, as compared with the control group (P < 0.05).

  4. RPR Titer Variation in the Two Weeks Following Syphilis Therapy

    PubMed Central

    Holman, Katherine M.; Wolff, Mark; Seña, Arlene C.; Martin, David H.; Behets, Frieda; Van Damme, Kathleen; Leone, Peter; McNeil, Linda; Gehrig, Meredyth L.; Hook, Edward W.

    2012-01-01

    Background Serologic tests for syphilis (STS) results at time of diagnosis are the basis for evaluating response to syphilis therapy. Following treatment, however, STS titers may continue to increase for several weeks. We evaluated RPR titer variation over the 14 days following therapy using data from a recent large, prospective RCT. Methods Prospectively enrolled participants in North America and Madagascar with primary, secondary or early latent syphilis were randomly assigned to penicillin, doxycycline (in the case of penicillin allergy) or azithromycin treatment. Blood for RPR analysis was drawn at days 0, 7, and 14 post-treatment. All RPR titers were determined simultaneously at a central laboratory. Results 470 patients had data available for at least 2 of 3 RPR measurements. Overall, 20% of patients showed a titer increase of at least one dilution in the 14 days following therapy. The greatest proportion of titer increases following therapy was seen in patients with primary syphilis. Comparing outcome of therapy using the initial (day 0) RPR titer vs. the maximal RPR titer (over 14 days), resulted in outcome reclassification in 2.98% of participants. Conclusions Despite the fact that about 20% of early syphilis patients had increases in RPR titers immediately following treatment, these changes rarely influenced assessment of therapeutic outcome. Only 3% of patients treated would have been reclassified. PMID:22801348

  5. Could lengthening minocycline therapy better treat early syphilis?

    PubMed

    Shao, Li-Li; Guo, Rui; Shi, Wei-Jie; Liu, Yuan-Jun; Feng, Bin; Han, Long; Liu, Quan-Zhong

    2016-12-01

    Syphilis is a sexually transmitted disease caused by Treponema pallidum. Minocycline, a representative tetracycline derivative, has the greatest antimicrobial activity among all tetracyclines. There are few reports about treating syphilis with minocycline because there is a lack of efficacy data from controlled trials. We compared the rates of serological cure in patients with early syphilis who were treated with minocycline or benzathine penicillin G (BPG).During the study period, a total of 40 syphilis patients received the BPG treatment, which was a single intramuscular dose of 2.4 million units of BPG, and 156 patients were treated with minocycline; 77 patients were placed in the 2-week, standard minocycline therapy group and received 100 mg of minocycline orally, twice daily for 14 days, and 79 patients were placed in the 4-week, lengthened minocycline therapy group and received 100 mg of minocycline orally, twice daily for 28 days. The outcome of interest was the rate of serological cure in these patients.At the end of the 2-year follow-up, the serological cure rate of the 4-week, lengthened minocycline therapy group (87.34%) was higher than that of both the 2-week, standard minocycline therapy group (72.73%) and the BPG treatment group (77.50%). In addition, the curative effect of the 4-week, lengthened minocycline therapy was significantly greater than that of the 2-week, standard minocycline therapy in patients who were aged >40 years; exhibited an initial rapid plasma reagin titer ≥1: 32; or exhibited secondary syphilis (P = 0.000, 0.008, 0.000; <0.05).Minocycline appears to be an effective agent for treating early syphilis, especially when applied as a 4-week, lengthened therapy.

  6. Could lengthening minocycline therapy better treat early syphilis?

    PubMed Central

    Shao, Li-Li; Guo, Rui; Shi, Wei-Jie; Liu, Yuan-Jun; Feng, Bin; Han, Long; Liu, Quan-Zhong

    2016-01-01

    Abstract Syphilis is a sexually transmitted disease caused by Treponema pallidum. Minocycline, a representative tetracycline derivative, has the greatest antimicrobial activity among all tetracyclines. There are few reports about treating syphilis with minocycline because there is a lack of efficacy data from controlled trials. We compared the rates of serological cure in patients with early syphilis who were treated with minocycline or benzathine penicillin G (BPG). During the study period, a total of 40 syphilis patients received the BPG treatment, which was a single intramuscular dose of 2.4 million units of BPG, and 156 patients were treated with minocycline; 77 patients were placed in the 2-week, standard minocycline therapy group and received 100 mg of minocycline orally, twice daily for 14 days, and 79 patients were placed in the 4-week, lengthened minocycline therapy group and received 100 mg of minocycline orally, twice daily for 28 days. The outcome of interest was the rate of serological cure in these patients. At the end of the 2-year follow-up, the serological cure rate of the 4-week, lengthened minocycline therapy group (87.34%) was higher than that of both the 2-week, standard minocycline therapy group (72.73%) and the BPG treatment group (77.50%). In addition, the curative effect of the 4-week, lengthened minocycline therapy was significantly greater than that of the 2-week, standard minocycline therapy in patients who were aged >40 years; exhibited an initial rapid plasma reagin titer ≥1: 32; or exhibited secondary syphilis (P = 0.000, 0.008, 0.000; <0.05). Minocycline appears to be an effective agent for treating early syphilis, especially when applied as a 4-week, lengthened therapy. PMID:28033297

  7. Unilateral facial paralysis after treatment of secondary syphilis.

    PubMed

    Berger, Emily M; Galadari, Hassan I; Gottlieb, Alice B

    2008-06-01

    Bell's palsy is an acute facial paralysis of unknown etiology. Infections including syphilis have been implicated as causes for peripheral facial paresis. The Jarisch-Herxheimer reaction is an acute worsening of skin manifestations and systemic symptoms occurring after administration of antimicrobial therapy for spirochetal infections. Although rare, neurological signs can present as part of the Jarisch-Herxheimer reaction. The authors report a case of Bell's palsy experienced by a patient shortly after treatment with penicillin for secondary syphilis and propose that this acute unilateral peripheral facial paralysis was a Jarisch-Herxheimer reaction in response to therapy.

  8. A decade of reorientation in the treatment of venereal syphilis

    PubMed Central

    Idsoe, O.; Guthe, T.; Christiansen, Sven; Krag, P.; Cutler, J. C.

    1954-01-01

    As experience with penicillin in the treatment of venereal syphilis has grown over the last decade, this drug, used without adjuvants, has become increasingly widely accepted as being effective, convenient, non-toxic, and relatively inexpensive. Metal chemotherapy required the use of repeated subcurative doses over a long period of time and was essentially suppressive in character; penicillin can be given in the form of repository preparations which ensure a treponemacidal blood-level of long duration. These can be given in large single doses or in repeated smaller doses; the therapeutic results will not vary whichever of these procedures is used. In the first part of this paper, the authors discuss the effect of penicillin and the time factor, the choice of penicillin preparation, the mode of administration, and the reaction to infection with Treponema pallidum. In the second part, they consider the present status of penicillin therapy in venereal syphilis, dealing with the principles of follow-up and control; with the treatment of early, latent, late, and congenital syphilis; and with the treatment of incubating syphilis and contacts. PMID:13182586

  9. Bone pain as the presenting manifestation of secondary syphilis.

    PubMed

    Middleton, S; Rowntree, C; Rudge, S

    1990-08-01

    A 31 year old fireman presented with acute pain and tenderness in both shins and forearms. Radiographs were normal but bone scintigraphy showed widespread increased isotope uptake. Serology was consistent with a diagnosis of secondary syphilis, and the patient's symptoms resolved completely six weeks after a course of penicillin.

  10. The Global Epidemiology of Syphilis in the Past Century – A Systematic Review Based on Antenatal Syphilis Prevalence

    PubMed Central

    Kenyon, Chris Richard; Osbak, Kara; Tsoumanis, Achilleas

    2016-01-01

    Background How can we explain the uneven decline of syphilis around the world following the introduction of penicillin? In this paper we use antenatal syphilis prevalence (ASP) to investigate how syphilis prevalence varied worldwide in the past century, and what risk factors correlate with this variance. Methods 1) A systematic review using PubMed and Google Scholar was conducted to identify countries with published data relating to ASP estimates from before 1952 until the present. Eleven countries were identified (Canada, Denmark, Finland, India, Japan, Norway, Singapore, South Africa, United States of America (USA), United Kingdom (UK) and Zimbabwe). The ASP epidemic curve for each population was depicted graphically. In South Africa and the USA, results are reported separately for the black and white populations. 2) National antenatal syphilis prevalence estimates for 1990 to 1999 and 2008 were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low risk populations compiled for the Global Burden of Diseases study and from a recent review paper respectively. National ASPs were depicted graphically and regional median ASPs were calculated for both time periods. 3) Linear regression was used to test for an association between ASP in 1990–1999 and 2008 and four risk factors (efficacy of syphilis screening/treatment, health expenditure, GDP per capita and circumcision prevalence). WHO world regions were included as potential explanatory variables. Results In most populations, ASP dropped to under 1% before 1960. In Zimbabwe and black South Africans, ASP was high in the pre-penicillin period, dropped in the post-penicillin period, but then plateaued at around 6% until the end of the 20th century when ASP dropped to just above 1%. In black Americans, ASP declined in the post penicillin period, but plateaued at 3–5% thereafter. ASP was statistically significantly higher in sub-Saharan Africa in 1990–1999 and 2008

  11. Factors associated with syphilis infection: a comprehensive analysis based on a case-control study.

    PubMed

    Xiao, Y; Li, S-L; Lin, H-L; Lin, Z-F; Zhu, X-Z; Fan, J-Y; Gao, K; Zhang, H-L; Lin, L-R; Liu, L-L; Tong, M-L; Niu, J-J; Yang, T-C

    2016-04-01

    This study aimed to comprehensively evaluate factors that influence the likelihood of syphilis infection from risk-taking behaviours and medical conditions. A retrospective case-control study was conducted by enrolling 664 syphilis inpatients (excluding 11 congenital syphilis patients) and 800 sex- and age-matched controls. Medical histories, clinical data and patient interview data were collected and subjected to logistic regression analyses. The prevalence of syphilis in the study population was 3·9% (675/17,304). By univariate analysis, syphilis infection was associated with migration between cities, marital status, smoking, reproductive history, hypertension, elevated blood urea nitrogen (BUN) and infection with hepatitis B virus (HBV) (P < 0·05). A high rate of syphilis-HBV co-infection was observed in HIV-negative patients and further research revealed an association between syphilis and specific HBV serological reactivity. Syphilis was also associated with the frequency, duration and status of tobacco use. Multivariate analysis indicated that syphilis infection was independently associated with migration between cities [adjusted odds ratio (aOR) 1·368, 95% confidence interval (CI) 1·048-1·785], current smoking (aOR 1·607, 95% CI 1·177-2·195), elevated BUN (aOR 1·782, 95% CI 1·188-2·673) and some serological patterns of HBV infection. To prevent the spread of infectious diseases, inpatients and blood donors should be tested for HIV, syphilis, HBV and HCV simultaneously.

  12. Evaluation of the BioPlex 2200 syphilis system as a first-line method of reverse-sequence screening for syphilis diagnosis.

    PubMed

    Marangoni, Antonella; Nardini, Paola; Foschi, Claudio; Moroni, Alessandra; D'Antuono, Antonietta; Bacchi Reggiani, Letizia; Cevenini, Roberto

    2013-07-01

    Despite recent technological advances, the diagnosis of syphilis remains a challenging enterprise. Actually, most high-volume laboratories have adopted the "reverse algorithm" due several factors, including the potential to automate testing. Recently, immunoassays processed on random-access systems have been proposed as screening tests. The purpose of this study was to evaluate diagnostic performances of BioPlex 2200 Syphilis IgG and BioPlex 2200 Syphilis IgM, tests based on Multiplex Flow technology, in comparison with the performance of Architect Syphilis TP, a chemiluminescent immunoassay for the detection of IgG and/or IgM anti-Treponema pallidum antibodies. A retrospective study was performed with a panel of 100 blood donor sera, a panel of 350 clinical and laboratory-characterized syphilitic sera, and 170 samples obtained from subjects with potentially interfering conditions. Moreover, 200 unselected samples submitted to the Microbiology Laboratory of St. Orsola Hospital in Bologna for routine screening for syphilis were evaluated. As confirmatory tests, T. pallidum hemagglutination and Western blot assays were used. Considering the IgG Western blot (WB) assay to be the gold standard method, BioPlex 2200 Syphilis IgG specificity was far higher than Architect Syphilis TP specificity (89.7% versus 78.4%, respectively), whereas the sensitivity was 100% for both automated methods. Compared to the IgM WB assay, BioPlex 2200 Syphilis IgM performed with a specificity of 94.9%, whereas the sensitivity was 84.8%. Considering the excellent ease of use and automation, the high sample throughput and its valuable analytical performances, BioPlex Syphilis 2200 IgG could represent a suitable choice for high-volume laboratories. BioPlex Syphilis 2200 IgM could be considered a good addition to IgG testing for uncovering active infections.

  13. Osteomyelitis as the only manifestation of late latent syphilis: case report and literature review.

    PubMed

    Liu, Z-Y; Zhang, Y; Qiu, K-F; Du, S-X

    2011-06-01

    Bone infection, particularly of the skull and the long bones of the legs and arms, despite being a common characteristic of tertiary stage syphilis and congenital syphilis in the past, is seldom encountered clinically due to effective antibiotic therapy. We report a case of a 62-year-old man who presented with one-month acute pain in the left leg. Treponema pallidum particle agglutination test was positive, and radiography showed a pathological fracture of the left tibiofibula. Surgical debridement and biopsy of the bone marrow were performed and a pathological diagnosis of syphilis osteomyelitis was entertained. The patient's symptoms resolved completely after a six-week course of penicillin. We identified 17 previously published cases of bone lesions of syphilis, eight of which had syphilitic osteomyelitis, seven were syphilitic osteitis and two had syphilitic periostitis. We suggest that bone lesions such as osteomyelitis caused by syphilis can be the only manifestation of late latent syphilis.

  14. [Ocular Syphilis Complicated with HIV Infection: A Report of 3 Cases].

    PubMed

    Fukushima, Kazuaki; Yanagisawa, Naoki; Sasaki, Shugo; Sekiya, Ryoko; Sekiya, Noritaka; Suganuma, Akihiko; Ajisawa, Atsushi; Imamura, Akifumi

    2016-05-01

    We present 3 cases of ocular syphilis in patients who had been newly diagnosed as having HIV. All the patients had only complained of ophthalmologic symptoms at the time of their initial visit. Treatment with penicillin was successful, resulting in no significant sequelae. Ocular syphilis may lead to reduced visual acuity or even blindness if left untreated. However, the diagnosis may be challenging, since patients may lack symptoms that are commonly observed in cases with primary and secondary syphilis. Considering the recent increase in the number of syphilis patients, clinicians should be aware of ocular syphilis and should have a high index of suspicion for syphilis in any patient at risk so as to ensure a prompt diagnosis.

  15. Tertiary Syphilis in the Cervical Spine: A Case Report and Review of the Literature

    PubMed Central

    Salem, K. M. I.; Majeed, H.; Bommireddy, R.; Klezl, Z.

    2012-01-01

    As the prevalence of syphilis rises, an increase in tertiary syphilis with spinal involvement is predicted. We report what we believe to be the first case of compressive cervical spine syphilitic gummata, with central cord compression signs. We also review the relevant literature to date. The diagnosis of syphilis in the spine relies on the physician to be aware of it as part of the differential diagnosis. Treponemal laboratory tests are an important aid in establishing a diagnosis. PMID:24436850

  16. Evaluation of Elecsys Syphilis Assay for Routine and Blood Screening and Detection of Early Infection

    PubMed Central

    Kremastinou, J.; Polymerou, V.; Lavranos, D.; Aranda Arrufat, A.; Harwood, J.; Martínez Lorenzo, M. J.; Ng, K. P.; Queiros, L.; Vereb, I.

    2016-01-01

    Treponema pallidum infections can have severe complications if not diagnosed and treated at an early stage. Screening and diagnosis of syphilis require assays with high specificity and sensitivity. The Elecsys Syphilis assay is an automated treponemal immunoassay for the detection of antibodies against T. pallidum. The performance of this assay was investigated previously in a multicenter study. The current study expands on that evaluation in a variety of diagnostic settings and patient populations, at seven independent laboratories. The samples included routine diagnostic samples, blood donation samples, samples from patients with confirmed HIV infections, samples from living organ or bone marrow donors, and banked samples, including samples previously confirmed as syphilis positive. This study also investigated the seroconversion sensitivity of the assay. With a total of 1,965 syphilis-negative routine diagnostic samples and 5,792 syphilis-negative samples collected from blood donations, the Elecsys Syphilis assay had specificity values of 99.85% and 99.86%, respectively. With 333 samples previously identified as syphilis positive, the sensitivity was 100% regardless of disease stage. The assay also showed 100% sensitivity and specificity with samples from 69 patients coinfected with HIV. The Elecsys Syphilis assay detected infection in the same bleed or earlier, compared with comparator assays, in a set of sequential samples from a patient with primary syphilis. In archived serial blood samples collected from 14 patients with direct diagnoses of primary syphilis, the Elecsys Syphilis assay detected T. pallidum antibodies for 3 patients for whom antibodies were not detected with the Architect Syphilis TP assay, indicating a trend for earlier detection of infection, which may have the potential to shorten the time between infection and reactive screening test results. PMID:27358468

  17. A case of secondary syphilis mimicking palmoplantar psoriasis in HIV infected patient.

    PubMed

    Bittencourt, Maraya de Jesus Semblano; Brito, Arival Cardoso de; Nascimento, Bianca Angelina Macêdo do; Carvalho, Alessandra Haber; Nascimento, Manoel Dias do

    2015-01-01

    Due to diverse clinical and histopathological presentations, diagnosis of secondary syphilis can occasionally prove challenging. Variable clinical presentations of secondary syphilis in HIV disease may result in an incorrect diagnosis and an inappropriate treatment regimen. Similarly, the histology of secondary syphilitic lesions may show considerable variation, depending on the clinical morphology of the eruption. We report a case of secondary syphilis in an HIV infected patient with cutaneous palmoplantar lesions simulating palmoplantar psoriasis.

  18. Musculoskeletal involvement of syphilis – a forgotten lesson

    PubMed Central

    Gomez, Jesus Vallejo; Molnar, Szabolcs Lajos; Val, Sami Mansour; Arnal, Rafael Gracia

    2012-01-01

    Syphilis is a sexually transmitted disease with a myriad of presentation and called ‘the great impostor’ for the variety of the symptoms. As a venereal disease it is transmissible mainly by sexual contact with infectious lesions but can spread by blood contamination. Without treatment it progresses through early and late syphilis. Since the introduction of penicillin its prevalence has strongly dropped but was never eradicated entirely. As the frequency and the progression are largely controlled there are several symptoms which are not common and can be a difficult differential diagnostic problem nowadays. The authors present a case where decades passed between the primary event and the actual hospitalisation with fever of unknown origin and coexistent swollen joint deformities. The patient was not treated entirely from his primary event and later, psoriasis was settled as a diagnosis, which was the cause of neglecting the secondary phase’s skin lesions. PMID:22787187

  19. Dr. Arthur Conan Doyle and the case of congenital syphilis.

    PubMed

    Silverstein, Arthur M; Ruggere, Christine

    2006-01-01

    In 1894, Dr. Arthur Conan Doyle wrote "The Third Generation," a short story involving the transmission of congenital syphilis from generation to generation. Analysts of his writings have interpreted the pathogenetic mechanism involved in modern terms: infection of mother by father and then transplacental infection of the fetus. However, a review of the contemporary literature and the history of the concepts of congenital and "hereditary" syphilis demonstrates that the late 19th-century understanding of the process involved a Lamarckian transmission of paternal infection, via the sperm at the moment of conception. It was undoubtedly this concept that Doyle learned in medical school in the late 1870s and that provided the background to his story.

  20. Evolution of the syphilis epidemic among men who have sex with men

    PubMed Central

    Solomon, Marc M.; Mayer, Kenneth H.

    2014-01-01

    Syphilis has existed for millenni, but its epidemiology was only recently linked to men who have sex with men (MSM) after the introduction of penicillin in the 1940s; the syphilis epidemic became concentrated within the MSM community in subsequent decades. The HIV/AIDS epidemic in the 1980s led to a surge of new syphilis cases and revealed the potentiation between HIV and syphilis, as evidenced by a shift in the natural history of neurosyphilis. In response, MSM revolutionised their sexual behaviour by implementing community-driven seroadaptive strategies to stem HIV transmission. The Centers for Disease Control in the US called for the elimination of syphilis in the late 1990s since the rates had fallen sharply but this effort was overtaken by a resurgence of global outbreaks among MSM in the 2000s, many of which were linked to methamphetamine use and sexual networking websites. Syphilis remains highly prevalent today, especially among MSM and individuals infected with HIV, and it continues to present a significant public health conundrum. Innovative syphilis prevention strategies are warranted. MSM engaging in high-risk behaviour such as condomless anal receptive intercourse, sex with multiple partners or recreational drug use should be routinely screened for syphilis infection; they should also be counselled about the limits of seroadaptive behaviours and HIV pre-exposure prophylaxis as they relate to syphilis transmission. PMID:25514173

  1. Clinical Spectrum of Oral Secondary Syphilis in HIV-Infected Patients

    PubMed Central

    Ramírez-Amador, Velia; Anaya-Saavedra, Gabriela; Crabtree-Ramírez, Brenda; Esquivel-Pedraza, Lilly; Saeb-Lima, Marcela; Sierra-Madero, Juan

    2013-01-01

    Background. Oral lesions may constitute the first clinical manifestation in secondary syphilis, but detailed descriptions in HIV-infected individuals are scarce. Objective. To describe the clinical characteristics of oral secondary syphilis in HIV-infected patients and its relevance in the early diagnosis of syphilis. Methods. Twenty HIV/AIDS adult subjects with oral secondary syphilis lesions presenting at two HIV/AIDS referral centers in Mexico City (2003–2011) are described. An oral examination was performed by specialists in oral pathology and medicine; when possible, a punch biopsy was done, and Warthin-Starry stain and immunohistochemistry were completed. Intraoral herpes virus infection and erythematous candidosis were ruled out by cytological analysis. Diagnosis of oral syphilis was confirmed with positive nontreponemal test (VDRL), and, if possible, fluorescent treponemal antibody test. Results. Twenty male patients (median age 31.5, 21–59 years) with oral secondary syphilis lesions were included. Oral lesions were the first clinical sign of syphilis in 16 (80%) cases. Mucous patch was the most common oral manifestation (17, 85.5%), followed by shallow ulcers (2, 10%) and macular lesions (1, 5%). Conclusions. Due to the recent rise in HIV-syphilis coinfection, dental and medical practitioners should consider secondary syphilis in the differential diagnosis of oral lesions, particularly in HIV-infected patients. PMID:26316966

  2. Characterization of Sera with Discordant Results from Reverse Sequence Screening for Syphilis

    PubMed Central

    Lee, Kyunghoon; Park, Hyewon; Roh, Eun Youn; Shin, Sue; Park, Kyoung Un; Park, Myoung Hee; Song, Eun Young

    2013-01-01

    Reverse sequence screening for syphilis (RSSS) (screening with treponemal tests, followed by confirmation with nontreponemal tests) has been increasingly adopted. CDC recommends confirmation of discordant results (reactive EIA/CIA and nonreactive nontreponemal test) with Treponema pallidum particle agglutination assay (TP-PA). We characterized sera with discordant results from RSSS with Architect Syphilis TP CIA. Among 15,713 screening tests using Architect Syphilis TP at Seoul National University Gangnam Center between October 2010 and May 2011, 260 (1.7%) showed reactive results. Rapid plasma reagin (RPR) and TP-PA were performed on 153 available sera among them. On sera with discordant results between Architect Syphilis TP and TP-PA, INNO-LIA Syphilis Score and FTA-ABS were performed. Among 153 sera, RPR was nonreactive in 126 (82.4%). Among them, TP-PA was positive in 103 (81.7%), indeterminate (±) in 7 (5.6%), and negative in 16 (12.7%). Out of 16 CIA(+)/RPR(−)/TP-PA(−) sera, INNO-LIA Syphilis Score and/or FTA-ABS were negative on 14 sera. Out of 7 CIA(+)/RPR(−)/TP-PA(±) sera, INNO-LIA Syphilis Score and FTA-ABS were positive/reactive in 6 sera. RSSS with confirmation by TP-PA on sera with discordant results between Architect Syphilis TP and RPR effectively delineated those discordant results and could be successfully adopted for routine checkup for syphilis. PMID:23509699

  3. Clinical Spectrum of Oral Secondary Syphilis in HIV-Infected Patients.

    PubMed

    Ramírez-Amador, Velia; Anaya-Saavedra, Gabriela; Crabtree-Ramírez, Brenda; Esquivel-Pedraza, Lilly; Saeb-Lima, Marcela; Sierra-Madero, Juan

    2013-01-01

    Background. Oral lesions may constitute the first clinical manifestation in secondary syphilis, but detailed descriptions in HIV-infected individuals are scarce. Objective. To describe the clinical characteristics of oral secondary syphilis in HIV-infected patients and its relevance in the early diagnosis of syphilis. Methods. Twenty HIV/AIDS adult subjects with oral secondary syphilis lesions presenting at two HIV/AIDS referral centers in Mexico City (2003-2011) are described. An oral examination was performed by specialists in oral pathology and medicine; when possible, a punch biopsy was done, and Warthin-Starry stain and immunohistochemistry were completed. Intraoral herpes virus infection and erythematous candidosis were ruled out by cytological analysis. Diagnosis of oral syphilis was confirmed with positive nontreponemal test (VDRL), and, if possible, fluorescent treponemal antibody test. Results. Twenty male patients (median age 31.5, 21-59 years) with oral secondary syphilis lesions were included. Oral lesions were the first clinical sign of syphilis in 16 (80%) cases. Mucous patch was the most common oral manifestation (17, 85.5%), followed by shallow ulcers (2, 10%) and macular lesions (1, 5%). Conclusions. Due to the recent rise in HIV-syphilis coinfection, dental and medical practitioners should consider secondary syphilis in the differential diagnosis of oral lesions, particularly in HIV-infected patients.

  4. Prosthetic rehabilitation of palatal perforation in a patient with ‘syphilis: the great imitator’

    PubMed Central

    Murthy, Varsha; Vaithilingam, Yuvraj; Livingstone, David; Pillai, Ajay

    2014-01-01

    Syphilis is a sexually transmissible disease caused by treponema palladium, a microaerophilic spirochete. Syphilis may progress from primary to tertiary stage if left unnoticed and untreated. Dentists should be vigilant and suspect sexually transmitted infections such as syphilis in the differential diagnosis of oral inflammatory or ulcerative lesions with palatal perforation. Moreover, it is imperative that dentists should have knowledge about its stages, characteristic features, oral presentation and prosthetic rehabilitation. This case report describes a case of tertiary syphilis with palatal perforation and the prosthetic rehabilitation of the defect with a prosthetic obturator. PMID:24891485

  5. The syphilis problem in Asir province, Saudi Arabia

    PubMed Central

    El Ghoroury, A. A.

    1954-01-01

    A combined national and international venereal disease team began activities in Saudi Arabia in November 1952, moving from Mecca to Asir province in May 1953, where it remained for two months examining and treating various groups of the population. A total of 309 cases of syphilis among a population of approximately 3,000 at Abha was given complete clinical and serological examination and treatment with PAM, in doses varying from 2.4 to 6.0 million units. Serological tests were made on 2,359 blood samples. Only one primary lesion was found; but secondary lesions were quite common, amounting to 5.8% of all cases treated, while tertiary lesions represented 12.6% of all cases treated and 67.2% of all clinical cases. Considerable variations in the prevalence of syphilis were noted among the different quarters of the town of Abha and among different tribes and villages. All the age-groups were more or less equally affected, but the females generally showed a higher positivity-rate than the males. All these features—together with the low social, economic, and sanitary standards of the population and many prevalent social habits, such as the use of common eating and drinking implements — would seem to indicate that the syphilis met in Asir, and locally known as “shadjar”, “balash”, “fringi”, “mabrouk”, or “wardi”, should be included with the endemic treponematoses met with elsewhere in the world. PMID:13182591

  6. Laboratory diagnosis and interpretation of tests for syphilis.

    PubMed Central

    Larsen, S A; Steiner, B M; Rudolph, A H

    1995-01-01

    The lack of a method for demonstrating the presence of Treponema pallidum by growth necessitates the use of alternative methods. Traditionally, these methods are divided into direct detection methods (animal inoculation, dark-field microscopy, etc.) and serologic tests for the presence of patient antibody against T. pallidum. Serologic methods are further divided into two classes. One class, the nontreponemal tests, detects antibodies to lipoidal antigens present in either the host or T. pallidum; examples are the Venereal Disease Research Laboratory and rapid plasma reagin and tests. Reactivity in these tests generally indicates host tissue damage that may not be specific for syphilis. Because these tests are easy and inexpensive to perform, they are commonly used for screening, and with proper clinical signs they are suggestive of syphilis. The other class of test, the treponemal tests, uses specific treponemal antigens. Confirmation of infection requires a reactive treponemal test. Examples of the treponemal tests are the microhemagglutination assay for antibodies to T. pallidum and the fluorescent treponemal antibody absorption test. These tests are more expensive and complicated to perform than the nontreponemal tests. On the horizon are a number of direct antigen, enzyme-linked immunosorbent assay, and PCR techniques. Several of these techniques have shown promise in clinical trials for the diagnosis of congenital syphilis and neurosyphilis that are presently difficult to diagnose. PMID:7704889

  7. Maternal and congenital syphilis in Bolivia, 1996: prevalence and risk factors.

    PubMed Central

    Southwick, K. L.; Blanco, S.; Santander, A.; Estenssoro, M.; Torrico, F.; Seoane, G.; Brady, W.; Fears, M.; Lewis, J.; Pope, V.; Guarner, J.; Levine, W. C.

    2001-01-01

    OBJECTIVES: The present study was carried out in seven maternity hospitals to determine the prevalence of maternal syphilis at the time of delivery and the associated risk factors, to conduct a pilot project of rapid syphilis testing in hospital laboratories, to assure the quality of syphilis testing, and to determine the rate of congenital syphilis in infants born to women with syphilis at the time of delivery--all of which would provide baseline data for a national prevention programme in Bolivia. METHODS: All women delivering either live-born or stillborn infants in the seven participating hospitals in and around La Paz, El Alto, and Cochabamba between June and November 1996 were eligible for enrolment in the study. FINDINGS: A total of 61 out of 1428 mothers (4.3%) of live-born infants and 11 out of 43 mothers (26%) of stillborn infants were found to have syphilis at delivery. Multivariate analysis showed that women with live-born infants who had less than secondary-level education, who did not watch television during the week before delivery (this was used as an indicator of socioeconomic status), who had a previous history of syphilis, or who had more than one partner during the pregnancy were at increased risk of syphilis. While 76% of the study population had received prenatal care, only 17% had syphilis testing carried out during the pregnancy; 91% of serum samples that were reactive to rapid plasma reagin (RPR) tests were also reactive to fluorescent treponemal antibody-absorption (FTA-ABS) testing. There was 96% agreement between the results from local hospital laboratories and national reference laboratories in their testing of RPR reactivity of serum samples. Congenital syphilis infection was confirmed by laboratory tests in 15% of 66 infants born to women with positive RPR and FTA-ABS testing. CONCLUSION: These results indicate that a congenital syphilis prevention programme in Bolivia could substantially reduce adverse infant outcomes due to this

  8. Acute periostitis in early acquired syphilis simulating shin splints in a jogger.

    PubMed

    Meier, J L; Mollet, E

    1986-01-01

    Acute periostitis affecting the long bones is a characteristic but uncommon manifestation of syphilis in the adult with an early acquired infection. This report describes the history of a jogger who developed acute localized periostitis of the shaft of both tibiae during the early stage of acquired syphilis. Symptomatology was initially attributed to the medial tibial stress syndrome.

  9. Response to therapy following retreatment of serofast early syphilis patients with benzathine penicillin.

    PubMed

    Seña, Arlene C; Wolff, Mark; Behets, Frieda; Van Damme, Kathleen; Martin, David H; Leone, Peter; McNeil, Linda; Hook, Edward W

    2013-02-01

    Persistent nontreponemal titers after treatment are common among patients with early syphilis. We retreated 82 human immunodeficiency virus-negative early syphilis participants who were serofast at 6 months using benzathine penicillin. Only 27% exhibited serological response after retreatment and after an additional 6 months of follow-up.

  10. Tonsillar Syphilis: an Unusual Site of Infection Detected by Treponema pallidum PCR

    PubMed Central

    Smith, John R. M.; Tsang, Raymond S. W.

    2015-01-01

    With the reemergence of syphilis, it is important that both clinical and public health practitioners recognize the various clinical manifestations of this disease (formerly known as “the great imitator”) and become familiar with the newer diagnostic tests. Here we report the first case of tonsillar syphilis diagnosed by PCR. PMID:26179306

  11. Don’t Forget What You Can’t See: A Case of Ocular Syphilis

    PubMed Central

    Lee, Monica I.; Lee, Annie W.C.; Sumsion, Sean M.; Gorchynski, Julie A.

    2016-01-01

    This case describes an emergency department (ED) presentation of ocular syphilis in a human immunodeficiency virus (HIV) infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM). This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR) and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss. PMID:27429702

  12. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

    PubMed Central

    Konda, Kelika A.; Roberts, Chelsea P.; Maguiña, Jorge L.; Leon, Segundo R.; Clark, Jesse L.; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2016-01-01

    Background Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Methods Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Results Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1–1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated

  13. Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru

    PubMed Central

    García, Patricia J.; Cárcamo, César P.; Chiappe, Marina; Valderrama, Maria; La Rosa, Sayda; Holmes, King K.; Mabey, David C. W.; Peeling, Rosanna W.

    2013-01-01

    Objectives Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening. Methods The study was implemented from September 2009–November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability. Results Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the “two for one strategy”, offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%. Conclusions Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1) engaging the authorities; (2) dissipating tensions between providers and identifying champions; (3) training according to the needs; (4) providing monitoring, supervision, support and recognition; (5) sharing results and discussing actions together; (6) consulting and obtaining feedback from users; and (7) integrating with other services such as with rapid HIV

  14. Cost-effectiveness of HIV and syphilis antenatal screening: a modeling study

    PubMed Central

    Bristow, Claire C.; Larson, Elysia; Anderson, Laura J.; Klausner, Jeffrey D.

    2016-01-01

    Objectives The World Health Organization called for the elimination of maternal-to-child transmission (MTCT) of HIV and syphilis, a harmonized approach for the improvement of health outcomes for mothers and children. Testing early in pregnancy, treating seropositive pregnant women, and preventing syphilis re-infection can prevent MTCT of HIV and syphilis. We assessed the health and economic outcomes of a dual testing strategy in a simulated cohort of 100,000 antenatal care patients in Malawi. Methods We compared four screening algorithms: (1) HIV rapid test only, (2) dual HIV and syphilis rapid tests, (3) single rapid tests for HIV and syphilis, and (4) HIV rapid and syphilis laboratory tests. We calculated the expected number of adverse pregnancy outcomes, the expected costs, and the expected newborn disability adjusted life years (DALYs) for each screening algorithm. The estimated costs and DALYs for each screening algorithm were assessed from a societal perspective using Markov progression models. Additionally, we conducted a Monte Carlo multi-way sensitivity analysis, allowing for ranges of inputs. Results Our cohort decision model predicted the lowest number of adverse pregnancy outcomes in the dual HIV and syphilis rapid test strategy. Additionally, from the societal perspective, the costs of prevention and care using a dual HIV and syphilis rapid testing strategy was both the least costly ($226.92 per pregnancy) and resulted in the fewest DALYs (116,639) per 100,000 pregnancies. In the Monte Carlo simulation the dual HIV and syphilis algorithm was always cost saving and almost always reduced disability adjusted life years (DALYs) compared to HIV testing alone. Conclusion The results of the cost-effectiveness analysis showed that a dual HIV and syphilis test was cost saving compared to all other screening strategies. Adding dual rapid testing to the existing prevention of mother-to-child HIV transmission programs in Malawi and similar countries is likely to

  15. Social network investigation of a syphilis outbreak in Ottawa, Ontario

    PubMed Central

    D’Angelo-Scott, H; Cutler, J; Friedman, D; Hendriks, A; Jolly, AM

    2015-01-01

    BACKGROUND: The incidence of syphilis in Ottawa, Ontario, has risen substantially since 2000 to six cases per 100,000 in 2003, again to nine cases per 100,000 in 2007, and recently rose to 11 cases per 100,000 in 2010. The number of cases reported in the first quarter of 2010 was more than double that in the first quarter of 2009. OBJECTIVE: In May 2010, the Ontario Ministry of Health and Long Term Care requested the assistance of the Field Epidemiology Program to describe the increase in infectious syphilis rates and to identify social network sources and prevention messages. METHODS: Syphilis surveillance data were routinely collected from January 1, 2009 to July 15, 2010, and social networks were constructed from an enhanced social network questionnaire. Univariate comparisons between the enhanced surveillance group and the remaining cases from 2009 on non-normally distributed data were conducted using Kruskal-Wallis tests and χ2 tests. RESULTS: The outbreak cases were comprised of 89% men. Seventeen of the 19 most recent cases consented to answer the questionnaire, which revealed infrequent use of condoms, multiple sex partners and sex with a same-sex partner. Information regarding social venues where sex partners were met was plotted together with sexual partnerships, linking 18 cases and 40 contacts, representing 37% of the outbreak population and connecting many of the single individuals and dyads. CONCLUSION: Uncovering the places sex partners met was an effective proxy measure of high-risk activities shared with infected individuals and demonstrates the potential for focusing on interventions at one named bar and one Internet site to reach a high proportion of the population at risk. PMID:26600816

  16. Syphilis in art: an entertainment in four parts. Part 1.

    PubMed

    Morton, R S

    1990-02-01

    It is widely recognised that the history of art reveals the contemporary attitudes of societies and artists to changing patterns of social and sexual behaviour. This collection of artistic creations shows that representations of syphilis in art, over more than five centuries, are consistent with this view. The first quarter century of the morbus gallicus in Europe, starting in 1493, coincided with the spread of Renaissance influence, including printing. A host of pamphlets with woodcut illustrations reflected public alarm at the epidemic proportions and severity of the new disease, with its disabling and sometimes deadly consequences. Also revealed in these early works are the astrological and theological beliefs of disease causation as well as identifiable and serious attempts at public education. These twinned themes of understanding and educational endeavour recur together throughout the centuries and take many forms as man attempts to outline and influence attitudes and so improve his medico-social health. Attitudes to causation changed with experience so that by the beginning of the 17th century the morbus gallicus is no longer a mere contagion but recognised socially and represented artistically, as a morbus venereus. Its clinical presentation had changed remarkably from the alarming early days; and so too had its prevalence--from epidemic to endemic proportions. We find that the artists of both the 16th and 17th centuries, while somewhat reticent about syphilis, are nonetheless at pains to suggest that sex is not without its serious side effects. Their artistic exhortations suggest women as the source of the disease, so that we find Venus shown as both ideal love and the source of contamination. Such attitudes contrast strikingly with what follows. The 18th century is characterised by the sophisticated elements of European societies taking an irreverent or satirical view of sex and syphilis. In England this is reflected in the works of Hogarth and other

  17. Endemic syphilis in the Bakwena Reserve of the Bechuanaland Protectorate

    PubMed Central

    Murray, J. F.; Merriweather, A. M.; Freedman, M. L.

    1956-01-01

    A form of endemic syphilis exists in the Bakwena Reserve of the Bechuanaland Protectorate known by the local name of “dichuchwa”. It is similar to bejel, njovera and the endemic syphilis reported elsewhere in the world. The Government of the Protectorate, with the assistance of WHO and UNICEF, began in November 1953 a mass campaign in the Reserve to control this disease and, at the same time, to study its epidemiological, clinical, social and therapeutic aspects. The seropositivity rate in the Reserve was found to be 37%. Dichuchwa is a childhood and family disease, usually spread non-venereally. The early lesions are similar to secondary lesions of sporadic venereal syphilis, and are often followed by tertiary lesions affecting mainly the skin, nasopharynx and long bones. Primary lesions are rare but may occur under certain epidemiological conditions if the inoculum is sufficiently large; thus a mother may develop primary sores on the nipples through suckling an infected infant. Lesions of the cardiovascular and central nervous systems and congenital syphilis are also rare. Superinfection of an already infected and allergic host is probably the chief reason for the frequency of the tertiary lesions. Treatment of the disease with penicillin is very effective, and the authors believe that mass treatment of cases and contacts combined with an improvement in the standards of hygiene could eradicate the disease. ImagesFig. 61Fig. 62Fig. 63Fig. 64Fig. 74Fig. 75Fig. 76Fig. 1Fig. 2Fig. 3Fig. 16Fig. 17Fig. 18Fig. 43Fig. 44Fig. 45Fig. 7Fig. 8Fig. 9Fig. 13Fig. 14Fig. 15Fig. 31Fig. 32Fig. 33Fig. 50Fig. 51Fig. 52Fig. 53Fig. 54Fig. 55Fig. 56Fig. 34Fig. 35Fig. 36Fig. 46Fig. 47Fig. 48Fig. 49Fig. 22Fig. 23Fig. 24Fig. 10Fig. 11Fig. 12Fig. 57Fig. 58Fig. 59Fig. 60Fig. 65Fig. 66Fig. 67Fig. 19Fig. 20Fig. 21Fig. 4Fig. 5Fig. 6Fig. 68Fig. 69Fig. 70Fig. 71Fig. 72Fig. 73Fig. 37Fig. 38Fig. 39Fig. 28Fig. 29Fig. 30Fig. 25Fig. 26Fig. 27Fig. 40Fig. 41Fig. 42 PMID:13404470

  18. Syphilis in art: an entertainment in four parts. Part 1.

    PubMed Central

    Morton, R S

    1990-01-01

    It is widely recognised that the history of art reveals the contemporary attitudes of societies and artists to changing patterns of social and sexual behaviour. This collection of artistic creations shows that representations of syphilis in art, over more than five centuries, are consistent with this view. The first quarter century of the morbus gallicus in Europe, starting in 1493, coincided with the spread of Renaissance influence, including printing. A host of pamphlets with woodcut illustrations reflected public alarm at the epidemic proportions and severity of the new disease, with its disabling and sometimes deadly consequences. Also revealed in these early works are the astrological and theological beliefs of disease causation as well as identifiable and serious attempts at public education. These twinned themes of understanding and educational endeavour recur together throughout the centuries and take many forms as man attempts to outline and influence attitudes and so improve his medico-social health. Attitudes to causation changed with experience so that by the beginning of the 17th century the morbus gallicus is no longer a mere contagion but recognised socially and represented artistically, as a morbus venereus. Its clinical presentation had changed remarkably from the alarming early days; and so too had its prevalence--from epidemic to endemic proportions. We find that the artists of both the 16th and 17th centuries, while somewhat reticent about syphilis, are nonetheless at pains to suggest that sex is not without its serious side effects. Their artistic exhortations suggest women as the source of the disease, so that we find Venus shown as both ideal love and the source of contamination. Such attitudes contrast strikingly with what follows. The 18th century is characterised by the sophisticated elements of European societies taking an irreverent or satirical view of sex and syphilis. In England this is reflected in the works of Hogarth and other

  19. A novel response to an outbreak of infectious syphilis in Christchurch, New Zealand.

    PubMed

    Coughlan, Edward; Young, Heather; Parkes, Catherine; Coshall, Maureen; Dickson, Nigel; Psutka, Rebecca; Saxton, Peter; Pink, Ramon; Adams, Katharine

    2015-04-01

    During 2012, Christchurch experienced a dramatic increase in cases of infectious syphilis among men who have sex with men. This was accompanied by some novel trends; notably, the acquisition of infection in a younger age group, with local sexual contacts, commonly via the use of social media. This study is a report on an approach to case identification and public health communication as a component of a multifaceted outbreak response. Enhanced syphilis surveillance data on public health responses to outbreaks of sexually transmissible infections was collated and reviewed, alongside clinical records and literature. Reported outbreak response methods were adapted for the Christchurch cohort. A Facebook page was created to raise awareness of infectious syphilis, the importance of screening and where to get tested. Twenty-six males were diagnosed with infectious syphilis in 2012, an increase from previous years, of which 22 reported only male sexual contact. High use of social media used to find potential sexual contacts was reported. Enhanced syphilis surveillance characterised in detail an infectious syphilis outbreak in Christchurch. Index cases were identified, contact tracing mapping was used to identify transmission networks and social media was also used to educate the risk group. There was a decrease in infectious syphilis presentations, with no cases in the last 3 months of 2012.

  20. Current Perspectives on Prevention of Mother-to-Child Transmission of Syphilis

    PubMed Central

    2016-01-01

    This article aims to provide an update on the prevention of mother-to-child transmission of syphilis by drawing upon some important basic concepts and reviewing the most recent literature on the diagnosis and treatment of syphilis in pregnancy. New technologies, such as automated and point-of-care immunologic tests, are shifting some paradigms, which will certainly be further investigated in the forthcoming years. This is the time to carefully evaluate traditional as well as new strategies to prevent congenital syphilis. Adverse outcomes of mother-to-child transmission of syphilis can be prevented with antenatal screening and penicillin therapy, which proved to have an excellent cost-benefit ratio even in populations with a low prevalence of syphilis. However, syphilis epidemiology is influenced by socioeconomic and cultural factors, and major challenges are faced by poor and developing countries in which the severity of the problem is extremely alarming. On the other hand, the emergence of new technologies has raised doubts about the best algorithm to be used when proper laboratory resources are available. Conditions are quite heterogeneous across populations, and some procedures should not be generalized while there is no evidence that supports some changes and while in-depth studies about local conditions are not conducted. Official organizations need to be alert in order to avoid isolated decisions and ensure that evidence-based guidelines be used in the management of syphilis in pregnancy. PMID:27081586

  1. [Syphilis in adolescent mothers in the city of Posadas, Province of Misiones].

    PubMed

    Jacquier, N; Dos Santos, L; Deschutter, J D; Duarte, B; Rodriguez Fermepin, M; Martinelli, M; de Torres, R A

    1999-01-01

    During three months (April to June 1997) 1,238 consecutive pregnant women were studied at the time of delivery at the Madariaga public Hospital. Syphilis was confirmed in 26 (2.1%) women, and 15 cases (57.7%) of congenital syphilis were demonstrated in newborns one of whom was a stillborn. Of the syphilitic women 61.5% were 20 years old (average), 65.4% were single, 19.2% had a stable partner and 15.4% were married; 70% of them had finished elementary school (seven years), but despite this discrete level of instruction and that they were benefited with free health attention, 73% of them had not started or completed the pregnancy control. None of these women acted as sexual workers or were drug users; 57.7% were unemployed and the remainder worked as domestic servants or were still going to school. Menarca started at 13 (average) and the age of the first sexual activity was 15 (average). The distribution of the cases of syphilis within the city area shows four clusters that coincide with the lower income population, but not with marginal groups. The failure to submit to medical control during pregnancy among syphilitic women is directly linked with an increased risk for congenital syphilis. The specific prevalence of syphilis in women (20 years old or less) pregnant or not, shows an alarming hidden epidemic situation. An interinstitutional and communitary program, with direct interventions within the detected population clusters, is now underway in order to control syphilis. Undesired pregnancy and syphilis seem to be associated with adolescent unsafe sex conducts. A coordinated program between Public Health Service and National Misiones University is operating, visiting home by home, in order to decrease or eliminate congenital syphilis and is considered a priority health problem. Unfortunately, if sexual conducts do not undergo changes in the near future, at least by the correct use of condoms, HIV will replace syphilis.

  2. The prevalence and correlates of syphilis and HIV among homosexual and bisexual men in Shijiazhuang, China.

    PubMed

    Zhang, Shao-Hui; Liu, Shu-Jun; Hu, Ling-Ling; Li, Jie-Fang; Liu, Li-Hua; Wei, Ning

    2016-02-01

    Bisexual men (men who have sex with men and women) are potential epidemiological bridges responsible for the spread of HIV and other sexually transmitted infections from men who have sex with men only to the heterosexual population. We aimed to estimate the prevalence of syphilis and HIV and the factors associated with syphilis infection among men who have sex with men and women and men who have sex with men only from Shijiazhuang, China. In 2011-2013, a cross-sectional cohort of 427 men who have sex with men was recruited by a snowball sampling method and tested for syphilis and HIV. Chi square and logistic regression were performed to identify syphilis risk factors. Among the 427 men who have sex with men, 71 (16.6%) cases were syphilis-positive and 16 cases (3.7%) were HIV-positive. The proportions of men who have sex with men and women and men who have sex with men only in the total sample were 31.4% and 68.6%, respectively. Men who have sex with men and women exhibited double the syphilis prevalence of men who have sex with men only and were more likely to practice insertive anal sex. Higher education level, being married, having more male partners, and both receptive and insertive anal sex roles were associated with syphilis among men who have sex with men and women. Residing in suburban areas, being married, being HIV positive, and an absence of desire to change sexual orientation were associated with syphilis among men who have sex with men only. Therefore, men who have sex with men and women represent an important sub-group in the syphilis epidemic and further interventions should be developed to reduce risk among different sub-sets of men who have sex with men.

  3. The Tuskegee Syphilis Study and the scientific concept of racial nervous resistance.

    PubMed

    Crenner, Christopher

    2012-04-01

    In 1932, the U.S. Public Health Service began a study of untreated syphilis among black men in Macon County, Alabama. This project, later known as the Tuskegee Syphilis Study, became one of the most notorious ventures of twentieth-century medicine. Much has been written on it. Historians have suggested that scientific racism strongly influenced the study. But specific links between earlier racial science and the scientific conduct of the study have remained unexplored. The examination in this paper of the concept of a racially determined resistance to syphilis in the nervous system establishes such a link. Discussion of nervous resistance to syphilis appeared in the medical literature in the early twentieth century as a conjecture about the natural inferiority of blacks. White physicians used the concept to interpret racial differences in neurosyphilis as evidence of the rudimentary development of the brain. A small community of African American physicians joined other national experts in syphilis who chose to explain apparent racial differences through alternate mechanisms. But the scientific advisors to the Tuskegee Syphilis Study favored the concept of a racial resistance to neurosyphilis and steered the early design of the study to help to elucidate it. The Tuskegee Syphilis Study was an examination of untreated syphilis, but it also became a demonstration of a putative racial characteristic of syphilis long considered evidence of the natural inferiority of blacks. An examination of the concept of racial nervous resistance and its influence on the research in Macon County helps to define the influence of scientific racism on this notorious medical study.

  4. Utility of the Determine Syphilis TP rapid test in commercial sex venues in Peru

    PubMed Central

    Campos, P E; Buffardi, A L; Chiappe, M; Buendía, C; Garcia, P J; Carcamo, C P; Garnett, G; White, P

    2006-01-01

    Objectives This study sought to evaluate the utility of the Determine Syphilis TP test performed in Peruvian commercial sex venues for the detection of active syphilis; and determine the feasibility of integrating rapid syphilis testing for female sex workers (FSW) into existing health outreach services. Methods We tested 3586 female sex workers for syphilis by Determine in the field using whole blood fingerstick, and by rapid plasma reagin (RPR) and Treponema pallidum haemagglutination assay (TPHA) in a central laboratory in Lima using sera. Results 97.4% of the FSW offered rapid syphilis testing participated; and among those who tested positive, 87% visited the local health centre for treatment. More than twice as many specimens were RPR reactive using serum in Lima (5.7%) than tested positive by whole blood Determine in the field (2.8%), and although most were confirmed by TPHA, only a small proportion (0.7%) were RPR reactive at ⩾1:8 dilutions, and likely indicating active syphilis. Sensitivity, specificity and positive predictive value of the Determine Syphilis TP test in whole blood when compared to serum RPR reactivity at any dilution confirmed by TPHA as the gold standard were 39.3%, 99.2% and 71.4%, respectively. Sensitivity improved to 64.0% when using serum RPR ⩾1:8 confirmed by TPHA. Invalid tests were rare (0.3%). Conclusions Rapid syphilis testing in sex work venues proved feasible, but Determine using whole blood obtained by fingerstick was substantially less sensitive than reported in previous laboratory‐based studies using serum. Although easy to perform in outreach venues, the utility of this rapid syphilis test was relatively low in settings where a large proportion of the targeted population has been previously tested and treated. PMID:17116642

  5. A probable case of congenital syphilis from pre-Columbian Austria.

    PubMed

    Gaul, Johanna Sophia; Grossschmidt, Karl; Gusenbauer, Christian; Kanz, Fabian

    2015-01-01

    This study examines the skeletal remains of a subadult from an archeological site in Austria. Radiocarbon dating and archeological attribution indicate that this individual is of pre-Columbian origin. Most of the skeleton was recovered, and only the teeth and the orbital roofs show changes. Dental defects such as the mulberry molar and a tapered, fang-like canine suggest a diagnosis of congenital syphilis. This is the first probable case of congenital syphilis from pre-Columbian Central Europe. Our findings contribute to the pre-Columbian theory, offering counter evidence to the assumption that syphilis was carried from Columbus' crew from the New to the Old World.

  6. Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals

    PubMed Central

    Shilaih, Mohaned; Marzel, Alex; Braun, Dominique L.; Scherrer, Alexandra U.; Kovari, Helen; Young, Jim; Calmy, Alexandra; Darling, Katharine; Battegay, Manuel; Hoffmann, Matthias; Bernasconi, Enos; Thurnheer, Maria C.; Günthard, Huldrych F.; Kouyos, Roger D.

    2017-01-01

    Abstract After several years of steady decline, syphilis is reemerging globally as a public health hazard, especially among people living with human immunodeficiency virus (HIV). Syphilis resurgence is observed mainly in men who have sex with men (MSM), yet other transmission groups are affected too. In this manuscript, we study the factors associated with syphilis incidence in the Swiss HIV cohort study in the era of highly effective antiretrovirals. Using parametric interval censored models with fixed and time-varying covariates, we studied the immunological, behavioral, and treatment-related elements associated with syphilis incidence in 3 transmission groups: MSM, heterosexuals, and intravenous drug users. Syphilis incidence has been increasing annually since 2005, with up to 74 incident cases per 1000 person-years in 2013, with MSM being the population with the highest burden (92% of cases). While antiretroviral treatment (ART) in general did not affect syphilis incidence, nevirapine (NVP) was associated with a lower hazard of syphilis incidence (multivariable hazard ratio 0.5, 95% confidence interval 0.2–1.0). We observed that condomless sex and younger age were associated with higher syphilis incidence. Moreover, time-updated CD4, nadir CD4, and CD8 cell counts were not associated with syphilis incidence. Finally, testing frequency higher than the recommended once a year routine testing was associated with a 2-fold higher risk of acquiring syphilis. Condomless sex is the main driver of syphilis resurgence in the Swiss HIV Cohort study; ART and immune reconstitution provide no protection against syphilis. This entails targeted interventions and frequent screening of high-risk populations. There is no known effect of NVP on syphilis; therefore, further clinical, epidemiological, and microbiological investigation is necessary to validate our observation. PMID:28079818

  7. Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals.

    PubMed

    Shilaih, Mohaned; Marzel, Alex; Braun, Dominique L; Scherrer, Alexandra U; Kovari, Helen; Young, Jim; Calmy, Alexandra; Darling, Katharine; Battegay, Manuel; Hoffmann, Matthias; Bernasconi, Enos; Thurnheer, Maria C; Günthard, Huldrych F; Kouyos, Roger D

    2017-01-01

    After several years of steady decline, syphilis is reemerging globally as a public health hazard, especially among people living with human immunodeficiency virus (HIV). Syphilis resurgence is observed mainly in men who have sex with men (MSM), yet other transmission groups are affected too. In this manuscript, we study the factors associated with syphilis incidence in the Swiss HIV cohort study in the era of highly effective antiretrovirals. Using parametric interval censored models with fixed and time-varying covariates, we studied the immunological, behavioral, and treatment-related elements associated with syphilis incidence in 3 transmission groups: MSM, heterosexuals, and intravenous drug users. Syphilis incidence has been increasing annually since 2005, with up to 74 incident cases per 1000 person-years in 2013, with MSM being the population with the highest burden (92% of cases). While antiretroviral treatment (ART) in general did not affect syphilis incidence, nevirapine (NVP) was associated with a lower hazard of syphilis incidence (multivariable hazard ratio 0.5, 95% confidence interval 0.2-1.0). We observed that condomless sex and younger age were associated with higher syphilis incidence. Moreover, time-updated CD4, nadir CD4, and CD8 cell counts were not associated with syphilis incidence. Finally, testing frequency higher than the recommended once a year routine testing was associated with a 2-fold higher risk of acquiring syphilis. Condomless sex is the main driver of syphilis resurgence in the Swiss HIV Cohort study; ART and immune reconstitution provide no protection against syphilis. This entails targeted interventions and frequent screening of high-risk populations. There is no known effect of NVP on syphilis; therefore, further clinical, epidemiological, and microbiological investigation is necessary to validate our observation.

  8. Syphilis Predicts HIV Incidence Among Men and Transgender Women Who Have Sex With Men in a Preexposure Prophylaxis Trial

    PubMed Central

    Solomon, Marc M.; Mayer, Kenneth H.; Glidden, David V.; Liu, Albert Y.; McMahan, Vanessa M.; Guanira, Juan V.; Chariyalertsak, Suwat; Fernandez, Telmo; Grant, Robert M.; Bekker, Linda-Gail; Buchbinder, Susan; Casapia, Martin; Chariyalertsak, Suwat; Guanira, Juan; Kallas, Esper; Lama, Javier; Mayer, Kenneth; Montoya, Orlando; Schechter, Mauro; Veloso, Valdiléa

    2014-01-01

    Background. Syphilis infection may potentiate transmission of human immunodeficiency virus (HIV). We sought to determine the extent to which HIV acquisition was associated with syphilis infection within an HIV preexposure prophylaxis (PrEP) trial and whether emtricitabine/tenofovir (FTC/TDF) modified that association. Methods. The Preexposure Prophylaxis Initiative (iPrEx) study randomly assigned 2499 HIV-seronegative men and transgender women who have sex with men (MSM) to receive oral daily FTC/TDF or placebo. Syphilis prevalence at screening and incidence during follow-up were measured. Hazard ratios for the effect of incident syphilis on HIV acquisition were calculated. The effect of FTC/TDF on incident syphilis and HIV acquisition was assessed. Results. Of 2499 individuals, 360 (14.4%) had a positive rapid plasma reagin test at screening; 333 (92.5%) had a positive confirmatory test, which did not differ between the arms (FTC/TDF vs placebo, P = .81). The overall syphilis incidence during the trial was 7.3 cases per 100 person-years. There was no difference in syphilis incidence between the study arms (7.8 cases per 100 person-years for FTC/TDF vs 6.8 cases per 100 person-years for placebo, P = .304). HIV incidence varied by incident syphilis (2.8 cases per 100 person-years for no syphilis vs 8.0 cases per 100 person-years for incident syphilis), reflecting a hazard ratio of 2.6 (95% confidence interval, 1.6–4.4; P < .001). There was no evidence for interaction between randomization to the FTC/TDF arm and incident syphilis on HIV incidence. Conclusions. In HIV-seronegative MSM, syphilis infection was associated with HIV acquisition in this PrEP trial; a syphilis diagnosis should prompt providers to offer PrEP unless otherwise contraindicated. PMID:24928295

  9. Atypical presentation of syphilis in an HTLV-I infected patient.

    PubMed

    Carnaúba, Dimas; Bittencourt, Achiléa; Brites, Carlos

    2003-08-01

    We report the case of a 44 year-old female, who presented a long-lasting, clinically atypical, secondary syphilis ("malignant syphilis") in the right foot, which started six months before medical evaluation. The patient had a serological diagnosis of HTLV-I infection and syphilis two years before the onset of the skin lesions, following a blood donation. As she believed she was allergic to penicillin, she initially received sulfamethoxazole + trimethoprim, without any improvement of the clinical picture. After failure of this first treatment regimen, she was given penicillin, which promoted complete healing of the lesion. We found evidence that infection by HTLV-I is capable of modifying the clinical course of secondary syphilis.

  10. Value of serological diagnosis in congenital syphilis. Report of nine cases.

    PubMed Central

    Borobio, M V; Nogales, M C; Palomares, J C

    1980-01-01

    The diagnosis of congenital syphilis is difficult since it depends mainly on the results of serological tests. The results of five serological tests (three specific and two non-specific) in nine neonates with congenital syphilis are compared with those obtained in three with passively acquired antibodies. It appeared that the serological diagnosis of congenital syphilis must be based on the finding of specific neonatal antibodies in cord serum, which give positive results to the fluorescent treponemal antibody absorption test for immunoglobulin M, together with high titres of total IgM and negative results to latex tests. The non-specific tests are useful for confirming the efficacy of treatment. The mean number of cases of congenital syphilis in Seville is 0.81/1000 live births. PMID:7448581

  11. Syphilis and HIV co-infection. Epidemiology, treatment and molecular typing of Treponema pallidum.

    PubMed

    Salado-Rasmussen, Kirsten

    2015-12-01

    The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten per cent of Danish men with syphilis acquired HIV infection within five years after they were diagnosed with syphilis during an 11-year study period. Interestingly, the risk of HIV declined during the later part of the period. Moreover, HIV-infected men had a substantial increased risk of re-infection with syphilis compared to HIV-uninfected men. As one third of the HIV-infected patients had viral loads >1,000 copies/ml, our conclusion supported the initiation of cART in more HIV-infected MSM to reduce HIV transmission. During a five-year study period, including the majority of HIV-infected patients from the Copenhagen area, we observed that syphilis was diagnosed in the primary, secondary, early and late latent stage. These patients were treated with either doxycycline or penicillin and the rate of treatment failure was similar in the two groups, indicating that doxycycline can be used as a treatment alternative - at least in an HIV-infected population. During a four-year study period, the T. pallidum strain type distribution was investigated among patients diagnosed by PCR

  12. April is STD Awareness Month: Know the Facts About Syphilis and How to Protect Yourself

    MedlinePlus

    ... Past Emails CDC Features April is STD Awareness Month Language: English Español (Spanish) Recommend on Facebook Tweet ... issue, CDC is dedicating all of STD Awareness Month (April) to syphilis prevention. We encourage everyone to ...

  13. A defined syphilis vaccine candidate inhibits dissemination of Treponema pallidum subspecies pallidum

    PubMed Central

    Lithgow, Karen V.; Hof, Rebecca; Wetherell, Charmaine; Phillips, Drew; Houston, Simon; Cameron, Caroline E.

    2017-01-01

    Syphilis is a prominent disease in low- and middle-income countries, and a re-emerging public health threat in high-income countries. Syphilis elimination will require development of an effective vaccine that has thus far remained elusive. Here we assess the vaccine potential of Tp0751, a vascular adhesin from the causative agent of syphilis, Treponema pallidum subsp. pallidum. Tp0751-immunized animals exhibit a significantly reduced bacterial organ burden upon T. pallidum challenge compared with unimmunized animals. Introduction of lymph nodes from Tp0751-immunized, T. pallidum-challenged animals to naive animals fails to induce infection, confirming sterile protection. These findings provide evidence that Tp0751 is a promising syphilis vaccine candidate. PMID:28145405

  14. Fibronectin tetrapeptide is target for syphilis spirochete cytadherence

    SciTech Connect

    Thomas, D.D.; Baseman, J.B.; Alderete, J.F.

    1985-11-01

    The syphilis bacterium, Treponema pallidum, parasitizes host cells through recognition of fibronectin (Fn) on cell surfaces. The active site of the Fn molecule has been identified as a four-amino acid sequence, arg-gly-asp-ser (RGDS), located on each monomer of the cell-binding domain. The synthetic heptapeptide gly-arg-gly-asp-ser-pro-cys (GRGDSPC), with the active site sequence RGDS, specifically competed with SVI-labeled cell-binding domain acquisition by T. pallidum. Additionally, the same heptapeptide with the RGDS sequence diminished treponemal attachment to HEp-2 and HT1080 cell monolayers. Related heptapeptides altered in one key amino acid within the RGDS sequence failed to inhibit Fn cell-binding domain acquisition or parasitism of host cells by T. pallidum. The data support the view that T. pallidum cytadherence of host cells is through recognition of the RGDS sequence also important for eukaryotic cell-Fn binding.

  15. An extraordinary case of syphilis presenting with a labial ulcer

    PubMed Central

    Demir, Filiz T.; Salaeva, Kenyul; Altunay, Ilknur K.; Yalcın, Ozben

    2016-01-01

    In the differential diagnosis of patients with ulcers on the lips characteristics like the duration of the ulcer, number, size, depth, shape, base, margins, and distribution are considered. Such ulcers arise from many diseases particularly, viral and bacterial infections, malignancies can also be responsible. Classic syphilitic chancres are painless erosions settled on hard papule; these are evident in the genital area in more than 90% of patients. This study describes a case of a 38-year-old female patient presenting with a painful ulcer covering 3 quarters of the upper lip showing settlement on erythematous, edematous, and indurated plaque covered with hemorrhagic crusts. The aim of this study was to consider differences between the classic syphilitic chancre typically found in the genital region from extragenital chancres and to raise awareness of the possibility of primary syphilis when patients present with painful ulcers on the lip. PMID:27761567

  16. A nodular-ulcerative form of secondary syphilis in AIDS

    PubMed Central

    Owen, Benjamin D.; Balavenkataraman, Arvind; Weinstein, Mitchell R.

    2017-01-01

    An uncommon variant in the pre-AIDS era, lues maligna is a nodular-ulcerative form of secondary syphilis. We present a case of a 41-year-old man with HIV infection who developed fever, chills, nausea, vomiting, right upper quadrant abdominal pain, weight loss, watery diarrhea, and a painless, nonpruritic rash. He had diffuse nodular-ulcerative lesions in various stages of development. He was found to have a CD4 count of 101 cells/mm3 (22%), an HIV viral load of 2,735,060 copies/mL, and a positive rapid plasma reagin at 1:64. He was started on emtricitabine, tenofovir, and dolutegravir, as well as doxycycline. He was given benzathine penicillin 2.4 million units intramuscularly and within hours developed a Jarisch-Herxheimer reaction. Skin lesions showed signs of healing, and constitutional symptoms improved 48 hours later. PMID:28127144

  17. [Positive syphilis serodiagnositic tests in air transport workers].

    PubMed

    Castoro, G

    1980-07-14

    The present study was carried out by the Aeronautic Medicine Section of Alitalia at Fiumicino, where in the years 1976-1977 and in the first four months of 1978, 6700 samples of serum from ground and air personnel were analysed as part of a preventive medicine check-up. A high percentage of positivity (9 per thousand in 1976, 12 per thousand in 1977 and 11 per thousand in the first four months of 1978) was observed. The problems of continual travelling and staying in countries were syphilis presents a very high morbility rate are the reasons for the infection. Social, sanitary, deontological and human problems of department physicians delegated to treat the disease are discussed.

  18. Secondary syphilis in cali, Colombia: new concepts in disease pathogenesis.

    PubMed

    Cruz, Adriana R; Pillay, Allan; Zuluaga, Ana V; Ramirez, Lady G; Duque, Jorge E; Aristizabal, Gloria E; Fiel-Gan, Mary D; Jaramillo, Roberto; Trujillo, Rodolfo; Valencia, Carlos; Jagodzinski, Linda; Cox, David L; Radolf, Justin D; Salazar, Juan C

    2010-05-18

    Venereal syphilis is a multi-stage, sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum (Tp). Herein we describe a cohort of 57 patients (age 18-68 years) with secondary syphilis (SS) identified through a network of public sector primary health care providers in Cali, Colombia. To be eligible for participation, study subjects were required to have cutaneous lesions consistent with SS, a reactive Rapid Plasma Reagin test (RPR-titer > or = 1 : 4), and a confirmatory treponemal test (Fluorescent Treponemal Antibody Absorption test- FTA-ABS). Most subjects enrolled were women (64.9%), predominantly Afro-Colombian (38.6%) or mestizo (56.1%), and all were of low socio-economic status. Three (5.3%) subjects were newly diagnosed with HIV infection at study entry. The duration of signs and symptoms in most patients (53.6%) was less than 30 days; however, some patients reported being symptomatic for several months (range 5-240 days). The typical palmar and plantar exanthem of SS was the most common dermal manifestation (63%), followed by diffuse hypo- or hyperpigmented macules and papules on the trunk, abdomen and extremities. Three patients had patchy alopecia. Whole blood (WB) samples and punch biopsy material from a subset of SS patients were assayed for the presence of Tp DNA polymerase I gene (polA) target by real-time qualitative and quantitative PCR methods. Twelve (46%) of the 26 WB samples studied had quantifiable Tp DNA (ranging between 194.9 and 1954.2 Tp polA copies/ml blood) and seven (64%) were positive when WB DNA was extracted within 24 hours of collection. Tp DNA was also present in 8/12 (66%) skin biopsies available for testing. Strain typing analysis was attempted in all skin and WB samples with detectable Tp DNA. Using arp repeat size analysis and tpr RFLP patterns four different strain types were identified (14d, 16d, 13d and 22a). None of the WB samples had sufficient DNA for typing. The clinical and microbiologic

  19. Secondary Syphilis in Cali, Colombia: New Concepts in Disease Pathogenesis

    PubMed Central

    Cruz, Adriana R.; Pillay, Allan; Zuluaga, Ana V.; Ramirez, Lady G.; Duque, Jorge E.; Aristizabal, Gloria E.; Fiel-Gan, Mary D.; Jaramillo, Roberto; Trujillo, Rodolfo; Valencia, Carlos; Jagodzinski, Linda; Cox, David L.; Radolf, Justin D.; Salazar, Juan C.

    2010-01-01

    Venereal syphilis is a multi-stage, sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum (Tp). Herein we describe a cohort of 57 patients (age 18–68 years) with secondary syphilis (SS) identified through a network of public sector primary health care providers in Cali, Colombia. To be eligible for participation, study subjects were required to have cutaneous lesions consistent with SS, a reactive Rapid Plasma Reagin test (RPR-titer ≥1∶4), and a confirmatory treponemal test (Fluorescent Treponemal Antibody Absorption test- FTA-ABS). Most subjects enrolled were women (64.9%), predominantly Afro-Colombian (38.6%) or mestizo (56.1%), and all were of low socio-economic status. Three (5.3%) subjects were newly diagnosed with HIV infection at study entry. The duration of signs and symptoms in most patients (53.6%) was less than 30 days; however, some patients reported being symptomatic for several months (range 5–240 days). The typical palmar and plantar exanthem of SS was the most common dermal manifestation (63%), followed by diffuse hypo- or hyperpigmented macules and papules on the trunk, abdomen and extremities. Three patients had patchy alopecia. Whole blood (WB) samples and punch biopsy material from a subset of SS patients were assayed for the presence of Tp DNA polymerase I gene (polA) target by real-time qualitative and quantitative PCR methods. Twelve (46%) of the 26 WB samples studied had quantifiable Tp DNA (ranging between 194.9 and 1954.2 Tp polA copies/ml blood) and seven (64%) were positive when WB DNA was extracted within 24 hours of collection. Tp DNA was also present in 8/12 (66%) skin biopsies available for testing. Strain typing analysis was attempted in all skin and WB samples with detectable Tp DNA. Using arp repeat size analysis and tpr RFLP patterns four different strain types were identified (14d, 16d, 13d and 22a). None of the WB samples had sufficient DNA for typing. The clinical and microbiologic

  20. Syphilis Mimicking Other Dermatological Diseases: Reactive Arthritis and Mucha-Habermann Disease

    PubMed Central

    da Silva Carneiro, Sueli Coelho; Pirmez, Rodrigo; de Hollanda, Taciana Rocha; Cuzzi, Tullia; Ramos-e-Silva, Marcia

    2013-01-01

    The authors present two cases of syphilis: one mimicking reactive arthritis and the other Mucha-Habermann disease. Both reports illustrate syphilis as ‘the great imitator’, a description given by Sir William Osler, and call attention to the strong need for awareness among physicians of all specialties, especially the younger ones, who are not used to seeing this increasingly prevalent disease, as it once was in the past. PMID:23467097

  1. Prenatal Transmission of Syphilis and Human Immunodeficiency Virus in Brazil: Achieving Regional Targets for Elimination

    PubMed Central

    Cerda, Rodrigo; Perez, Freddy; Domingues, Rosa Maria S.M.; Luz, Paula M.; Grinsztejn, Beatriz; Veloso, Valdilea G.; Caffe, Sonja; Francke, Jordan A.; Freedberg, Kenneth A.; Ciaranello, Andrea L.

    2015-01-01

    Background. The Pan-American Health Organization has called for reducing (1) human immunodeficiency virus (HIV) mother-to-child transmission (MTCT) to ≤0.30 infections/1000 live births (LB), (2) HIV MTCT risk to ≤2.0%, and (3) congenital syphilis (CS) incidence to ≤0.50/1000 LB in the Americas by 2015. Methods. Using published Brazilian data in a mathematical model, we simulated a cohort of pregnant women from antenatal care (ANC) through birth. We investigated 2 scenarios: “current access” (89.1% receive one ANC syphilis test and 41.1% receive 2; 81.7% receive one ANC HIV test and 18.9% receive birth testing; if diagnosed, 81.0% are treated for syphilis and 87.5% are treated for HIV) and “ideal access” (95% of women undergo 2 HIV and syphilis screenings; 95% receive appropriate treatment). We conducted univariate and multivariate sensitivity analyses on key inputs. Results. With current access, we projected 2.95 CS cases/1000 LB, 0.29 HIV infections/1000 LB, 7.1% HIV MTCT risk, and 11.11 intrauterine fetal demises (IUFD)/1000 pregnancies, with significant regional variation. With ideal access, we projected improved outcomes: 1.00 CS cases/1000 LB, 0.10 HIV infections/1000 LB, HIV MTCT risk of 2.4%, and 10.65 IUFD/1000 pregnancies. Increased testing drove the greatest improvements. Even with ideal access, only HIV infections/1000 LB met elimination goals. Achieving all targets required testing and treatment >95% and reductions in prevalence and incidence of HIV and syphilis. Conclusions. Increasing access to care and HIV and syphilis antenatal testing will substantially reduce HIV and syphilis MTCT in Brazil. In addition, regionally tailored interventions reducing syphilis incidence and prevalence and supporting HIV treatment adherence are necessary to completely meet elimination goals. PMID:26180825

  2. Incident syphilis infection among people who inject drugs in Tijuana, Mexico.

    PubMed

    Pines, Heather A; Rusch, Melanie L; Vera, Alicia; Rangel, Gudelia; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2015-12-01

    Given that syphilis is associated with HIV infection among people who inject drugs (PWID), we examined syphilis incidence among PWID in Tijuana, Mexico. From 2006 to 2007, 940 PWID (142 women and 798 men) were recruited via respondent-driven sampling and followed for 18 months. At semi-annual visits, participants were tested for syphilis and completed surveys, which collected information on socio-demographics, sexual behaviours, substance use and injection behaviours. Poisson regression was used to estimate syphilis incidence rates (IRs), incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Twenty-one participants acquired syphilis during follow-up (IR = 1.57 per 100 person-years, 95% CI: 1.02-2.41). In a multivariate analysis, syphilis incidence was higher among women (IRR = 3.90, 95% CI: 1.37-11.09), HIV-positive participants (IRR = 4.60, 95% CI: 1.58-13.39) and those who reported ever exchanging sex for drugs, money, or other goods (IRR = 2.74, 95% CI: 0.97-7.76), while syphilis incidence was lower among those living in Tijuana for a longer duration (IRR = 0.95 per year, 95% CI: 0.91-1.00) and those reporting at least daily injection drug use (past 6 months) (IRR = 0.22, 95% CI: 0.09-0.54). Our findings suggest interventions that address the destabilising conditions associated with migration and integrate sexual and drug-related risk reduction strategies may help reduce syphilis incidence among PWID along the Mexico-US border.

  3. Prevalence of Syphilis among Blood and Stem Cell Donors in Saudi Arabia: An Institutional Experience

    PubMed Central

    Elyamany, Ghaleb; Al amro, Mohamed; Pereira, Winston Costa; Alsuhaibani, Omar

    2016-01-01

    Introduction Syphilis is one of the known transfusion-transmissible infections and causes 100,000 deaths yearly, with around 90% of these deaths occurring in the developing world. Little data is available regarding the prevalence of syphilis among Saudi blood and stem cell donors. We conducted a survey on the incidence of syphilis among all blood and stem cell donors. Methods This study was conducted at the Prince Sultan Military Medical City in Riyadh, Saudi Arabia in the 10 years period data during 2006–2015. Data were analyzed about full history, physical examination, age, sex, weight, profession, marital status, number of the donations, data of last donation, having a relation who received blood transfusion, as well as the screening test results of the donated blood. We determined the seroprevalence of infection and compared by sex and other variable through frequency analysis, Chi square, Fisher, and prevalence ratios. Results Approximately 240,000 blood donors were screened and studied in the period of study. Most of the blood donors were male (98.3%) and 89% of them were citizens of Saudi Arabia. According to our findings, we estimated that, in the last 10 years, approximately 0.044% of all the blood donors were syphilis positive cases. No cases were detected as positive for syphilis among stem cell donors. Only 60 blood donors tested positive for syphilis. In addition, we studied 202 stem cell transplant donors during the same period, of which 59% were male and none texted positive for syphilis. Conclusions A concerted effort between the government, health care providers, regulatory bodies and accreditation agencies have all contributed in eliminating the risk of spreading syphilis among blood donors. PMID:27757184

  4. Herpes simplex virus 2 and syphilis among young drug users in Baltimore, Maryland

    PubMed Central

    Plitt, S; Sherman, S; Strathdee, S; Taha, T

    2005-01-01

    Objectives: To examine the sex specific seroprevalence and correlates of herpes simplex virus 2 (HSV-2) and syphilis among a cohort of young drug users. Methods: Drug users aged 15–30 years old who used heroin, cocaine, or crack were recruited between October 1999 and August 2002. Baseline interviews gathered information on sociodemographics, drug use and sexual behaviours. Serum was tested at baseline for HSV-2 and syphilis seroreactivity. For each sexually transmitted infection (STI), infected and non-infected participants were stratified by sex and compared using χ2, Mann-Whitney tests, and logistic regression. Results: Of the 543 participants recruited, 42.4% were female and 39.3% were African-American. The seroprevalence of STIs among females and males, respectively, were HSV-2: 58.7% and 22.0%; syphilis: 4.3% and 0.3%. In multivariate models, older age, African-American race, having over 30 lifetime sex partners, current HIV infection and previous incarceration were independently associated with HSV-2 infection among males. For females, older age, African-American race, sex trade, and daily heroin use were independently associated with HSV-2. For females, only a self reported previous syphilis diagnosis was associated with current syphilis seroreactivity in multivariate analyses. Conclusions: Examination of this cohort revealed a particularly high seroprevalence of HSV-2 and syphilis, especially among female drug users. Few infected participants had been previously diagnosed with these infections. PMID:15923296

  5. Community Reactions to a Syphilis Prevention Campaign for Gay and Bisexual Men in Los Angeles County

    PubMed Central

    Nanín, José E.; Bimbi, David S.; Grov, Christian; Parsons, Jeffrey T.

    2010-01-01

    “Stop the Sores” (STS), a humor-based syphilis prevention campaign, was implemented in response to increasing syphilis prevalence among gay and bisexual men in Los Angeles County. In 2004, 564 men completed surveys measuring exposure and reactions to the campaign and syphilis testing. Mean age was 39, and men of color comprised a significant proportion of the sample (46.8%). Most men reported being HIV-negative (79.3%). Overall, 7.8% of the sample reported ever having syphilis; HIV-positive men were six times more likely to report this. Over one half of the sample (58.5%) reported exposure to the campaign. Men reporting any recent unprotected anal sex were twice more likely (than those who did not) to see the campaign. Men of color were twice more likely than White men to report wanting to speak to their friends about it. Finally, 39.1% of men exposed to the campaign reported being tested for syphilis as a result. Factors related to higher likelihood to test for syphilis included HIV seropositive status, any recent unprotected anal insertive sex, recent use of methamphetamine, recent use of “poppers,” and recent use of erectile dysfunction drugs. Although STS was somewhat effective, outreach efforts to particular subgroups may need to increase. PMID:19291502

  6. A community level syphilis prevention programme: outcome data from a controlled trial

    PubMed Central

    Ross, M; Chatterjee, N; Leonard, L

    2004-01-01

    Objectives: This study investigated the impact of a small media campaign to reduce syphilis through testing, treatment, and condom use in two urban predominantly African-American communities with high syphilis rates. Methods: Data were collected from intervention and comparison zip codes using cross sectional street intercept interviews at baseline and 2 years later (n = 1630) following a small media syphilis prevention campaign with role model story posters, billboards, and other merchandise. Community businesses and a community based organisation served as partners, distributing condoms and small media. Results: Comparing intervention with comparison zip codes, there were significant increases in condom use in last sexual act, and some aspects of knowledge of syphilis. However, there was significant cross contamination of media impact, with respondents in the comparison zip code seeing an average of two media items compared with three in the intervention zip code. Media exposure was associated with significant increases in knowledge of syphilis, testing, and condom use. Conclusions: Targeted community based small media interventions using community partners for distribution are effective in increasing syphilis knowledge, testing, and condom use. PMID:15054168

  7. Epidemiology of syphilis-related hospitalisations in Spain between 1997 and 2006: a retrospective study

    PubMed Central

    Ariza-Megía, M Carmen; González-Escalada, Alba; Álvaro-Meca, Alejandro; Gil-deMiguel, Ángel; Gil-Prieto, Ruth

    2011-01-01

    Objective In order to illustrate the important public health impact of syphilis, which is a preventable infection, the epidemiology of syphilis-related hospitalisations in Spain was studied over a 10-year period. Methods A retrospective study was conducted using the National Epidemiological Surveillance System for Hospital Data (Minimum Data Set). All hospitalisations due to syphilis infection in any diagnostic position (ICD-9-CM 090–097) between 1997 and 2006 were analysed, according to the Spanish version of the International Classification of Diseases, ninth revision (ICD-9-CM). Results There were 9556 hospitalisations associated with syphilis in Spain. The hospitalisation rate was 2.33 per 100 000 population, the mortality rate was 0.07 per 100 000 population and the lethality was 3.17%. The hospitalisation rate increased significantly after 2000 and was higher in men. Conclusion Syphilis remains a major public health problem because of both potential complications and its close association with HIV infection. It is necessary to promote early diagnosis, ensure treatment in patients with syphilis and emphasise health promotion and prevention programmes. PMID:22080538

  8. Late Neurosyphilis and Tertiary Syphilis in Guangdong Province, China: Results from a Cross-sectional Study

    PubMed Central

    Tang, Weiming; Huang, Shujie; Chen, Lei; Yang, Ligang; Tucker, Joseph D.; Zheng, Heping; Yang, Bin

    2017-01-01

    Due to challenges in diagnosis and the need for complex laboratory tests, misdiagnosis of neurosyphilis and tertiary syphilis is common in China. We validated the diagnosis and examined the treatment of late neurosyphilis and tertiary syphilis in Guangdong Province, China. A cross-sectional study was conducted to collect data from late neurosyphilis and tertiary syphilis cases reported between 2009 and 2014 in Guangdong, China. Descriptive analysis, bivariate analyses and multiple logistic regressions were performed to determine the structural factors associated with correct diagnosis and standard treatment of late neurosyphilis and tertiary syphilis. Among the 3805 respondents (3805/3936, 96.7%), 1,837 (48.3%) met the misdiagnosed criteria. The misdiagnosis rate decreased over the study period (54.2% in 2009 and 41.8% in 2014). Only 27.1% and 24.9% of the correctly diagnosed late neurosyphilis and tertiary syphilis cases received standard treatment, respectively. Multiple logistic regression revealed that departments of dermatology or STDs [aOR = 3.24, 95% CI: 2.66–3.95], county or township level hospitals [aOR = 2.89, 95% CI: 2.14–3.89], and hospitals situated outside of Pearl River Delta area [aOR = 1.70, 95% CI: 1.46–1.97] had higher likelihood in misdiagnosis of neurosyphilis, compared to the reference groups. Targeted trainings for physicians and expanded syphilis screening services are urgently needed. PMID:28338084

  9. Origins of syphilis and management in the immunocompetent patient: facts and controversies.

    PubMed

    Farhi, David; Dupin, Nicolas

    2010-01-01

    Despite the continued efficacy of penicillin since the 1940s, many aspects of the natural history, diagnosis, and management of syphilis remain controversial. A key factor among the numerous factors explaining the persistence of significant areas of controversies is the absence of a gold standard direct method for distinguishing between the different stages of syphilis and appraising treatment response. This contribution presents an overview of some of the most debated aspects of the origins, diagnosis, and management of syphilis in immunocompetent patients. The two main current hypotheses on the origins of Treponema pallidum are the "Columbian" and the "Pre-Columbian" hypotheses. Strong evidence supports that Columbus' crew brought T pallidum to Europe at the time of discovery of the New World. Because T pallidum culture and inoculation to animals are not readily available methods, the gold standard method for the diagnosis of syphilis is the direct identification of T pallidum by dark field microscopy or direct fluorescent antibody tests. These methods, however, are inapplicable in many patients, and thus the diagnosis of syphilis is usually based on the clinical and serologic picture. Serologic tests should only be considered as surrogate markers of the disease and do not provide definite distinction between syphilis stages. The optimal combination of serologic tests is still undefined. Other areas of controversy include the identification of patients who would benefit from a lumbar puncture, the diagnostic criteria of neurosyphilis, and the most relevant markers of treatment response.

  10. Incidence of syphilis, active component, U.S. Armed Forces, 1 January 2010 through 31 August 2015.

    PubMed

    Clark, Leslie L; Hunt, Devin J

    2015-09-01

    In 2014,the Centers for Disease Control and Prevention reported significant increases in cases of primary and secondary syphilis in the U.S.; among beneficiaries of the Military Health System, monthly surveillance reports tracking reportable medical events of syphilis have reflected similar increases. This analysis reports on incident cases and rates of syphilis among active component service members of the U.S. Armed Forces from 1 January 2010 through 31 August 2015. During the surveillance period, 2,976 cases of syphilis were diagnosed. Crude incidence rates increased from 30.9 cases per 100,000 person-years (p-yrs) in 2010 to 47.4 cases per 100,000 p-yrs in 2015. Males accounted for 88.7% of cases. Incidence rates of syphilis were highest among service members who were black, non-Hispanic or who were aged 20-29 years. About one-quarter of syphilis cases (24.4%; 727 cases) were diagnosed as HIV infected. Primary and secondary syphilis cases comprised 42% of all syphilis cases. Increasing rates of primary and secondary syphilis in active component service members reflect similar trends reported in the U.S. civilian population.

  11. A review and update on adult syphilis, with particular reference to its treatment.

    PubMed

    Goldmeier, D; Hay, P

    1993-01-01

    Syphilis has become less common in Europe in the last decade, but has once again become a major problem in the USA, and remains so in many developing countries. Several treponemal genes have now been cloned and expressed in Escherichia coli, allowing study of treponemal proteins. The importance of cell mediated immunity in syphilis has been demonstrated in animal models. A diagnosis of syphilis is usually confirmed by dark-field microscopy or serological tests. Seroconversion may be delayed in HIV infected individuals. A positive reaginic test in cerebrospinal fluid (CSF) has a high specificity but low sensitivity in the diagnosis of neurosyphilis. Indeed, virulent treponemes can be identified in CSF samples which have negative reaginic tests, normal cell counts and protein levels. In the CSF, the FTA-Abs test has a high sensitivity but low specificity for neurosyphilis. Penicillin remains the treatment of choice for all stages of syphilis, although it penetrates the blood brain barrier poorly. Treatment with intramuscular benzathine penicillin 2.4 million units stat, or 600,000 units procaine penicillin daily does not produce treponemicidal levels within the CSF. However, the incidence of neurosyphilis is low in immunocompetent patients treated with such regimens during early syphilis. Acceptable alternatives in penicillin-allergic patients include ceftriaxone and doxycycline. Erythromycin is not recommended as it has produced unacceptably high rates of treatment failure. Recently, a strain of macrolide-resistant Treponema pallidum was isolated from a patient with secondary syphilis. For the treatment of neurosyphilis, treponemicidal levels of penicillin can be achieved in the CSF using 2.4 million units procaine penicillin daily with concurrent probenecid 500 mg 4 times a day, or an intravenous infusion of benzyl penicillin 12-24 million units daily. Early syphilis can be treated adequately over 10 days, but 21 to 28 days is appropriate for late syphilis. In HIV

  12. Human immunodeficiency virus-positive secondary syphilis mimicking cutaneous T-cell lymphoma.

    PubMed

    Yamashita, Michiko; Fujii, Yoshiyuki; Ozaki, Keiji; Urano, Yoshio; Iwasa, Masami; Nakamura, Shingen; Fujii, Shiro; Abe, Masahiro; Sato, Yasuharu; Yoshino, Tadashi

    2015-10-08

    Malignant syphilis or lues maligna is a severe form of secondary syphilis that was commonly reported in the pre-antibiotic era, and has now reemerged with the advent of the human immunodeficiency virus (HIV) epidemic. However, the characteristic histopathological findings of malignant syphilis remain controversial. The aim of this case report was to clarify the clinical and histopathological findings of HIV-positive malignant secondary syphilis. A Japanese man in his forties complained of fever, skin lesions, headache, and myalgia without lymphadenopathy during the previous 4 weeks. The skin lesions manifested as erythematous, nonhealing, ulcerated papules scattered on his trunk, extremities, palm, and face. Although the skin lesions were suspected to be cutaneous T-cell lymphomas on histological analyses, they lacked T-cell receptor Jγ rearrangement; moreover, immunohistochemical analyses confirmed the presence of spirochetes. The patient was administered antibiotics and anti-retroviral therapy, which dramatically improved the symptoms. On the basis of these observations of the skin lesions, we finally diagnosed the patient with HIV-associated secondary syphilis that mimicked cutaneous T-cell lymphoma. The patient's systemic CD4+ lymphocyte count was very low, and the infiltrate was almost exclusively composed of CD8+ atypical lymphocytes; therefore, the condition was easily misdiagnosed as cutaneous lymphoma. Although the abundance of plasma cells is a good indicator of malignant syphilis on skin histological analyses, in some cases, the plasma cell count may be very low. Therefore, a diagnosis of malignant secondary syphilis should be considered before making a diagnosis of primary cutaneous peripheral T-cell lymphoma or lymphoma associated with HIV infection.

  13. Performance of routine syphilis serology in the Ethiopian cohort on HIV/AIDS

    PubMed Central

    Dorigo-Zetsma, J; Belewu, D; Meless, H; Sanders, E; Coutinho, R; Schaap, A; Wolday, D

    2004-01-01

    Objectives: To assess the performance of routine syphilis screening during 5 year follow up of Ethiopian factory workers, participating in a cohort study on HIV/AIDS. Methods: Syphilis serology test results of factory workers, who each donated at least six blood samples were evaluated. Screening in 1997–8 had been performed by the Treponema pallidum particle agglutination (TPPA) assay and in 1999–2001 by the rapid plasma reagin (RPR) test. TPPA had been followed by RPR or RPR by TPPA, in case of a positive screening result. Samples of study subjects showing inconsistent sequential TPPA and/or RPR results were retested independently by three laboratory technicians. Results: A total of 540 cohort participants (8.3% HIV positive at enrolment) donated 4376 blood samples (mean 8.3 per subject). From 93 of the 176 participants with at least one positive TPPA result during follow up, 152 samples were retested by RPR and/or TPPA. Based on the revised syphilis test results, the 540 cohort participants were classified as having no (70.5%), past (20.6%), prevalent (6.9%), or incident (2.0%) syphilis. The RPR screening test was difficult to interpret and yielded 8.2% biological false positive (BFP) RPR results, or 3.2% if weak positive results were excluded. There was no correlation between HIV infection and BFP RPR reactions. Sample mix-ups were detected in 1.2%. Conclusion: Evaluation of routine syphilis screening as performed in a long term cohort study on HIV/AIDS in Ethiopia showed difficulties encountered in syphilis screening programmes such as a high percentage of BFP RPR, inconsistencies in interpretation of the RPR test, and sample mix ups. The findings stress the need to develop a syphilis screening assay that is easy to perform and interpret and to implement quality assurance programmes. PMID:15054167

  14. Sexual risk behaviors, HIV, and syphilis among female sex workers in Nepal

    PubMed Central

    Kakchapati, Sampurna; Singh, Dipendra Raman; Rawal, Bir Bahadhur; Lim, Apiradee

    2017-01-01

    Purpose Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it. Materials and methods The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome. Results A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV. Conclusion HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs. PMID:28184170

  15. The effects of early syphilis on CD4 counts and HIV-1 RNA viral loads in blood and semen

    PubMed Central

    Sadiq, S; McSorley, J; Copas, A; Bennett, J; Edwards, S; Kaye, S; Kirk, S; French, P; Weller, I

    2005-01-01

    Objective: To examine the effect of early syphilis on blood and semen plasma HIV-1 viral loads and CD4 counts. Methods: In a retrospective case-control study, blood plasma HIV-1 viral loads and CD4 counts in cases during early syphilis (n = 63, 27 receiving antiretroviral therapy) were compared to those before and after syphilis and with controls with non-systemic acute sexually transmitted infections (STI) (n = 104, 39 receiving antiretroviral therapy). In a prospective substudy in those not receiving antiretroviral therapy, semen plasma viral loads during early syphilis (n = 13) were compared with those 1 month, 3 months, and 6 months after treatment for syphilis and with controls with no STIs (n = 20). Results: Retrospective study: CD4 counts were similar in cases (median 410, n = 139 counts) during early syphilis compared to before (485, n = 80) and after (475, n = 88). In a secondary analysis, a drop in CD4 count (21%) among those with early latent syphilis was observed compared with controls. Blood plasma viral loads did not change significantly overall or in those with primary, secondary, or early latent syphilis. Effects were similar on or off antiretroviral therapy. Prospective study: blood and semen viral loads were slightly higher in cases compared with controls but treatment of early syphilis did not reduce either. Conclusions: We detected no association between early syphilis and changes in blood or semen viral load or CD4 count. Increased HIV-1 infectivity associated with early syphilis is unlikely to be associated with increased levels of HIV-1 RNA in blood or semen. PMID:16199736

  16. Predictors of Serological Cure and Serofast State After Treatment in HIV-Negative Persons With Early Syphilis

    PubMed Central

    Seña, Arlene C.; Wolff, Mark; Martin, David H.; Behets, Frieda; Van Damme, Kathleen; Leone, Peter; Langley, Carol; McNeil, Linda; Hook, Edward W.

    2011-01-01

    Background. Syphilis management requires serological monitoring after therapy. We compared factors associated with serological response after treatment of early (ie, primary, secondary, or early latent) syphilis. Methods. We performed secondary analyses of data from a prospective, randomized syphilis trial conducted in the United States and Madagascar. Human immunodeficiency virus (HIV)–negative participants aged ≥18 years with early syphilis were enrolled from 2000–2009. Serological testing was performed at baseline and at 3 and 6 months after treatment. At 6 months, serological cure was defined as a negative rapid plasma reagin (RPR) test or a ≥4-fold decreased titer, and serofast status was defined as a ≤2-fold decreased titer or persistent titers that did not meet criteria for treatment failure. Results. Data were available from 465 participants, of whom 369 (79%) achieved serological cure and 96 (21%) were serofast. In bivariate analysis, serological cure was associated with younger age, fewer sex partners, higher baseline RPR titers, and earlier syphilis stage (P ≤ .008). There was a less significant association with Jarisch-Herxheimer reaction after treatment (P = .08). Multivariate analysis revealed interactions between log-transformed baseline titer with syphilis stage, in which the likelihood of cure was associated with increased titers among participants with primary syphilis (adjusted odds ratio [AOR] for 1 unit change in log2 titer, 1.83; 95% confidence interval [CI], 1.25–2.70), secondary syphilis (AOR, 3.15; 95% CI, 2.14–4.65), and early latent syphilis (AOR, 1.86; 95% CI, 1.44–2.40). Conclusions. Serological cure at 6 months after early syphilis treatment is associated with age, number of sex partners, Jarisch-Herxheimer reaction, and an interaction between syphilis stage and baseline RPR titer. PMID:21998287

  17. Recent Syphilis Infection Prevalence and Risk Factors Among Male Low-Income Populations in Coastal Peruvian Cities

    PubMed Central

    Snowden, Jonathan M.; Konda, Kelika A.; Leon, Segundo R.; Giron, Jessica M.; Escobar, Guadalupe; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2010-01-01

    Background The objective of this study was to examine the epidemiology of syphilis among high-risk socially marginalized populations in urban, coastal Peru, to quantify the prevalence of recent syphilis infection and identify risk factors. Methods Survey data and serologic specimens were collected from a population-based sample of 3 populations: men who have sex with only men (MSOM), socially marginalized heterosexual men, and socially marginalized women. Syphilis prevalence was determined for each population, and multivariate analysis was used to analyze risk factors for recent syphilis infection among the MSOM and among the socially marginalized men. Results The prevalence of recent syphilis infection was 10.5% among the MSOM, 1.5% among the socially marginalized men, and 2.0% among the women. Among both MSOM and the socially marginalized men, recent syphilis infection was significantly associated with Herpes simplex virus Type 2 infection (prevalence ratio = 1.96; 95% confidence interval, 1.03–3.74, and PR = 3.72; 95% CI, 2.12–6.53, respectively). Recent syphilis infection was also significantly associated with HIV infection among the socially marginalized men (PR = 11.13; 95% CI, 4.50 –27.51) and with the number of sexually active years among the MSOM (PR = 1.05, 95% CI, 1.01–1.10). Conclusions All 3 groups included in this study exhibited a high prevalence of recent syphilis infection, with recent infection being most prevalent among the MSOM. These findings demonstrate the need for more effective syphilis control services among those populations, to decrease syphilis-associated morbidity, transmission of syphilis, and the potential transmission of HIV. PMID:19940809

  18. Misrepresentations of the Tuskegee Study of Untreated Syphilis.

    PubMed Central

    White, Robert M.

    2005-01-01

    The Tuskegee Study of Untreated Syphilis (TSUS) is the subject of medical research, healthcare, ethics, race relations and fictitious media portrayals (e.g., movie, play). Unraveling misrepresentations about the TSUS is important because prevailing views continue to contribute to alleged mistrust of the medical system by the black community and compromised doctor-patient and researcher-participant relationships. A comparative analysis of standard TSUS information was conducted and included evidenced-based alternative information in an effort to: (a) contextualize the TSUS with accurate medical, public health and historical information and (b) balance claims of racism, nontreatment and denial of treatment. An article in the Winter 2003 Radcliffe Quarterly misrepresented the images of two historical African-American health institutions, the John A. Andrew Memorial Hospital and the Tuskegee Veterans Administration Hospital. A critical analysis challenges these pictorial misrepresentations and documents, in part, a continuing and prevailing pattern of biased misrepresentations in discussions about the TSUS. The National Medical Association (NMA) and the Journal of the National Medical Association have a history of advocacy for African-American health, a record of combating racial discrimination and a quest for truth about the status of the black community. As past NMA historical notables have performed through their advancement, service and leadership, health professionals now have the opportunity, obligation and information to educate the American community about the TSUS with evidenced-based information. Images Figure 2 Figure 3 Figure 4 Figure 5 p581-a PMID:15868777

  19. Misrepresentations of the Tuskegee Study of Untreated Syphilis.

    PubMed

    White, Robert M

    2005-04-01

    The Tuskegee Study of Untreated Syphilis (TSUS) is the subject of medical research, healthcare, ethics, race relations and fictitious media portrayals (e.g., movie, play). Unraveling misrepresentations about the TSUS is important because prevailing views continue to contribute to alleged mistrust of the medical system by the black community and compromised doctor-patient and researcher-participant relationships. A comparative analysis of standard TSUS information was conducted and included evidenced-based alternative information in an effort to: (a) contextualize the TSUS with accurate medical, public health and historical information and (b) balance claims of racism, nontreatment and denial of treatment. An article in the Winter 2003 Radcliffe Quarterly misrepresented the images of two historical African-American health institutions, the John A. Andrew Memorial Hospital and the Tuskegee Veterans Administration Hospital. A critical analysis challenges these pictorial misrepresentations and documents, in part, a continuing and prevailing pattern of biased misrepresentations in discussions about the TSUS. The National Medical Association (NMA) and the Journal of the National Medical Association have a history of advocacy for African-American health, a record of combating racial discrimination and a quest for truth about the status of the black community. As past NMA historical notables have performed through their advancement, service and leadership, health professionals now have the opportunity, obligation and information to educate the American community about the TSUS with evidenced-based information.

  20. Immune Evasion and Recognition of the Syphilis Spirochete in Blood and Skin of Secondary Syphilis Patients: Two Immunologically Distinct Compartments

    PubMed Central

    Cruz, Adriana R.; Ramirez, Lady G.; Zuluaga, Ana V.; Pillay, Allan; Abreu, Christine; Valencia, Carlos A.; La Vake, Carson; Cervantes, Jorge L.; Dunham-Ems, Star; Cartun, Richard; Mavilio, Domenico; Radolf, Justin D.; Salazar, Juan C.

    2012-01-01

    Background The clinical syndrome associated with secondary syphilis (SS) reflects the propensity of Treponema pallidum (Tp) to escape immune recognition while simultaneously inducing inflammation. Methods To better understand the duality of immune evasion and immune recognition in human syphilis, herein we used a combination of flow cytometry, immunohistochemistry (IHC), and transcriptional profiling to study the immune response in the blood and skin of 27 HIV(-) SS patients in relation to spirochetal burdens. Ex vivo opsonophagocytosis assays using human syphilitic sera (HSS) were performed to model spirochete-monocyte/macrophage interactions in vivo. Results Despite the presence of low-level spirochetemia, as well as immunophenotypic changes suggestive of monocyte activation, we did not detect systemic cytokine production. SS subjects had substantial decreases in circulating DCs and in IFNγ-producing and cytotoxic NK-cells, along with an emergent CD56−/CD16+ NK-cell subset in blood. Skin lesions, which had visible Tp by IHC and substantial amounts of Tp-DNA, had large numbers of macrophages (CD68+), a relative increase in CD8+ T-cells over CD4+ T-cells and were enriched for CD56+ NK-cells. Skin lesions contained transcripts for cytokines (IFN-γ, TNF-α), chemokines (CCL2, CXCL10), macrophage and DC activation markers (CD40, CD86), Fc-mediated phagocytosis receptors (FcγRI, FcγR3), IFN-β and effector molecules associated with CD8 and NK-cell cytotoxic responses. While HSS promoted uptake of Tp in conjunction with monocyte activation, most spirochetes were not internalized. Conclusions Our findings support the importance of macrophage driven opsonophagocytosis and cell mediated immunity in treponemal clearance, while suggesting that the balance between phagocytic uptake and evasion is influenced by the relative burdens of bacteria in blood and skin and the presence of Tp subpopulations with differential capacities for binding opsonic antibodies. They also

  1. The Great Impostor: Transaminitis Masking the Coinfection of Syphilis and Human Immunodeficiency Virus

    PubMed Central

    Capatina-Rata, Ana

    2017-01-01

    Introduction. The incidence of syphilis continues to rise in the United States over the past 15 years. This disease process is classified into stages and may present with a coinfection of Human Immunodeficiency Virus (HIV). Case Report. We present a case of a 32-year-old African American male who presented with cutaneous manifestations of secondary syphilis and transaminitis. A workup revealed that the transaminitis was secondary to underlying syphilitic hepatitis in the presence of HIV coinfection. The patient had a reactive rapid plasma reagin (RPR) of 1 : 64 TU and reactive Treponema pallidum particle agglutination assay (TPPA). Lab findings showed alkaline phosphate (ALP) of 648 unit/L, aspartate aminotransferase (AST) of 251 unit/L, and alanine aminotransferase (ALT) of 409 unit/L. Conclusion. Syphilitic hepatitis is a recognized entity in the medical literature. It is a manifestation of secondary syphilis and it is more commonly seen in coinfected patients with both syphilis and HIV. Therefore, primary care physicians should keep infectious etiologies (e.g., syphilis and HIV) in the differential diagnosis of patients who present with unexplained liver dysfunction in a cholestatic pattern.

  2. Prevalence of anaemia, syphilis and hepatitis B in pregnant women in Nausori, Fiji

    PubMed Central

    Tayler-Smith, K.; Khogali, M.; Marks, G. B.

    2013-01-01

    Setting: An antenatal clinic serving a population of 47 604 in Nausori, Fiji. Objective: 1) To estimate the prevalence of anaemia, syphilis and hepatitis B in pregnant women attending their first antenatal visit; and 2) to estimate the uptake of treatment for syphilis and for the prevention of hepatitis B transmission in affected individuals. Design: Retrospective review of the clinic register and patient records for the year 2011. Results: The prevalence of anaemia, hepatitis B and syphilis were respectively 22%, 2% and 5%. Among women with syphilis, 78% of those for whom data were available received a complete course of three doses of penicillin during their pregnancy, and 83% of babies born to women with hepatitis B received hepatitis B immunoglobulin. Conclusion: The prevalence of anaemia in pregnant women has declined but remains high, and further research is required to identify the major causes of this condition in Fiji. The prevalence of syphilis has remained static, while hepatitis B has decreased over the past decade. There are some gaps in the implementation of effective interventions to manage these conditions in pregnant women. PMID:26393000

  3. Feasibility of one-stop antenatal syphilis screening in Ulaanbaatar, Mongolia: women and providers perspectives.

    PubMed

    Munkhuu, Bayalag; Liabsuetrakul, Tippawan; McNeil, Edward; Janchiv, Radnaabazar

    2009-07-01

    Congenital syphilis can be prevented by antenatal syphilis screening, however, the complexity of delivering prenatal service can result in low screening rates, and thus lower prevention and treatment rates. One-stop antenatal syphilis screening, which includes rapid testing and treatment, is the proposed method to overcome this problem. The feasibility of this type of screening needs to be tested to dertermine its effectiveness. In this study, the opinions and level of satisfaction of women undergoing antenatal care and their health care providers regarding a one-stop syphylis screening and treatment service at two antenatal clinics in Ulaanbaatar, Mongolia were assessed. The majority of the 246 women studied were satisfied with the service. The mean aggregate satisfaction score derived from 12 questions regarding specific aspects of satisfaction was 3.2. Most providers were also satisfied, not reporting any significant problems interfering with routine antenatal care. However, all providers felt the one-stop service is time consuming and leads to high staff workloads and needs good clinical management. The provider preferred instead to treat husbands presumptively to avoid the possibility of diagnosing couples with discordant syphilis, which could lead to possible violence. A one-stop syphilis diagnosis and treatment service during antenatal care is feasible in Ulaanbaatar, Mongolia from both the women's and providers' perspectives.

  4. Serological Response to Treatment of Syphilis with Doxycycline Compared with Penicillin in HIV-infected Individuals.

    PubMed

    Salado-Rasmussen, Kirsten; Hoffmann, Steen; Cowan, Susan; Jensen, Jørgen Skov; Benfield, Thomas; Gerstoft, Jan; Katzenstein, Terese Lea

    2016-08-23

    Serological response to treatment of syphilis with orally administered doxycycline or intramuscularly administered penicillin was assessed in patients with concurrent HIV. All HIV-infected individuals diagnosed with syphilis attending 3 hospitals in Copenhagen, Denmark were included. Odds ratios (ORs) with 95% confidence intervals (CI) associated with serological outcome were modelled using propensity-score-adjusted logistic regression analysis. In total, 202 cases were treated with doxycycline or intramuscular penicillin. At 12 months, serological failure was observed in 12 cases (15%) treated with doxycycline and in 8 cases (17%) treated with penicillin (OR 0.78 (95% CI 0.16-3.88), p = 0.76). The serological cure rate at 12 months was highest in patients with primary syphilis (100%), followed by patients with secondary (89%), early latent (71%) and late latent (67%) syphilis (p = 0.006). In conclusion, this study provides evidence for the use of doxycycline as a treatment option when treating a HIV-infected population for syphilis.

  5. Rash and hepatitis within days of starting a new antiretroviral regimen: nevirapine hypersensitivity, secondary syphilis or both?

    PubMed

    Saxon, Cara J; Helbert, Matthew R; Komolafe, Adeniyi J; Higgins, Stephen P

    2014-03-01

    We report a case in which an HIV-positive man developed general malaise, skin rash and biochemical hepatitis within days of starting a nevirapine-based antiretroviral treatment regimen. At the same time, his syphilis serology proved positive. We discuss the diagnostic dilemma: was this a nevirapine hypersensitivity reaction, secondary syphilis or both?

  6. State of the art syphilis diagnostics: rapid point-of-care tests.

    PubMed

    Kay, Natasha S; Peeling, Rosanna W; Mabey, David C

    2014-01-01

    Syphilis remains an important and entirely preventable cause of stillbirth and neonatal mortality. More than 1 million women with active syphilis become pregnant each year. Without treatment, 25% of them will deliver a stillborn baby, 33% will deliver a live low-birth weight baby with an increased chance of dying in the first month of life. Adverse pregnancy outcomes due to syphilis can be prevented by screening pregnant women, and treating those who test positive with a single dose of penicillin before 28 weeks gestation. Until recently access to screening in low- and middle-income countries has been limited, since screening tests have been laboratory based, requiring equipment, electricity and trained laboratory staff. Now a number of rapid, cheap, simple and accurate screening tests are available and can give a result in 15-20 min, enabling those who require treatment to be treated at their first visit.

  7. The Science behind Pre-Columbian Evidence of Syphilis in Europe: Research by Documentary

    PubMed Central

    Armelagos, George J.; Zuckerman, Molly K.; Harper, Kristin N.

    2012-01-01

    This article discusses the presentation of scientific finding via documentary and absent the process of peer-review. We use, as an example, PBS’s Syphilis Enigma, in which researchers presented novel evidence concerning the origin of syphilis that had never been reviewed by other scientists. These “findings” then entered the world of peer-reviewed literature through citations of the documentary itself or material associated with the documentary. Here, we demonstrate that the case for pre-Columbian syphilis in Europe that was made in the documentary does not withstand scientific scrutiny. We also situate this example from paleopathology within a larger trend of “science by documentary” or “science by press conference,” in which researchers seek to bypass the peer review process by presenting unvetted findings directly to the public. PMID:22499439

  8. A rare case of immune reconstitution inflammatory syndrome presenting as secondary syphilis.

    PubMed

    Khatri, Asma; Skalweit, Marion J

    2015-09-01

    Immune reconstitution syndrome has rarely been reported in the context of syphilis infection. We report a patient with AIDS (CD4 42 cells/mm(3), viral load 344,000 cp/ml), treated previously for secondary syphilis and started on an integrase inhibitor-based single-tablet antiretroviral treatment regimen. After four weeks of antiretroviral treatment, he presented with non-tender, non-blanching erythematous nodules on his chest, an elevated rapid plasma reagin (1:1024) and immune reconstitution (CD4 154 cells/mm(3), HIV-RNA 130 cp/ml). A detailed workup to exclude opportunistic infections including secondary and neurosyphilis was performed. The patient was continued on antiretroviral treatment and treated empirically for neurosyphilis given cerebrospinal lymphocytosis and dermatopathology suggesting treponemal antigen-driven B-cell hyperplasia. We favour a diagnosis of immune reconstitution in association with prior syphilis infection attributable to rapid and potent immune restoration afforded by integrase inhibitors.

  9. Facebook-augmented partner notification in a cluster of syphilis cases in Milwaukee.

    PubMed

    Hunter, Paul; Oyervides, Otilio; Grande, Katarina M; Prater, Daphne; Vann, Vannessa; Reitl, Irmine; Biedrzycki, Paul A

    2014-01-01

    Public health professionals face many challenges in infectious disease cluster case identification and partner notification (PN), especially in populations using social media as a primary communication venue. We present a method using Facebook and social network diagram illustration to identify, link, and notify individuals in a cluster of syphilis cases in young black men who have sex with men (MSM). Use of Facebook was crucial in identifying two of 55 individuals with syphilis, and the cooperation of socially connected individuals with traditional PN methods yielded a high number of contacts per case. Integration of PN services for HIV and sexually transmitted diseases, as well as collaboration between the city and state information systems, assisted in the cluster investigation. Given that rates of syphilis and HIV infection are increasing significantly in young African American MSM, the use of social media can provide an additional avenue to facilitate case identification and notification.

  10. Detection of immunoglobulin M in cerebrospinal fluid from syphilis patients by enzyme-linked immunosorbent assay.

    PubMed Central

    Lee, J B; Farshy, C E; Hunter, E F; Hambie, E A; Wobig, G H; Larsen, S A

    1986-01-01

    Cerebrospinal fluid (CSF) samples were evaluated in an immunoglobulin M enzyme-linked immunosorbent assay (IgM ELISA) for syphilis with sonic extracts of Treponema pallidum coated on polystyrene plates. The ELISA procedure was reproducible, and T. pallidum antigens were stable., A total of 15 CSF samples from patients with neurosyphilis, 18 CSF samples from patients with syphilis, 12 CSF samples from patients treated for syphilis, and 494 CSF samples from patients with neurologic or other systemic diseases were tested. The IgM ELISA gave reactive results in all of six symptomatic and congenital neurosyphilitic patients and none of nine asymptomatic neurosyphilitic patients. Of 524 CSF samples from nonneurosyphilitic individuals, 513 were nonreactive, resulting in 98% test specificity. The IgM ELISA in CSF should prove to be useful for confirmation of symptomatic neurosyphilis. PMID:3533984

  11. A case of secondary syphilis with mucous patches on the hard palate.

    PubMed

    Ban, M; Ohtani, M; Seishima, M

    1995-01-01

    A rare case of secondary syphilis showing mucous patches on the hard palate is reported. A 31-year-old male had two erosive patches which were slightly raised on his hard palate. A linear lesion was also present on the inside of his right alveolar process. Many red-brown macules on his abdomen and bilateral inguinal lymphadenopathy accompanied these symptoms. The serological tests for syphilis were positive: VDRL test 1:512, TPHA test 1:20,480, and IgM-FTA-ABS test 1:40. Immunohistochemical staining with rabbit monoclonal antibody to Treponema pallidum by the biotin-streptoavidin system detected treponemal organisms in the paraffin-embedded specimen from his mucous patch. A diagnosis of secondary syphilis was made, and he was given amoxicillin (AMPC) at 750 mg per day for 4 weeks. His eruptions, including the mucous patch, healed in a week.

  12. Awareness of the Tuskegee syphilis study: impact on offenders' decisions to decline research participation.

    PubMed

    Poythress, Norman; Epstein, Monica; Stiles, Paul; Edens, John F

    2011-01-01

    Ethnic and racial minorities are often under-represented in research. There is considerable speculation that Blacks, in particular, are discouraged from research participation because of researcher improprieties in the U.S. Public Health Service (USPHS) Syphilis Study at Tuskegee (aka the Tuskegee Syphilis Study [TSS]), a 40-year (1932-1972) study in which investigators withheld medical treatment from African-American men infected with syphilis. We debriefed 281 offenders who declined participation in a research study to assess the extent to which knowledge of the TSS impacted their decisions not to enroll. Relatively few (44/281; 15.6%) reported awareness of the TSS. Half (n = 22) of these "aware" individuals could cite factually accurate information about the TSS, and only four individuals indicated that awareness of TSS had "somewhat" influenced their decision to not participate. Findings suggest that the legacy of the TSS played a relatively minor role in these offenders' decisions to decline research participation.

  13. Syphilis may be a confounding factor, not a causative agent, in syphilitic ALS.

    PubMed

    Tuk, Bert

    2016-01-01

    Based upon a review of published clinical observations regarding syphilitic amyotrophic lateral sclerosis (ALS), I hypothesize that syphilis is actually a confounding factor, not a causative factor, in syphilitic ALS. Moreover, I propose that the successful treatment of ALS symptoms in patients with syphilitic ALS using penicillin G and hydrocortisone is an indirect consequence of the treatment regimen and is not due to the treatment of syphilis. Specifically, I propose that the observed effect is due to the various pharmacological activities of penicillin G ( e.g., a GABA receptor antagonist) and/or the multifaceted pharmacological activity of hydrocortisone. The notion that syphilis may be a confounding factor in syphilitic ALS is highly relevant, as it suggests that treating ALS patients with penicillin G and hydrocortisone-regardless of whether they present with syphilitic ALS or non-syphilitic ALS-may be effective at treating this rapidly progressive, highly devastating disease.

  14. HIV and Syphilis Infection among Men attending a Sexually Transmitted Infection Clinic in Puerto Rico

    PubMed Central

    Colón-López, Vivian; Ortiz, Ana P.; Banerjee, Geetanjoli; Gertz, Alida M.; García, Hermes

    2013-01-01

    Objective This study aimed to assess the demographic, behavioral, and clinical factors associated with HIV and syphilis infection among a sample of men attending a sexually transmitted infection clinic during 2009 to 2010 in San Juan, Puerto Rico (PR). Methods A sample of 350 clinical records from men visiting the clinic for the first time during 2009 to 2010 was reviewed. Descriptive statistics were used to describe the study sample, and bivariate analyses were performed separately for HIV and syphilis to identify factors associated with these infectious diseases. Variables that were significantly associated (p<0.05) with HIV and syphilis in the bivariate analysis were considered for inclusion in the logistic regression models. Results Overall, 11.2% and 14.1% of the men were infected with HIV and syphilis, respectively, and 5.1% were coinfected with HIV and syphilis. In multivariate logistic regression models, ever injecting drugs (POR = 8.1; 95%Cl 3.0, 21.8) and being a man who has sex with men (MSM) (POR = 5.3; 95%CI 2.3, 11.9) were positively associated with HIV infection. Being a man older than 45 years (POR = 4.0; 95%CI: 1.9, 8.9) and being an MSM (POR = 2.5; 95%CI: 1.3, 4.9) were both significantly associated with syphilis infection. Conclusion These findings reinforce the need for greater education and prevention efforts for HIV and other STIs among men in PR, particularly those who are MSM. However, there is a need to make an a priori assessment of the level of health literacy in the members of this group so that a culturally sensitive intervention can be provided to the men who attend this STI clinic. PMID:23556260

  15. Clinical prediction and diagnosis of neurosyphilis in HIV-infected patients with early Syphilis.

    PubMed

    Dumaresq, Jeannot; Langevin, Stéphanie; Gagnon, Simon; Serhir, Bouchra; Deligne, Benoît; Tremblay, Cécile; Tsang, Raymond S W; Fortin, Claude; Coutlée, François; Roger, Michel

    2013-12-01

    The diagnosis of neurosyphilis (NS) is a challenge, especially in HIV-infected patients, and the criteria for deciding when to perform a lumbar puncture (LP) in HIV-infected patients with syphilis are controversial. We retrospectively reviewed demographic, clinical, and laboratory data from 122 cases of HIV-infected patients with documented early syphilis who underwent an LP to rule out NS, and we evaluated 3 laboratory-developed validated real-time PCR assays, the Treponema pallidum particle agglutination (TPPA) assay, the fluorescent treponemal antibody absorption (FTA-ABS) assay, and the line immunoassay INNO-LIA Syphilis, for the diagnosis of NS from cerebrospinal fluid (CSF) samples of these patients. NS was defined by a reactive CSF-VDRL test result and/or a CSF white blood cell (WBC) count of >20 cells/μl. Thirty of the 122 patients (24.6%) had early NS. Headache, visual symptoms, a CD4 cell count of <500 cells/μl, and viremia, as defined by an HIV-1 RNA count of ≥50 copies/ml, were associated with NS in multivariate analysis (P = <0.001 for each factor). Blood serum rapid plasma reagin (RPR) titers were not associated with early NS (P = 0.575). For the diagnosis of NS, the PCR, FTA-ABS, TPPA, and INNO-LIA assays had sensitivities of 58%, 100%, 68%, and 100%, specificities of 67%, 12%, 49%, and 13%, and negative predictive values of 85%, 100%, 84%, and 100%, respectively. Visual disturbances, headache, uncontrolled HIV-1 viremia, and a CD4 cell count of <500 cells/μl were predictors of NS in HIV-infected patients with early syphilis, while blood serum RPR titers were not; therefore, RPR titers should not be used as the sole criterion for deciding whether to perform an LP in early syphilis. When applied to CSF samples, the INNO-LIA Syphilis assay easily helped rule out NS.

  16. State-Specific Rates of Primary and Secondary Syphilis Among Men Who Have Sex with Men - United States, 2015.

    PubMed

    de Voux, Alex; Kidd, Sarah; Grey, Jeremy A; Rosenberg, Eli S; Gift, Thomas L; Weinstock, Hillard; Bernstein, Kyle T

    2017-04-07

    In 2015, the rate of reported primary and secondary syphilis in the United States was 7.5 cases per 100,000 population, nearly four times the previous lowest documented rate of 2.1 in 2000 (1). In 2015, 81.7% of male primary and secondary syphilis cases with information on the sex of the sex partner were among gay, bisexual, and other men who have sex with men (collectively referred to as MSM) (1). These data suggest a disproportionate incidence of disease among MSM. However, attempts to quantify this disparity have been hindered by limited data on the size of the MSM population at the state level. To produce the first estimates of state-specific rates of primary and secondary syphilis among MSM, CDC used MSM population estimates based on a new methodology (2) and primary and secondary syphilis case counts reported in 2015 to the National Notifiable Diseases Surveillance System. Among 44 states reporting information on the sex of sex partners for ≥70% of male cases, the overall rate of primary and secondary syphilis among all men (aged ≥18 years) in the United States in 2015 was 17.5 per 100,000, compared with 309.0 among MSM and 2.9 among men who reported sex with women only. The overall rate of primary and secondary syphilis among MSM was 106.0 times the rate among men who have sex with women only and 167.5 times the rate among women.* These data highlight the disproportionate impact of syphilis among MSM and underscore the need for innovative and targeted syphilis prevention measures at the state and local level, especially among MSM. It is important that health care providers recognize the signs and symptoms of syphilis, screen sexually active MSM for syphilis at least annually, and provide timely treatment according to national sexually transmitted diseases treatment guidelines (3).

  17. Three cases of ocular syphilis and the resurgence of the disease in Queensland

    PubMed Central

    Sara, Sergio A; McAllister, Andrew S

    2016-01-01

    The past few years has seen a resurgence of syphilis. It is predominantly associated within men who have sex with men and also within heterosexual Indigenous Australians. Possessing the ability to mimic a variety of ocular diseases, it typically manifests as uveitis, although it can affect any structure within the eye. Thus, a high degree of clinical suspicion by ophthalmologists is required to prevent disease progression and ocular morbidity. Patients require prolonged antibiotic treatment with intravenous benzylpenicillin and outpatient monitoring to successfully resolve the infection. We describe a case series of ocular syphilis presentations in Queensland, Australia. PMID:27672343

  18. Study of distribution and factors affecting syphilis epidemic among inner-city minorities of Baltimore.

    PubMed

    Williams, P B; Ekundayo, O

    2001-11-01

    Disparities in health and medical conditions among ethnic and racial groups have been repeatedly documented. These inequalities, which have been noted in the recent past, include health outcomes such as quality of life and mortality, process, accessibility and appropriateness of care, and the prevalence of certain degenerative conditions and infectious diseases. Syphilis, a sexually transmitted disease (STD) which seemed to have disappeared or had been controlled over the years, has now re-emerged as a major public health problem in many rural, urban and suburban communities. Progression of the current rate of syphilis, which erupted in Baltimore during the later part of 1994, has continued unabated, most especially among the ethnic minorities, despite efforts of the Baltimore City Health Department and Maryland Department of Health and Mental Hygiene to control the epidemic. With the current incidence rates of 270 per 100 000 live births for congenital syphilis and 99.3 per 100 000 population for primary, secondary and latent syphilis (96% of the cases being in the non-white population), Baltimore becomes the city with the highest number of syphilis cases in the nation, surpassing the national average of 2.6 cases per 100 000 population. This study, which utilizes a combination of retrospective and questionnaire-oriented approach, was designed to assess factors that influenced the high incidence of syphilis among Baltimore inner-city dwellers between 1994 and 1998. Data for the study included syphilis reports from private physicians, the Baltimore City Health Department, STD clinics, the Center for Disease Control (CDC), and ethnographic interviews. Factors favoring the distribution and infectivity of the disease among the inner-city dwellers include greater poverty, high level of communication gaps between providers and a cross-section of minority inner-city dwellers, exchange of sex for crack cocaine, lower educational background, and inadequate and

  19. Multisite Laboratory Evaluation of a Dual Human Immunodeficiency Virus (HIV)/Syphilis Point-of-Care Rapid Test for Simultaneous Detection of HIV and Syphilis Infection

    PubMed Central

    Bristow, Claire C.; Adu-Sarkodie, Yaw; Ondondo, Raphael O.; Bukusi, Elizabeth Anne; Dagnra, Claver Anoumou; Oo, Khin Yi; Pe, Eh Htoo; Khamsay, Chanthavysouk; Houng, Le Thi; Campuzano, Roberto Vázquez; Estes, Jason; Klausner, Jeffrey D.

    2014-01-01

    Background.  Recently, test developers have created rapid point-of-care tests that can simultaneously detect multiple infections within the same specimen using a single device. The SD BIOLINE Duo HIV/Syphilis rapid point-of-care test uses a solid-phase immunochromatographic assay to detect immunoglobulin (Ig)G, IgM, and IgA antibodies to human immunodeficiency virus (HIV)-specific antigens (HIV-1 gp41, sub O, HIV-2 gp36) and recombinant Treponema pallidum antigen (17 kDa) in human serum. This study was a multisite laboratory-based evaluation of the performance of SD BIOLINE HIV/Syphilis Duo test using previously characterized sera in 6 countries. Methods.  Laboratories in Ghana, Mexico, Laos, Togo, Kenya, and Myanmar participated in the evaluation during 2012–2013. Each site characterized sera using T pallidum particle agglutination assay or T pallidum hemagglutination assay and HIV enzyme immunoassay, Western blot, and/or HIV antibody rapid tests. Those gold standard test results were compared with SD BIOLINE Duo test results. We calculated the sensitivity and specificity of test performance and used the exact binomial method to calculate 95% confidence intervals (CIs). Results.  The sensitivity and specificity for the HIV antibody test component (n = 2336) were estimated at 99.91% (95% CI, 99.51% and 100%) and 99.67% (95% CI, 99.16% and 99.91%), respectively. For the T pallidum test component (n = 2059), the sensitivity and specificity were estimated at 99.67% (95% CI, 98.82% and 99.96%) and 99.72% (95% CI, 99.29% and 99.92%), respectively. Conclusions.  The sensitivity and specificity of the SD BIOLINE HIV/Syphilis Duo test were consistently high across sera specimens from 6 countries around the world. Dual rapid tests should be considered for improved HIV and syphilis screening coverage. PMID:25734088

  20. Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015.

    PubMed

    Abara, Winston E; Hess, Kristen L; Neblett Fanfair, Robyn; Bernstein, Kyle T; Paz-Bailey, Gabriela

    2016-01-01

    Globally, men who have sex with men (MSM) are disproportionately burdened with syphilis. This review describes the published literature on trends in syphilis infections among MSM in the US and Western Europe from 1998, the period with the fewest syphilis infections in both geographical areas, onwards. We also describe disparities in syphilis trends among various sub-populations of MSM. We searched electronic databases (Medline, Embase, Global Health, PsychInfo, CAB Abstracts, CINAHL, Sociological Abstracts, Web of Science, Cochrane Library, and LILACS) for peer-reviewed journal articles that were published between January 2004 and June 2015 and reported on syphilis cases among MSM at multiple time points from 1998 onwards. Ten articles (12 syphilis trend studies/reports) from the US and eight articles (12 syphilis trend studies/reports) from Western Europe were identified and included in this review. Taken together, our findings indicate an increase in the numbers and rates (per 100,000) of syphilis infections among MSM in the US and Western Europe since 1998. Disparities in the syphilis trends among MSM were also noted, with greater increases observed among HIV-positive MSM than HIV-negative MSM in both the US and Western Europe. In the US, racial minority MSM and MSM between 20 and 29 years accounted for the greatest increases in syphilis infections over time whereas White MSM accounted for most syphilis infections over time in Western Europe. Multiple strategies, including strengthening and targeting current syphilis screening and testing programs, and the prompt treatment of syphilis cases are warranted to address the increase in syphilis infections among all MSM in the US and Western Europe, but particularly among HIV-infected MSM, racial minority MSM, and young MSM in the US.

  1. Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015

    PubMed Central

    Abara, Winston E.; Hess, Kristen L.; Neblett Fanfair, Robyn; Bernstein, Kyle T.; Paz-Bailey, Gabriela

    2016-01-01

    Globally, men who have sex with men (MSM) are disproportionately burdened with syphilis. This review describes the published literature on trends in syphilis infections among MSM in the US and Western Europe from 1998, the period with the fewest syphilis infections in both geographical areas, onwards. We also describe disparities in syphilis trends among various sub-populations of MSM. We searched electronic databases (Medline, Embase, Global Health, PsychInfo, CAB Abstracts, CINAHL, Sociological Abstracts, Web of Science, Cochrane Library, and LILACS) for peer-reviewed journal articles that were published between January 2004 and June 2015 and reported on syphilis cases among MSM at multiple time points from 1998 onwards. Ten articles (12 syphilis trend studies/reports) from the US and eight articles (12 syphilis trend studies/reports) from Western Europe were identified and included in this review. Taken together, our findings indicate an increase in the numbers and rates (per 100,000) of syphilis infections among MSM in the US and Western Europe since 1998. Disparities in the syphilis trends among MSM were also noted, with greater increases observed among HIV-positive MSM than HIV-negative MSM in both the US and Western Europe. In the US, racial minority MSM and MSM between 20 and 29 years accounted for the greatest increases in syphilis infections over time whereas White MSM accounted for most syphilis infections over time in Western Europe. Multiple strategies, including strengthening and targeting current syphilis screening and testing programs, and the prompt treatment of syphilis cases are warranted to address the increase in syphilis infections among all MSM in the US and Western Europe, but particularly among HIV-infected MSM, racial minority MSM, and young MSM in the US. PMID:27447943

  2. Increased incidence of syphilis in men who have sex with men and risk management strategies, Germany, 2015

    PubMed Central

    Jansen, Klaus; Schmidt, Axel J.; Drewes, Jochen; Bremer, Viviane; Marcus, Ulrich

    2016-01-01

    In Germany, the number of reported syphilis cases increased between 11% and 22% per year between 2010 and 2014. We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men (MSM) in Germany (2003, 2007, 2010, 2013) to assess if this rise is ongoing and to find possible explanations for it. Syphilis notifications increased in 2015 by 19% to a total of 6,834. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases. MSM diagnosed with HIV reported condomless anal intercourse with non-steady partners more frequent than MSM not diagnosed with HIV or untested for HIV, but the latter also reported higher frequencies of this behaviour in the more recent surveys. Transmission in HIV-positive MSM probably plays an important, but not exclusive role, for the syphilis dynamics in Germany. A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based (rapid) testing, should be critically evaluated to effectively reduce syphilis infections. PMID:27813472

  3. Increased incidence of syphilis in men who have sex with men and risk management strategies, Germany, 2015.

    PubMed

    Jansen, Klaus; Schmidt, Axel J; Drewes, Jochen; Bremer, Viviane; Marcus, Ulrich

    2016-10-27

    In Germany, the number of reported syphilis cases increased between 11% and 22% per year between 2010 and 2014. We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men (MSM) in Germany (2003, 2007, 2010, 2013) to assess if this rise is ongoing and to find possible explanations for it. Syphilis notifications increased in 2015 by 19% to a total of 6,834. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases. MSM diagnosed with HIV reported condomless anal intercourse with non-steady partners more frequent than MSM not diagnosed with HIV or untested for HIV, but the latter also reported higher frequencies of this behaviour in the more recent surveys. Transmission in HIV-positive MSM probably plays an important, but not exclusive role, for the syphilis dynamics in Germany. A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based (rapid) testing, should be critically evaluated to effectively reduce syphilis infections.

  4. Acceptable Interventions to Reduce Syphilis Transmission Among High-Risk Men Who Have Sex With Men in Los Angeles

    PubMed Central

    Plant, Aaron; Javanbakht, Marjan; Cross, John; Montoya, Jorge A.; Bolan, Robert; Kerndt, Peter R.

    2015-01-01

    Objectives. We examined perceptions of and attitudes toward existing and potential syphilis interventions, including case management and Web-based programs, to increase syphilis testing among high-risk men who have sex with men (MSM). Methods. Between October 2010 and June 2011, we conducted in-depth interviews with 19 MSM in Los Angeles, California, with repeat early syphilis infections (primary, secondary, and early latent syphilis) within the previous 5 years. We analyzed the interviews inductively to determine the most acceptable potential interventions. Results. Experiences with health department and community-based standard of care case management were generally positive. The most popular interventions among respondents included a Web site providing information on syphilis and syphilis testing, automated Web reminders to test, being paid to test, free online home testing kits, and preexposure prophylactic medication. Respondents’ beliefs that they would continue to practice high-risk sexual behaviors reinforced their reasons for wanting increased accessibility and convenient testing strategies. Conclusions. Public health officials should consider participant responses to potential interventions for syphilis, which suggest that high-risk MSM would consider testing more often or using other interventions. PMID:25602881

  5. Systematic Differences in Risk Behaviours and Syphilis Prevalence across Types of Female Sex Workers: a Preliminary Study in Liuzhou, China

    PubMed Central

    Li, Jing; Chen, Xiang-Sheng; Merli, M. Giovanna; Weir, Sharon S.; Henderson, Gail E.

    2011-01-01

    Background Female sex workers (FSWs) have become one of the key populations for HIV/STI control in China. Categorization of FSWs can help prioritize HIV/STI intervention efforts. We examined two possible categorizations of FSWs and the relationship with syphilis infection risk in Liuzhou City, China. Methods From October 2009 to February 2010, a total of 583 FSWs recruited by respondent-driven sampling in a cross-sectional survey were tested for syphilis and interviewed to collect socio-demographic and behavioural information. Respondents were categorized based on transaction price for vaginal sex and type of sex work location. The relationship between the two categorizations and syphilis infection risk was assessed using univariate and multivariate logistic regression analysis. Results The prevalence rates of lifetime and active syphilis infection were 8.6% and 4.1% respectively. Lifetime and active syphilis prevalence were higher among FSWs in the lowest price category (52.7% and 25.4% respectively) and those working in streets (69.7% and 39.8% respectively) or through telephone (46.3% and 17.0% respectively). Multivariate analysis showed that lifetime syphilis prevalence was significantly higher among street-(Adjusted odds ratio AOR 38.7, 95% CI 10.7-139.9) and telephone-based FSWs (AOR 10.8, 95% CI 3.3-35.1), and that active syphilis prevalence was significantly higher among street-based FSWs (AOR 15.2, 95% CI 3.7-62.1) after adjusting for demographic and behavioural factors. Conclusions Categorization based on sex work location was more closely related to the risk of syphilis infection than the price classification. Street- and telephone-based FSWs had significantly higher risk of syphilis infection. Focused interventions among these particular high-risk FSWs subgroups are warranted. PMID:22337106

  6. Immune reconstitution inflammatory syndrome presenting as secondary syphilis with polymorphous erythema and knee arthritis.

    PubMed

    Brochard, J; Khatchatourian, L; Woaye-Hune, P; Biron, C; Lefebvre, M; Denis-Musquer, M; Grange, P; Dupin, N; Raffi, F

    2017-03-08

    Syphilis and HIV are strongly linked to one another and immune reconstitution inflammatory syndrome (IRIS) after antiretroviral therapy (ART) initiation can complicate matters. A 24-years-old homosexual man was hospitalized for fever, cough and headache. HIV infection had been diagnosed 5 years earlier but he discontinued ART for the last 2 years. This article is protected by copyright. All rights reserved.

  7. Sexually transmitted diseases and native Americans: trends in reported gonorrhea and syphilis morbidity, 1984-88.

    PubMed Central

    Toomey, K E; Oberschelp, A G; Greenspan, J R

    1989-01-01

    Native Americans experienced higher reported gonorrhea and syphilis morbidity than did non-Native Americans from 1984 through 1988 in 13 States with large Native American populations. Gonorrhea rates among American Indians and Alaska Natives were approximately twice the rates for non-Indians. The highest gonorrhea rate was reported among Alaska Natives, with a 5-year average of 1,470 cases per 100,000, more than five times the average non-Native rate in Alaska. The average primary and secondary (P&S) syphilis rate from 1984 through 1988 was more than two times higher among Native Americans, largely due to high syphilis morbidity in Arizona and New Mexico. In Arizona the average American Indian P&S syphilis case rate was seven times higher than the non-Indian rate. True rates for sexually transmitted diseases (STD) among Native Americans may be higher than those reported due to racial misclassification of Native American cases, particularly in nonreservation areas. Improved recognition and reporting of STD cases among Native Americans are needed to target STD prevention and education more effectively. PMID:2511589

  8. Syphilis as a Sole Indicator of Sexual Abuse: Two Cases with No Intervention.

    ERIC Educational Resources Information Center

    Horowitz, Susan; Chadwick, David L.

    1990-01-01

    Two cases of suspected sexual abuse of five-year-old children with syphilis are reported. Lack of confirmation of abuse by either child or in parental interviews led to closing of the cases by Child Protection Services and continued residence by the children in their original homes. (DB)

  9. A Novel Quantum Dots-Based Point of Care Test for Syphilis

    NASA Astrophysics Data System (ADS)

    Yang, Hao; Li, Ding; He, Rong; Guo, Qin; Wang, Kan; Zhang, Xueqing; Huang, Peng; Cui, Daxiang

    2010-05-01

    One-step lateral flow test is recommended as the first line screening of syphilis for primary healthcare settings in developing countries. However, it generally shows low sensitivity. We describe here the development of a novel fluorescent POC (Point Of Care) test method to be used for screening for syphilis. The method was designed to combine the rapidness of lateral flow test and sensitiveness of fluorescent method. 50 syphilis-positive specimens and 50 healthy specimens conformed by Treponema pallidum particle agglutination (TPPA) were tested with Quantum Dot-labeled and colloidal gold-labeled lateral flow test strips, respectively. The results showed that both sensitivity and specificity of the quantum dots-based method reached up to 100% (95% confidence interval [CI], 91-100%), while those of the colloidal gold-based method were 82% (95% CI, 68-91%) and 100% (95% CI, 91-100%), respectively. In addition, the naked-eye detection limit of quantum dot-based method could achieve 2 ng/ml of anti-TP47 polyclonal antibodies purified by affinity chromatography with TP47 antigen, which was tenfold higher than that of colloidal gold-based method. In conclusion, the quantum dots were found to be suitable for labels of lateral flow test strip. Its ease of use, sensitiveness and low cost make it well-suited for population-based on-the-site syphilis screening.

  10. Detailed Knowledge of the Tuskegee Syphilis Study: Who Knows What? A Framework for Health Promotion Strategies

    ERIC Educational Resources Information Center

    Green, B. Lee; Li, Lin; Morris, J. Fontain; Gluzman, Rima; Davis, Jenna L.; Wang, Min Qi; Katz, Ralph V.

    2011-01-01

    This report explores the level of detailed knowledge about the Tuskegee Syphilis Study (TSS) among 848 Blacks and Whites in three U.S. cities across an array of demographic variables. The Tuskegee Legacy Project (TLP) Questionnaire was used, which was designed to explore the willingness of minorities to participate in biomedical studies. A…

  11. Educational intervention in Primary Care for the prevention of congenital syphilis 1

    PubMed Central

    Lazarini, Flaviane Mello; Barbosa, Dulce Aparecida

    2017-01-01

    ABSTRACT Objectives: to evaluate the efficiency of educational interventions related to the knowledge of health care professionals of Primary Care and to verify the impact on the vertical transmission rates of congenital syphilis. Method: a quasi-experimental study conducted in the city of Londrina, Paraná, between 2013 and 2015. An educational intervention on diagnosis, treatment and notification was carried out with 102 professionals with knowledge measurement before and after the intervention. Incidence and mortality data from congenital syphilis were taken from the system for notifiable diseases (SINAN) and the Mortality Information System (SIM). Excel tabulation and statistical analysis was done in the Statistical Package for Social Sciences, version 2.1. A descriptive and inferential analysis was performed. Results: the mean number of correct responses increased from 53% to 74.3% after the intervention (p < 0.01). The adherence to professional training was 92.6%. There was a significant reduction in the vertical transmission rate of syphilis from 75% in 2013 to 40.2% in 2015. In 2014 and 2015 there were no records of infant mortality from this condition. Conclusion: the educational intervention significantly increased the knowledge of health professionals about syphilis and collaborated to reduce the rate of vertical transmission of the disease. PMID:28146181

  12. Prevalence of human immunodeficiency virus, syphilis, hepatitis B and C in blood donations in Namibia

    PubMed Central

    2014-01-01

    Background Transfusion Transmissible Infections (TTIs) such as Human Immunodeficiency Virus (HIV), syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV) are infections which are common in some communities in Southern Africa. It is important to screen blood donations for these infections. Methods This is a retrospective study which involved reviewing of previous blood donation records for the year 2012 in Namibia. The records were analyzed to determine the prevalence of HIV, syphilis, Hepatitis B and C among blood donations with regard to gender, age and geographical region of the donors. Results The findings indicated a significantly low prevalence of HIV, syphilis, HBsAg and anti-Hepatitis C among the blood donations. A low infection rate of 1.3% by any of the four tested TTIs was found among the blood donations given by the donor population in Namibia in 2012. Conclusion The blood donations given by the donor population in Namibia has a low infection rate with the HIV, syphilis, HBsAg and anti-HCV. A strict screening regime must continue to be used as the infections are still present albeit in small numbers. PMID:24884633

  13. Lessons from the syphilis outbreak in homosexual men in east London

    PubMed Central

    Hourihan, M; Wheeler, H; Houghton, R; Goh, B

    2004-01-01

    Objectives: To describe the epidemiology, presentation, and diagnosis of early syphilis in 103 homosexual men in east London. Methods: A retrospective study using data from KC60 returns, the Health Protection Agency (HPA) enhanced surveillance forms and case notes. Results: 40 cases of primary (PS), 40 of secondary (SS) and 23 of early latent syphilis were identified, 33% co-infected with HIV. 41% had concurrent sexually transmitted infections (STIs). Pain featured in 35% of PS and itch in 13% of rashes. Dark ground microscopy (DGM), performed in 44 of the symptomatic cases, was positive in 37 (84%) allowing early management. Initial syphilis serology was negative in 15/40 (37%) cases of PS. 51% and 49% opted for parenteral and oral treatment, respectively. In 53/103 (51%) cases oral sex was the only risk factor. 86% of infections were UK acquired. Only 4% of contacts were seen. Conclusion: This outbreak, reflecting the resurgence of syphilis across the United Kingdom, highlights several important points. Painful chancres and itchy rash are common presentations. DGM is a highly sensitive diagnostic tool. Initial negative serological screening tests are common in PS and sero-surveillance for 3 months is recommended. The high prevalence of concomitant STIs indicates ongoing unprotected sexual intercourse. Oral sex is a significant risk factor and is a distinctly "unsafe" practice. Conventional partner notification is ineffective. Other methods of screening of the at-risk homosexual population are warranted. Continued education is required to reduce STI acquisition in homosexual men. PMID:15572625

  14. Treponema pallidum specific IgM haemagglutination test for serodiagnosis of syphilis.

    PubMed Central

    Sato, T; Kubo, E; Yokota, M; Kayashima, T; Tomizawa, T

    1984-01-01

    The Treponema pallidum specific IgM haemagglutination (TP-IgM-HA) test uses erythrocytes sensitised with antiserum to human IgM to separate IgM from IgG in serum. Specific antitreponemal IgM captured in this way is detected by adding a second reagent comprising erythrocytes sensitised with T pallidum antigen. Eighty two serum samples from 82 patients with untreated syphilis, 521 samples from 73 patients with treated syphilis, and 1872 samples from people who did not have syphilis were examined by the 19S(IgM)-TPHA (T pallidum haemagglutination), IgM-FTA-ABS (fluorescent treponemal antibody absorbed), TP-IgM-ELISA (enzyme linked immunosorbent assay), and TP-IgM-HA tests for the presence of 19S(IgM) antibodies specific to treponemes. The sensitivity of the TP-IgM-HA test was 97.6% and the specificity was 99.7%. We also traced IgM specific to treponemes in untreated patients with primary syphilis by four different tests. The TP-IgM-HA test results clearly reflected the effect of the treatment. PMID:6394097

  15. A Novel Quantum Dots–Based Point of Care Test for Syphilis

    PubMed Central

    2010-01-01

    One-step lateral flow test is recommended as the first line screening of syphilis for primary healthcare settings in developing countries. However, it generally shows low sensitivity. We describe here the development of a novel fluorescent POC (Point Of Care) test method to be used for screening for syphilis. The method was designed to combine the rapidness of lateral flow test and sensitiveness of fluorescent method. 50 syphilis-positive specimens and 50 healthy specimens conformed by Treponema pallidum particle agglutination (TPPA) were tested with Quantum Dot-labeled and colloidal gold-labeled lateral flow test strips, respectively. The results showed that both sensitivity and specificity of the quantum dots–based method reached up to 100% (95% confidence interval [CI], 91–100%), while those of the colloidal gold-based method were 82% (95% CI, 68–91%) and 100% (95% CI, 91–100%), respectively. In addition, the naked-eye detection limit of quantum dot–based method could achieve 2 ng/ml of anti-TP47 polyclonal antibodies purified by affinity chromatography with TP47 antigen, which was tenfold higher than that of colloidal gold–based method. In conclusion, the quantum dots were found to be suitable for labels of lateral flow test strip. Its ease of use, sensitiveness and low cost make it well-suited for population-based on-the-site syphilis screening. PMID:20672123

  16. [A study of Kyokan Gijuku: a supplement to the history of syphilis testing in Tokyo].

    PubMed

    Nakanishi, Atsuo; Higuchi, Teruo

    2009-09-01

    The testing and treatment of licensed prostitutes for syphilis in the Tokyo area began around February 1872 (Meiji 5) within the Yoshiwara red-light district, surprisingly enough from the request of the brothels themselves. In 1876 (Meiji 9), an ordinance for the testing of licensed prostitutes for syphilis was passed, making testing and treatment mandatory, but little research has been done on the changes this brought about within the district in the intervening period. It is this interval of time that we have undertaken to examine, making use not only of laws, ordinances, and other public documents, but also manners and customs, incidents within the district, and sources from the hygiene police, among other materials. The results of our research into the four-and-a-half-year period beginning in May 1871 (Meiji 4) lead us to surmise that, due to three disastrous conflagrations, the district hit an economic dead end, and its syphilis testing activities were swallowed up by an officialdom bent on strengthening the hygienic police. Some of the physicians at the Kyokan Gijuku showed a subjective concern with syphilis testing at the Yoshiwara in its early stages, but they never carried out systematic education on the subject within the school.

  17. Tracing partners of patients with syphilis infection remains challenging: experience of Geneva Hospital.

    PubMed

    de Lorenzi, Caroline; Angèle, Gayet-Ageron; Martine, Girard-Strohbach; Laurence, Toutous Trellu

    2017-01-01

    Syphilis has been reinstated on the list of notifiable diseases in Switzerland since 2006 and the active management of sexual partners is encouraged to avoid reinfection. However, contact tracing has yielded unsatisfactory results and the incidence of syphilis remains important, especially in high-risk populations. The aim of this study was to compare the proportions of notified sexual partners of patients diagnosed with syphilis by the laboratories of Geneva University Hospitals (HUG) with those diagnosed in private laboratories (non-HUG) and to assess the risk factors for no notification to sexual partners. All syphilis cases notified to the Office of the Surgeon General in Geneva (Switzerland) between 1 January 2011 and 31 December 2013 were analysed. The proportions of partner notification (PN) between HUG and non-HUG laboratories were compared by Chi square test and the main risk factors for no notification to sexual partners were assessed by binomial log-linear regression. Among a total of 720 notifications reported, 244 cases were diagnosed with contagious syphilis stages and 263 with non-contagious stages (i.e. successfully treated patients with or late latent cases). Overall, PN was higher among contagious than non-contagious cases (58.4% versus 31.0%; p = 0.030) and it was significantly higher in the non-HUG compared to the HUG group (75.9% versus 50.0%, respectively; p < 0.001). Risk factors independently associated with no notification to sexual partners were the place of diagnosis (risk ratio [RR] 1.66; 95% confidence interval [CI] 1.21-2.27 for HUG versus non-HUG, respectively), age >45 years (RR 1.36; 95% CI: 1.05-1.76) and if the patient had received treatment for syphilis (RR 1.91; 95% CI: 1.38-2.66). Our results illustrate the difficulty of contact tracing in syphilis infection and the necessity to improve this crucial part of sexually transmitted infection management.

  18. Genital Cytomegalovirus Replication Predicts Syphilis Acquisition among HIV-1 Infected Men Who Have Sex with Men

    PubMed Central

    Gianella, Sara; Smith, Davey M.; Daar, Eric S.; Dube, Michael P.; Lisco, Andrea; Vanpouille, Christophe; Margolis, Leonid; Haubrich, Richard H.; Morris, Sheldon R.

    2015-01-01

    Objective Sexually transmitted infections (STI) are common among HIV-infected men who have sex with men (MSM). While behavioral factors are important in STI acquisition, other biological factors such as immune modulation due to chronic viral infection may further predispose to STI acquisition. Design Post Hoc analysis including data collected over 12 months of follow-up from 131 HIV-infected MSM receiving antiretroviral therapy and screened for incident bacterial STI every 3 months. Methods Genital secretions collected at baseline were used to measure herpesvirus replication and inflammatory cytokines. Baseline predictors of STI were determined using survival analysis of time to incident STI. Results All participants were seropositive for cytomegalovirus (CMV), and 52% had detectable genital CMV at baseline. Thirty-five individuals acquired STI during follow-up, sometimes with multiple pathogen (17 syphilis, 21 gonorrhea, 14 chlamydia). Syphilis acquisition was associated with genital CMV replication at baseline (19.1% CMV-shedders versus 4.8% non-shedders, p=0.03) and younger age (p=0.02). Lower seminal MCP-1 was associated with higher seminal CMV levels and with syphilis acquisition (p<0.01). For syphilis acquisition, in multivariable Cox-Proportional Hazard model adjusted hazard rates were 3.56 (95%CI:1.00–12.73) for baseline CMV replication and 2.50 (0.92–6.77) for younger age. Conclusions This post hoc analysis suggest that CMV-associated decrease in seminal MCP-1 levels might predispose HIV-infected MSM to syphilis acquisition, but not other STI. Future studies should determine underlying mechanisms and if a causal association exists. PMID:26061824

  19. Duration of syphilis symptoms at presentations in men who have sex with men in Australia: are current public health campaigns effective?

    PubMed

    Chow, E P F; Dutt, K; Fehler, G; Denham, I; Chen, M Y; Batrouney, C; Peel, J; Read, T R H; Bradshaw, C S; Fairley, C K

    2016-01-01

    The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007-2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6-14] days and 14 (IQR 7-30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64-256) was higher than in primary syphilis (median 4, IQR 1-32) and in early latent syphilis (median 32, IQR 4-64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.

  20. What is the role of a full physical examination in the management of asymptomatic patients with late syphilis?

    PubMed

    Dabis, R; Radcliffe, K

    2012-12-01

    According to the British Association for Sexual Health and HIV guidelines, a full physical examination is recommended in patients with possible late syphilis. The aim of this audit was to review all cases of late syphilis diagnosed at our centre since 1994 to see if a full cardiovascular and neurological examination was documented and also to see what a full examination contributed to the management of asymptomatic patients. Of the 480 medical notes audited, 295 patients were asymptomatic of whom 288 (98%) had normal physical examinations; the rest were either not documented, declined or defaulted follow-up. Seven asymptomatic patients had positive clinical findings but these did not lead to a diagnosis of cardiovascular or neurological syphilis. This audit has shown that performing a physical examination in asymptomatic patients added no benefit in diagnosing complications of late syphilis; it would appear that the physical examination did not alter the management.

  1. Syphilis and human experimentation from World War II to the present: a historical perspective and reflections on ethics.

    PubMed

    Cuerda-Galindo, E; Sierra-Valenti, X; González-López, E; López-Muñoz, F

    2014-11-01

    Even after the Nuremberg code was published, research on syphilis often continued to fall far short of ethical standards. We review post-World War II research on this disease, focusing on the work carried out in Guatemala and Tuskegee. Over a thousand adults were deliberately inoculated with infectious material for syphilis, chancroid, and gonorrhea between 1946 and 1948 in Guatemala, and thousands of serologies were performed in individuals belonging to indigenous populations or sheltered in orphanages. The Tuskegee syphilis study, conducted by the US Public Health Service, took place between 1932 and 1972 with the aim of following the natural history of the disease when left untreated. The subjects belonged to a rural black population and the study was not halted when effective treatment for syphilis became available in 1945.

  2. Factors associated with HIV and syphilis co-infection among men who have sex with men in seven Chinese cities.

    PubMed

    Das, Aritra; Li, Jianjun; Zhong, Fei; Ouyang, Lin; Mahapatra, Tanmay; Tang, Weiming; Fu, Gengfeng; Zhao, Jinkou; Detels, Roger

    2015-03-01

    HIV-syphilis co-infection is often cited as a major reason behind recent resurgence in syphilis prevalence among men who have sex with men in China. Most published literatures explore factors associated with either HIV or syphilis, but not their co-infection. We analysed data from a cross-sectional survey on men who have sex with men in seven Chinese cities. Snowball sampling was used to recruit participants for the survey. Socio-demographic and behavioural predictors for HIV-syphilis mono/co-infection were examined using ordinal logistic regression. Factor scores were used to summarise (1) HIV-related knowledge and (2) access to HIV preventive services. Prevalence of HIV, syphilis, and their co-infection, among 2936 self-identified men who have sex with men, were 7.7%, 14.3%, and 2.6%, respectively. In the adjusted analysis, the significant positive correlates of poorer diagnoses (co-infection vs mono- and no infection or co- and mono-infection vs no infection) were: 30 to 39 years and ≥40 years age, education up to senior high school, unprotected anal intercourse, recent sexually transmitted infection symptoms, incorrect knowledge about routes of transmission, and access to preventive or counselling/testing services for HIV. For effective control of this dual epidemic, integrated HIV and syphilis surveillance and targeted intervention strategies for Chinese men who have sex with men are needed urgently.

  3. Clinical comparison of the Treponema pallidum CAPTIA syphilis-G enzyme immunoassay with the fluorescent treponemal antibody absorption immunoglobulin G assay for syphilis testing.

    PubMed

    Halling, V W; Jones, M F; Bestrom, J E; Wold, A D; Rosenblatt, J E; Smith, T F; Cockerill, F R

    1999-10-01

    Recently, a treponema-specific immunoglobulin G (IgG) enzyme immunoassay (EIA), the CAPTIA Syphilis-G (Trinity Biotech, Jamestown, N.Y.), has become available as a diagnostic test for syphilis. A total of 89 stored sera previously tested by the fluorescent treponemal antibody absorption (FTA-ABS) IgG assay were evaluated by the CAPTIA EIA. The FTA-ABS IgG procedure was performed by technologists unblinded to results of rapid plasmid reagin (RPR) testing of the same specimens. Borderline CAPTIA-positive samples (antibody indices of >/=0.650 and 0.900, the sample was considered positive. Thirteen of 89 (15%) samples had discrepant results. Compared to the FTA-ABS assay, the CAPTIA EIA had a sensitivity and specificity and positive and negative predictive values of 70.7, 97.9, 96.7, and 79.7%, respectively. In another analysis, discrepancies between results were resolved by repeated FTA-ABS testing (technologists were blinded to previous RPR results) and patient chart reviews. Seven CAPTIA-negative samples which were previously interpreted (unblinded) as minimally reactive by the FTA method were subsequently interpreted (blinded) as nonreactive. One other discrepant sample (CAPTIA negative and FTA-ABS positive [at an intensity of 3+], unblinded) was FTA negative with repeated testing (blinded). For the five remaining discrepant samples, chart reviews indicated that one patient (CAPTIA negative and FTA-ABS positive [minimally reactive], blinded) had possible syphilis. These five samples were also evaluated and found to be negative by another treponema-specific test, the Treponema pallidum microhemagglutination assay. Therefore, after repeated testing and chart reviews, 2 of the 89 (2%) samples had discrepant results; the adjusted sensitivity, specificity, and positive and negative predictive values were 96.7, 98.3, 96.7, and 98.3%, respectively. This study demonstrates that the CAPTIA IgG EIA is a

  4. Florida's multifaceted response for increases in syphilis among MSM: the Miami-Ft. Lauderdale initiative.

    PubMed

    Schmitt, Karla; Bulecza, Susan; George, Daniel; Burns, Tomas E; Jordahl, Lori

    2005-10-01

    After many years of declining rates, it became apparent in 1999 that syphilis cases were on the rise in Florida. Data analysis identified that the outbreak was predominately contained in Miami and Ft. Lauderdale and among men who have sex with men. An in-depth investigation was undertaken to identify the risk factors, the best way to attack the outbreak, and how to build sustainability into implemented strategies. After thorough review of the data and extensive dialogue with local public health and community participants, the Bureau of STD Prevention & Control developed initiatives that focused public awareness through print, radio, and television media resources; expanded access to men's health services; and enhanced education/training for public and private health care providers, STD program field staff, and community representatives. This initiative has resulted in unprecedented community involvement in syphilis control efforts.

  5. [Low seroprevalence of syphilis and HIV in refugees and asylum seekers in Germany in 2015].

    PubMed

    Jablonka, A; Solbach, P; Nothdorft, S; Hampel, A; Schmidt, R E; Behrens, G M N

    2016-07-01

    Background | Currently only estimates exist of seroprevalence of syphilis and human immunodeficiency virus (HIV) in refugees arriving in Germany during the current refugee crisis. Objectives | To assess the prevalence of syphilis and human immunodeficiency virus (HIV) in refugees arriving in northern Germany in 2015. Materials and methods | In a cross-sectional study in 790 patients from all age groups tests for serological markers of treponema pallidum and in 789 patients for human immunodeficiency virus (HIV) were performed in August 2015 in reception centers in northern Germany. Results | The overall prevalence of treponema pallidum antibodies was 0.13 % (1/790; [95 % CI: 0 - 0.4]). HIV antibodies were positive in two refugees from sub-Saharan Africa (2/789; 0.25 %, [95 % CI: 0 - 0.6]). Conclusions | This study showed a low prevalence of treponema pallidum antibodies and human immunodeficiency virus infection (HIV) in a German refugee cohort, not significantly different from German controls.

  6. [Staging of scientific facts in syphilis education. "The Shipwrecked" in the Berlin German Theater (1913)].

    PubMed

    Lazardzig, J

    2002-04-01

    The "Deutsche Gesellschaft zur Bekämpfung der Geschlechtskrankheiten" (DGBG) used plays as a means of public education. The play "Damaged Goods" (Les Avariés) by the French dramatist Eugéne Brieux (1858-1932) was used extensively for this purpose in Germany between 1910 and 1920. By proliferating a specific image of both the medical profession and the syphilis, it helped established the self-confidence of the then new dermatological discipline. The teaching of Alfred Fournier (1832-1914) provided the medical background for the play. In "The Inheritance of Syphilis" (1882) Fournier had laid the dramatic framework for Brieux' play. Analyzing the Berlin premiere of "Damaged Goods" on June 25 1913 in the German Theatre/Berlin, the interplay between scientific facts and theatrical license and their diverse influences on the public becomes obvious.

  7. Brief communication: a case of congenital syphilis during the colonial period in Mexico City.

    PubMed

    Mansilla, J; Pijoan, C M

    1995-06-01

    Congenital syphilis has been diagnosed very seldom in ancient populations. The case that we examined comes from San Jeronimo's Church (17th and 18th centuries AD; Mexico City). Coffin 43 contained an incomplete skeleton of an approximately 2-year-old infant. The pathological lesions of this skeleton include bilateral osteochondritis, diaphyseal osteomyelitis, and osteitis and/or periostitis on the long bones. The radiographic appearance depicts symmetrical osteomyelitic foci, particularly at the proximal extremity of both tibiae (Wimberger's sign). The skull exhibits hydrocephaly and periosteal changes on the vault, and the unerupted upper incisors evince dental hypoplasia and other pathological alterations reminiscent of Hutchinson's incisors. All these features strongly suggest a case of early congenital syphilis.

  8. Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study.

    PubMed

    Seibt, Creta Elisa; Munerato, Maria Cristina

    2016-01-01

    Syphilis is an infectious disease caused by the bacterium Treponema pallidum. Syphilis has three clinical stages and may present various oral manifestations, mainly at the secondary stage. The disease mimics other more common oral mucosa lesions, going undiagnosed and with no proper treatment. Despite the advancements in medicine toward prevention, diagnosis, and treatment syphilis remains a public health problem worldwide. In this sense, dental surgeons should be able to identify the most common manifestations of the disease in the oral cavity, pointing to the role of this professional in prevention and diagnosis. This study describes a case series of seven patients with secondary syphilis presenting different oral manifestations.

  9. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

    PubMed Central

    Nishijima, Takeshi; Teruya, Katsuji; Shibata, Satoshi; Yanagawa, Yasuaki; Kobayashi, Taiichiro; Mizushima, Daisuke; Aoki, Takahiro; Kinai, Ei; Yazaki, Hirohisa; Tsukada, Kunihisa; Genka, Ikumi; Kikuchi, Yoshimi; Oka, Shinichi; Gatanaga, Hiroyuki

    2016-01-01

    Background The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM) largely remains unknown. Methods The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8) among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods. Results Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21%) or became infected with syphilis during follow-up (13%). After excluding 214 patients (MSM with syphilis at baseline (n = 190) and no follow-up syphilis test (n = 24)), of 671 men, 112 (17%) developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5–52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008–2009: 48.2/1,000 person-years, 2010–2011: 51.1/1,000 person-years, 2012–2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315). Multivariable analysis identified young age (<33 years versus >40, HR 4.0, 95%CI 2.22–7.18, p<0.001), history of syphilis at baseline (HR 3.0, 95%CI 2.03–4.47, p<0.001), positive anti-amoeba antibody (HR 1.8, 95%CI 1.17–2.68, p = 0.006), and high baseline CD4 count (CD4 ≥350 /μL versus CD4 <200, HR 1.6, 95%CI 1.00–2.53, p = 0.050) as risk factors for incident syphilis. Incidence of syphilis was particularly high among young patients (age <33 years: 60.1/1,000 person-years). Interestingly, 37% of patients with incident syphilis were asymptomatic. Conclusions Although incidence of syphilis did not increase during the observation period, it was high among HIV-1-infected MSM, especially among young HIV-1-infected MSM and those with history

  10. A WHO study of treatment schedules for early syphilis in use throughout the world

    PubMed Central

    Willcox, R. R.

    1954-01-01

    Ten years have elapsed since penicillin was introduced in the treatment of syphilis. In order to appraise recent trends in syphilotherapy in the world, WHO carried out a detailed study of treatment practices in early syphilis. A questionnaire was circulated to leading venereologists and clinics in the world, and 277 replies were received from 55 countries giving particulars of 294 schedules. A total of 65.3% of the participants used penicillin alone and 28.9% used it in combination with other drugs. In North America all clinics relied solely on penicillin as against 52.2% in Europe; and procaine penicillin G in oil with aluminium monostearate (PAM) was used in 91% of clinics in the Americas and Asia and in 60.6% of European clinics. The most common dosage of penicillin in all stages of early syphilis was 4.8-6.0 million units; but appreciably larger doses were used in Europe than elsewhere, some 39.4% of schedules using 10.8 million units or more. There were single instances of 36 million units being given. Consolidation treatment was given in none of the North American clinics; seldom in Asia; by about one-third of the participants in Central and South America; and, for secondary syphilis, in 59% of European schedules. This study shows that with intensive treatment with PAM the saving in drug cost to clinics over the classical courses of arsenic and bismuth may be as much as £4 per case, but the overhead expenses are, of course, not reduced. PMID:13182588

  11. What's new in sexually transmitted infections in the HIV care setting: focus on syphilis and gonorrhea.

    PubMed

    Marrazzo, Jeanne M

    Sexually transmitted infections are a resurgent problem in HIV disease. The number of new cases of syphilis among men who have sex with men has continued to increase, requiring renewed vigilance in screening, diagnosis, and treatment. Drug-resistant gonorrhea has prompted changes in treatment regimens and warrants continued monitoring. This article summarizes an IAS-USA continuing education webinar presented by Jeanne M. Marrazzo, MD, MPH, in January 2014.

  12. Hepatitis B, HIV, and Syphilis Seroprevalence in Pregnant Women and Blood Donors in Cameroon

    PubMed Central

    Mbah, Rahel; Rembert, Nicole J.; Tancho, Samuel; Halle-Ekane, Gregory E.; Enah, Comfort; Welty, Thomas K.; Tih, Pius M.; Tita, Alan T. N.

    2016-01-01

    Objectives. We estimated seroprevalence and correlates of selected infections in pregnant women and blood donors in a resource-limited setting. Methods. We performed a cross-sectional analysis of laboratory seroprevalence data from pregnant women and voluntary blood donors from facilities in Cameroon in 2014. Rapid tests were performed to detect hepatitis B surface antigen, syphilis treponemal antibodies, and HIV-1/2 antibodies. Blood donations were also tested for hepatitis C and malaria. Results. The seroprevalence rates and ranges among 7069 pregnant women were hepatitis B 4.4% (1.1–9.6%), HIV 6% (3.0–10.2%), and syphilis 1.7% (1.3–3.8%) with significant variability among the sites. Correlates of infection in pregnancy in adjusted regression models included urban residence for hepatitis B (aOR 2.9, CI 1.6–5.4) and HIV (aOR 3.5, CI 1.9–6.7). Blood donor seroprevalence rates and ranges were hepatitis B 6.8% (5.0–8.8%), HIV 2.2% (1.4–2.8%), syphilis 4% (3.3–4.5%), malaria 1.9%, and hepatitis C 1.7% (0.5–2.5%). Conclusions. Hepatitis B, HIV, and syphilis infections are common among pregnant women and blood donors in Cameroon with higher rates in urban areas. Future interventions to reduce vertical transmission should include universal screening for these infections early in pregnancy and provision of effective prevention tools including the birth dose of univalent hepatitis B vaccine. PMID:27578957

  13. Field Evaluation of a Dual Rapid Immunodiagnostic Test for HIV and Syphilis infection in Peru

    PubMed Central

    Bristow, Claire C.; Leon, Segundo R.; Huang, Emily; Ramos, Lourdes B.; Vargas, Silver K.; Flores, Juan A.; Konda, Kelika A.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2015-01-01

    Background Integrated prevention for HIV and syphilis is warranted because both syphilis and HIV infections have evidence-based, scalable interventions using current health care mechanisms. The advent of dual rapid point-of-care tests, single devices that can detect multiple infections using the same specimen, provides the opportunity to integrate the screening of syphilis into HIV programs, potentially increasing the numbers of people tested and allowing for same-day testing and treatment. The aim of this study was to evaluate the MedMira Multiplo Rapid TP/HIV Antibody Test (MedMira Inc, Halifax, Nova Scotia, Canada), a qualitative, rapid immunoassay that detects antibodies to T. pallidum and HIV. Methods The reference standard test for comparison to the T. pallidum component of the Multiplo TP/HIV Test was Treponema Pallidum Particle Agglutination assay. For the HIV component, the reference test included a 4th-generation enzyme immunoassay with a confirmatory Western blot test. Results The sensitivity and specificity for the HIV antibody component were 93.8% (95% CI: 69.8%, 99.8%) and 100% (95% CI: 97.7%, 100%), respectively. The Treponema pallidum component of the test had a sensitivity of 81.0% (95% CI: 68.1%, 94.6%) and a specificity of 100% (95% CI: 97.6%, 100%). Conclusions Our study showed excellent performance of the HIV antibody component of the test and very good performance for the Treponema pallidum antibody component of the MedMira Multiplo Rapid TP/HIV Antibody Test, which should be considered to improve screening coverage. Use of effective dual tests will create improved access to more comprehensive care by integrating the screening of syphilis into HIV prevention programs. PMID:26650998

  14. Oral syphilis: report of three cases and characterization of the inflammatory cells.

    PubMed

    Strieder, Luciana Rocha; León, Jorge Esquiche; Carvalho, Yasmin Rodarte; Kaminagakura, Estela

    2015-04-01

    Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody-absorption, anti-HIV-1 and anti-HIV-2, and anti-hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation.

  15. Incidence of syphilis seroconversion among HIV-infected persons in Asia: results from the TREAT Asia HIV Observational Database

    PubMed Central

    Ahn, Jin Young; Boettiger, David; Kiertiburanakul, Sasisopin; Merati, Tuti Parwati; Huy, Bui Vu; Wong, Wing Wai; Ditangco, Rossana; Lee, Man Po; Oka, Shinichi; Durier, Nicolas; Choi, Jun Yong

    2016-01-01

    Introduction Outbreaks of syphilis have been described among HIV-infected men who have sex with men (MSM) in Western communities, whereas reports in Asian countries are limited. We aimed to characterize the incidence and temporal trends of syphilis among HIV-infected MSM compared with HIV-infected non-MSM in Asian countries. Methods Patients enrolled in the TREAT Asia HIV Observational Database cohort and with a negative non-treponemal test since enrolment were analyzed. Incidence of syphilis seroconversion, defined as a positive non-treponemal test after previously testing negative, was evaluated among patients at sites performing non-treponemal tests at least annually. Factors associated with syphilis seroconversion were investigated at sites doing non-treponemal testing in all new patients and subsequently testing routinely or when patients were suspected of having syphilis. Results We included 1010 patients from five sites that performed non-treponemal tests in all new patients; those included had negative non-treponemal test results during enrolment and subsequent follow-ups. Among them, 657 patients were from three sites conducting regular non-treponemal testing. The incidence of syphilis seroconversion was 5.38/100 person-years (PY). Incidence was higher in MSM than non-MSM (7.64/100 PY vs. 2.44/100 PY, p<0.001). Among MSM, the incidence rate ratio (IRR) for every additional year from 2009 was 1.19 (p=0.051). MSM status (IRR 3.48, 95% confidence interval (CI) 1.88–6.47), past syphilis diagnosis (IRR 5.15, 95% CI 3.69–7.17) and younger age (IRR 0.84 for every additional 10 years, 95% CI 0.706–0.997) were significantly associated with syphilis seroconversion. Conclusions We observed a higher incidence of syphilis seroconversion among HIV-infected MSM and a trend to increasing annual incidence. Regular screening for syphilis and targeted interventions to limit transmission are needed in this population. PMID:27774955

  16. BIOCHEMICAL STUDIES ON SO-CALLED SYPHILIS ANTIGEN.

    PubMed

    Noguchi, H; Bronfenbrenner, J

    1911-01-05

    Noguchi has repeatedly done before) that the antigen should be selected from the aceton-insoluble fractions. Iodine Value in Relation to Antigenic Value.-Speaking generally of the aceton-insoluble fraction, a high antigenic value is associated with a high iodine value of lipoids obtained from the liver and heart. This rule does not, however, apply to the corresponding fraction from the brain. Standard Antigen.-The preparation of a standard antigen for Noguchi's method for the diagnosis of syphilis is given just before the summary. The directions will enable one to make a stock solution, from which, at any time, a suitable antigenic emulsion may be obtained.

  17. [Clinical and therapeutic differences in neuro-ophthalmological involvement secondary to syphilis].

    PubMed

    Crespo-Burillo, J A; Gil-Perez, D; Alarcia-Alejos, R; Hernando-Quintana, N; Garcia-Rubio, S; Martin-Martinez, J

    2014-09-16

    INTRODUCTION. There are many forms of neuro-ophthalmological involvement secondary to syphilis, and not all of them are well known. Our aim is to determine the clinical and therapeutic differences in these patients. CASE REPORTS. Our sample included eight patients diagnosed with an ocular and neuro-ophthalmological disorder due to syphilis over the years 2012 and 2013. Five of them presented uveitis, pan-eveitis being the most frequent, with three cases. Two cases presented papilloedema and another displayed retrobulbar optic neuropathy. A total of 62.5% were diagnosed with neurosyphilis, the presence of which was related with compromise of the optic nerve (p = 0.035). None of them gave positive for VDRL in cerebrospinal fluid and they were diagnosed by the presence of FTA antibodies together with high protein levels in cerebrospinal fluid, lymphocytic pleocytosis or intrathecal synthesis of antibodies. In the absence of uveitis, diagnosis was delayed by a mean time of 2.6 months (p = 0.047). All the patients, except one who required a vitrectomy, progressed favourably with intravenous antibiotic therapy. CONCLUSIONS. In cases of neuro-ophthalmological compromise, whether inflammatory or non-inflammatory, the physician must bear syphilis in mind as a potential causation in order to avoid delays in the diagnosis, since early well-tailored treatment can prevent permanent loss of sight.

  18. Response of HIV-infected patients with syphilis to therapy with penicillin or intravenous ceftriaxone

    PubMed Central

    2011-01-01

    Background Ceftriaxone is commonly used as an alternative antibiotic drug in treating syphilis but clinical data on its efficacy are limited. Objective: To evaluate the response of HIV-infected patients with active syphilis to treatment with penicillin or ceftriaxone. Methods A retrospective study involving 24 consecutive patients with a positive Veneral Disease Research Laboratory test (VDRL) and at least one specific treponemal test. 12 patients were treated with different regimens of high-dose penicillin G for at least 2 weeks. Another 12 patients were treated with ceftriaxone 1-2 g per day intravenously for 10-21 days. Results After a median follow up of 18,3 months all patients of the penicillin-treated group and 11 of 12 ceftriaxone-treated patients showed a ≥ 4-fold decline in VDRL-titers; 91% of them already within 6 months after therapy. Conclusion Our serological data demonstrate a comparable efficacy of currently recommened penicillin and ceftriaxone treatment regimens for active syphilis in HIV-infected patients. PMID:21463980

  19. The syphilis epidemics in Hungary 1985-2004, before entering the European Union.

    PubMed

    Talha, Elyas; Nagy, Károly; Horváth, Attila

    2013-09-01

    In the decade prior to the turn of the millennium, great interest was raised, and rightly so, by the STD (syphilis and HIV/AIDS) epidemic that developed in the Eastern-Central European Region. Its coincidence with the far-reaching political and economic changes that took place at that time suggested a link between the two events.Hungary, where these infections had had low incidence before the period investigated, also experienced an increase in STD incidence. The trend in syphilis infection during the 20 years between 1985-2004, that preceded the turn of the millennium and when finally Hungary joined the European Union, have been analyzed. Due to the nature of venereological epidemiological surveillance in Hungary, syphilis prevalence data are appropriate for further analysis from socio-demographic aspects. Behavioural changes underlying the specific features of the epidemics in Hungary had developed several years earlier and cannot be linked to the political and economic changes that started in the early 90s. The only exception is the phenomenon of growing migration that appeared simultaneously with the political changes and had a decisive impact on the spread and level of infection in some areas in the country. As shown by our data, trends seen in specific demographic groups (females, rural population) preceded the suddenly occurring political changes by about 15 years.

  20. Syphilis among middle-aged female sex workers in China: a three-site cross-sectional study

    PubMed Central

    Liu, Hongjie; Dumenci, Levent; Morisky, Donald E; Xu, Yongfang; Li, Xiaojing; Jiang, Baofa

    2016-01-01

    Objectives This study addresses the lack of empirical studies about the epidemic of syphilis among middle-aged female sex workers (FSWs). The objectives of this study were to investigate prevalence of syphilis, and its potential risk factors among middle-aged FSWs in China. Design A cross-sectional study with respondent-driven sampling (RDS). Setting A multisite study conducted at three Chinese cites (Nanning, Hefei, and Qingdao) with different levels of sexually transmitted diseases in 2014. Participants 1245 middle-aged female sex workers who were over 35 years old (about 400 per study site). Main outcome measures Unprotected commercial sex, and syphilis and HIV infection were biologically tested and measured. Results The RDS-adjusted prevalence of active syphilis was 17.3% in Hefei, 9.9% in Qingdao, and 5.4% in Nanning. The RDS-adjusted prevalence of prevalent syphilis was between 6.8% and 33.6% in the three cities. The proportion of unprotected sex in the past 48 h verified by the prostate-specific antigen test (PSA) was between 27.8% and 42.4%. Multiple log-binomial regression analyses indicate that middle-aged FSWs who had 5 or more clients in the past week prior to interviews and engaged in unprotected sex were more likely to be active syphilitic cases. Middle-aged FSWs who had rural residency were less likely to be active syphilitic cases. Conclusions In contrast with previous studies that reported low prevalence of syphilis and high prevalence of protected sex among FSWs in China, both the prevalence of syphilis and unprotected sex were high among middle-aged FSWs. Evidence-based intervention programmes should be developed and evaluated among this vulnerable population in China and other countries with similar settings. PMID:27165644

  1. Diagnostic accuracy of a point‐of‐care syphilis test when used among pregnant women in Bolivia

    PubMed Central

    Tinajeros, F; Grossman, D; Richmond, K; Steele, M; Garcia, S G; Zegarra, L; Revollo, R

    2006-01-01

    Objective To evaluate the performance of a point‐of‐care (POC) syphilis test when used in urban Bolivian maternity hospitals. Methods We tested 8892 pregnant women for syphilis using the Abbott Determine Syphilis TP rapid POC test and rapid plasma reagin (RPR) in the laboratory of four large urban maternity hospitals where national statistics reported a syphilis prevalence of at least 3%. Sera were stored and transferred to the national reference laboratory (INLASA) where RPR testing was repeated. When the reference laboratory staff observed a positive RPR result, a Treponema pallidum particle agglutination assay (TPPA) was performed to confirm these findings. We calculated test performance characteristics for the POC test and hospital RPR using RPR performed at the reference laboratory confirmed by TPPA as the reference standard. Participants received treatment during their initial visit based on the POC test results. Results The sensitivity, specificity, negative predictive value and positive predictive values of the POC syphilis test were: 91.8% (95% confidence intervals 88.4% to 94.5%), 98.5% (98.2% to 98.8%), 71.0% (66.6% to 75.2%), and 99.7% (99.5% to 99.8%), respectively. The RPR values were 75.7% (70.8% to 80.2%), 99.0% (98.9% to 99.3%), 76.9% (72.0% to 81.3%), and 99.0% (98.8% to 99.2%), respectively. Conclusion The Abbott Determine Syphilis TP test proved to be more sensitive than routine RPR and had comparable specificity. POC testing may be a simple way to expand syphilis screening to clinics with no laboratory facilities, improve case detection, and facilitate treatment delivery. PMID:17121762

  2. Prevalence of HIV, Syphilis, HCV and Their High Risk Behaviors among Migrant Workers in Eastern China

    PubMed Central

    Wang, Qing; Zheng, Hui; Chen, Xin; Su, Jing; Peng, Zhihang; Yu, Rongbin; Wang, Ning

    2013-01-01

    Objective The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China. Methods A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening. Results 17,377 (92.8%) of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73%) of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid) partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4%) had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently) was associated with being divorced or widowed (P<0.05 for single); male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job); having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%–0.06%) and 0.40% (95%CI: 0.31%–0.51%), respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%–0.70%). Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners. Conclusions Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant workers

  3. Management of Adult Syphilis: Key Questions to Inform the 2015 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines.

    PubMed

    Ghanem, Khalil G

    2015-12-15

    A panel of experts generated 8 "key questions" in the management of adult syphilis. A systematic literature review was conducted and tables of evidence were constructed to answer these important questions. Penicillin is the drug of choice to treat syphilis. Doxycycline to treat early and late latent syphilis is an acceptable alternate option if penicillin cannot be used. There is no added benefit to enhanced antimicrobial therapy when treating human immunodeficiency virus-infected persons with syphilis. If a patient misses a dose of penicillin in a course of weekly therapy for late syphilis, clinical experience suggests that an interval of 10-14 days between doses might be acceptable before restarting the sequence of injections. Pharmacologic considerations suggest that an interval of 7-9 days between doses, if feasible, may be more optimal. Missed doses are not acceptable for pregnant women. A cerebrospinal fluid examination to diagnose neurosyphilis is recommended in persons diagnosed with tertiary syphilis (eg, cardiovascular syphilis or late benign syphilis), persons with neurological signs or symptoms consistent with neurosyphilis, and asymptomatic persons whose serological titers do not decline appropriately following recommended therapy and in whom reinfection is ruled out. Infection and reinfection rates, particularly among men who have sex with men, are high. Frequent serological screening of this population appears to be the most cost-efficient intervention. The Centers for Disease Control and Prevention continues to recommend the use of the traditional rapid plasma reagin-based screening algorithm. The positive predictive value for syphilis associated with an isolated unconfirmed reactive treponemal chemiluminescence assay or enzyme immunoassay is low if the epidemiological risk and clinical probability for syphilis are low. Among pregnant women with serodiscordant serologies (positive treponemal tests and a negative nontreponemal test), the risk of

  4. Prevalence and factors associated with syphilis in parturient women in Northeast, Brazil

    PubMed Central

    2013-01-01

    Background Congenital syphilis is a major public health concern, even after the implementation of intervention protocols in several countries. This study aimed to analyze the prevalence and socio-demographic, behavioral and institutional factors associated with syphilis in parturient women attending public maternity hospitals in Northeast, Brazil. Methods A cross-sectional study was conducted from June to September 2010 with a proportionate stratified sampling of 222 parturient women using a structured questionnaire. The study analyzed socio-demographic, behavioral and institutional variables. The structured questionnaire was conducted with parturient women and complementary information was obtained through hospitals records, admission forms and prenatal cards. Data were stored using the Statistical Package SPSS version 18. A descriptive statistical analysis was performed using frequency distribution, central tendency and measures of spread for the variables. A bivariate analysis was done using chi square test and Fisher’s exact test, with a significance level of 5% and a 95% confidence interval, in order to analyze the relation between the variables and risk factors for syphilis. The multivariate logistic regression analysis was done in the statistical package STATA, version 11.0. Results The prevalence of syphilis in parturient women was 7.7%. The bivariate analyses showed that the rate was higher among women who: were from Fortaleza (p = 0.019), studied for less than nine years (p = 0.044), had more than one sexual partner in life (p = 0.021), did not live with partner (p = 0.022), used illegal drugs (p < 0.0001), whose partner used illegal drugs and had diagnosis of syphilis (p = 0.001 and p < 0.0001 respectively). The non-adjusted analysis found significant positive association between syphilis and the following variable: being from Fortaleza (OR = 7.26; CI 95% = 1.49-100.20), having studied for less than nine years (OR

  5. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers

    PubMed Central

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-01-01

    Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous

  6. Quantitative profile of cardiolipin and group treponemal IgD antibodies in syphilis estimated by single radial immunodiffusion technique (SRID).

    PubMed

    Ionescu, A D; Petcovici, M; Ionescu-Dorohoi, T

    1989-01-01

    150 serum samples (reactive in VDRL, Reiter-ELISA, FTA-Abs tests), from male patients 25-45 years old, in various stages of syphilis whether treated or untreated, were tested for IgD by SRID. On 154 sera from healthy males 25-45 years old, the reference normal values for IgD levels were established, as: 0-131.2 IU/ml with a mean of 29.92 +/- 29.61 IU/ml. Cardiolipin and group treponemal fraction values for IgD class were obtained by assessing the difference between the immunodiffusion diameter values produced by sera before and after complete absorption with VDRL antigen or delipidated T. reiteri suspension. The individual, mean +/- SD values (expressed in IU/ml) and the percentage of cardiolipin and treponemal IgD of the total IgD class were calculated for each stage. The mean value of the total IgD class, excepting secondary syphilis (sigma 2) 52.53 +/- 26.66 IU/ml), did not overstep the normal levels but all minimal individual values from syphilitic patients (7.09-14.89 IU/ml) surpassed significantly the normal minimal values which were less than or equal to 3.54 IU/ml. The total lack of cardiolipin (IgD and the presence of group treponemal IgD in all sera of the syphilis stages studied were manifest. The group treponemal IgD mean values ranged between 7-9 IU/ml, with a maximum of 19.32 +/- 10.58 IU/ml in sigma 2 followed by latent syphilis (sigma lat) with a mean value of 9.37 +/- 4.9 IU/ml. A significant percentage of treponemal IgD vs total IgD was recorded: primary syphilis (sigma 1) 32.01%, primary-secondary syphilis (sigma 1-2) 28.76%, sigma 2 36.77%, sigma lat and treated persistent seroreactive syphilis (sigma t+) 29.61%. The high proportion of treponemal IgD in latent and treated persistent reactive syphilis suggests a steady activation of B lymphocytes by treponemal antigens and presumably is an expression of an active infectious process. The absence of cardiolipin IgD and the presence of only the treponemal IgD, in all sera from all stages, might

  7. Syphilis and HIV co-infection in patients who attend an AIDS outpatient clinic in Vitoria, Brazil

    PubMed Central

    Callegari, Fabiola Mesquita; Pinto-Neto, Lauro Ferreira da Silva; Medeiros, Charlla Jezus; Scopel, Camila Binsi; Page, Kimberly; Miranda

    2013-01-01

    Our goal was to determine the prevalence of, and risk factors associated with, syphilis in HIV-infected patients who attend an AIDS outpatient clinic in Vitoria, Brazil. We conducted a cross-sectional study—including interviews for demographic, behavioral, and clinical characteristics—and blood collection (venipuncture and fingerstick) for VDRL and treponemal tests (rapid test) in a total of 438 patients. The mean age was 43.0 years (SD = 11), and mean years of school was 8.1 (SD = 4.2). The prevalence of syphilis was 5.3% (95% CI, 3.3%–7.3%). The treponemal test was positive in 18.9% of participants. In multivariate analysis, prevalent syphilis infection was independently associated with male gender (AOR 4.6, 95% CI, 1.1–20.0), a history of male-male sex (AOR 1.8, 95% CI, 1.6–4.1), current use of antiretroviral therapy (AOR 5.5, 95% CI, 1.7–16.7), and history of treated syphilis infection (AOR 5.5, 95% CI, 2.0–15.8). Syphilis prevalence was high in patients living with HIV/AIDS who attend an AIDS clinic; therefore, routine STI counseling and screening should be included in their care. PMID:23732958

  8. Hepatitis B, Hepatitis C, Human immunodeficiency virus and syphilis frequency among blood donors: A single center study.

    PubMed

    Yildiz, Sule Menziletoglu; Candevir, Aslihan; Kibar, Filiz; Karaboga, Gulser; Turhan, Ferda Tekin; Kis, Cem; Dincer, Suleyman; Guvenc, Birol

    2015-12-01

    We aimed to provide updated results for seroprevalence of hepatitis B, hepatitis C viruses while presenting first data for human immunodeficiency virus and syphilis seropositivity amongst blood donors in Adana, Turkey. Screening and confirmatory test results of 62,461 donors were evaluated. HBsAg, anti-HCV, anti-HIV1/2 and syphilis seropositivity was 1.92%, 0.48%, 0.20%, 0.18% respectively, based on screening tests, and 1.66%, 0.05%, 0.003%, 0.10% respectively, according to confirmatory tests. Transfusion-transmitted infections (TTI) was more prevalent in low-educated donors. HBsAg and syphilis seropositivity rates were higher in married subjects. We found that the prevalence of HBV and HCV was significantly decreased in the last two decades in Adana. Importantly, this study provides first data in HIV and syphilis seropositivity rates among blood donors in our region and both HIV and syphilis seroprevalences were found to be low compared to many regions of Turkey. However, considering the fact that increasing number of immigrants may change prevalences and trends of TTI both in Adana and in Turkey, strict monitorization and yearly reporting of TTI rates seem necessary to be able to take proactive measures.

  9. HIV and syphilis infection among men who have sex with men--Bangkok, Thailand, 2005-2011.

    PubMed

    2013-06-28

    Although efforts to control the heterosexual human immunodeficiency virus (HIV) epidemic in Thailand had shown success by the late 1990s, HIV continued to spread in other risk groups, including men who have sex with men (MSM). In 2003, the Thailand Ministry of Public Health-U.S. CDC Collaboration (TUC) started surveillance among MSM in Bangkok, finding an HIV prevalence of 17.3%. By 2005, HIV prevalence in this group had risen to 28.3% and has since stabilized at around 30%. To obtain additional information about HIV and sexually transmitted infection (STI) prevalence and incidence in a clinic-based population of MSM, TUC, in collaboration with the Thai Red Cross AIDS Research Center, analyzed data collected at the Silom Community Clinic (SCC), an HIV and STI testing center targeting MSM. This report describes trends in HIV and syphilis prevalence and incidence seen among SCC MSM clients during 2005-2011. At first clinic visit, the prevalence of HIV infection among 4,762 clients was 28.3% and of syphilis (all stages) was 9.8%. Among those returning for HIV or syphilis testing before the end of 2011, the incidence of HIV infection was 6.3 per 100 person-years (PY) and 3.6 per 100 PY for syphilis. These results show ongoing epidemics of HIV and syphilis infection in MSM in Bangkok, underscoring the urgent need for preventive interventions to reduce the spread of HIV and STI in this population.

  10. Declining syphilis prevalence in pregnant women in Nairobi since 1995: another success story in the STD field?

    PubMed

    Temmerman, M; Fonck, K; Bashir, F; Inion, I; Ndinya-Achola, J O; Bwayo, J; Kirui, P; Claeys, P; Fransen, L

    1999-06-01

    Untreated maternal syphilis during pregnancy will cause adverse pregnancy outcomes in more than 60% of the infected women. In Nairobi, Kenya, the prevalence of syphilis in pregnant women of 2.9% in 1989, showed a rise to 6.5% in 1993, parallel to an increase of HIV-1 prevalence rates. Since the early 1990s, decentralized STD/HIV prevention and control programmes, including a specific syphilis control programme, were developed in the public health facilities of Nairobi. Since 1992 the prevalence of syphilis in pregnant women has been monitored. This paper reports the findings of 81,311 pregnant women between 1994 and 1997. A total of 4244 women (5.3%) tested positive with prevalence rates of 7.2% (95% CI: 6.7-7.7) in 1994, 7.3% (95% CI: 6.9-7.7) in 1995, 4.5% (95% CI: 4.3-4.8) in 1996 and 3.8% (95% CI: 3.6-4.0) in 1997. In conclusion, a marked decline in syphilis seroprevalence in pregnant women in Nairobi was observed since 1995-96 (P<0.0001, Chi-square test for trend) in contrast to upward trends reported between 1990 and 1994-95 in the same population.

  11. Factors associated with a clinician's offer of screening HIV-positive patients for sexually transmitted infections, including syphilis.

    PubMed

    Heller, R; Fernando, I; MacDougall, M

    2011-06-01

    This retrospective study assessed whether Quality Improvement Scotland national standards for the sexual health care offered to HIV-positive individuals are being met by the Edinburgh genitourinary (GU) medicine clinic; specifically whether HIV-positive patients are offered: (a) sexually transmitted infection (STI) screening annually and (b) syphilis testing six-monthly. The study also reviewed what factors were associated with a clinician's offer of STI screening and syphilis testing. Of the 509 patients seen within the study period, case notes documented that 64% were offered STI screens, and 69% were offered syphilis testing, results consistent with audits of services elsewhere. Sexual orientation (P < 0.0005), relationship status (P = 0.007) and receipt of antiretrovirals (P = 0.001) were independent predictors of clinician offer of STI screening, while gender (P < 0.0005) and receipt of antiretrovirals (P = 0.063) were independent predictors of offer of syphilis testing. Our results suggest that one explanation for clinicians failing to offer STI screens and syphilis serology testing is their (implicit) risk assessment that STI testing is not required in individual patients.

  12. Short-Term Impact Evaluation of a Social Marketing Campaign to Prevent Syphilis Among Men Who Have Sex With Men

    PubMed Central

    Darrow, William W.; Biersteker, Susan

    2008-01-01

    Objectives. We carried out an independent short-term impact evaluation of a social marketing campaign designed to reduce syphilis infections among men who have sex with men in south Florida in 2004. Methods. Venue-based surveys were conducted shortly after the campaign began and 6 months later to assess changes in exposure to campaign materials, awareness, knowledge about syphilis, perceptions of risk, sexual behavior, clinic visits, and testing and treatment for syphilis among participants. Results. Exposure to social marketing campaign materials increased from 18.0% at baseline to 36.5% at follow-up (P< .001). Awareness of syphilis and perceptions of risk increased among Broward County residents but not among Miami–Dade County residents. Risky sexual practices and patterns of recreational drug use did not change. No significant increases in knowledge, clinic visits, or testing or treatment for syphilis among participants were detected over the 6-month study period. Conclusions. None of the campaign objectives were fully met. The interventions were insufficient to produce a significant impact among men who have sex with men in south Florida. PMID:18172146

  13. Rapid Treponema pallidum clearance from blood and ulcer samples following single dose benzathine penicillin treatment of early syphilis.

    PubMed

    Tipple, Craig; Jones, Rachael; McClure, Myra; Taylor, Graham

    2015-02-01

    Currently, the efficacy of syphilis treatment is measured with anti-lipid antibody tests. These can take months to indicate cure and, as a result, syphilis treatment trials require long periods of follow-up. The causative organism, Treponema pallidum (T. pallidum), is detectable in the infectious lesions of early syphilis using DNA amplification. Bacteraemia can likewise be identified, typically in more active disease. We hypothesise that bacterial clearance from blood and ulcers will predict early the standard serology-measured treatment response and have developed a qPCR assay that could monitor this clearance directly in patients with infectious syphilis. Patients with early syphilis were given an intramuscular dose of benzathine penicillin. To investigate the appropriate sampling timeframe samples of blood and ulcer exudate were collected intensively for T. pallidum DNA (tpp047 gene) and RNA (16S rRNA) quantification. Sampling ended when two consecutive PCRs were negative. Four males were recruited. The mean peak level of T. pallidum DNA was 1626 copies/ml whole blood and the mean clearance half-life was 5.7 hours (std. dev. 0.53). The mean peak of 16S rRNA was 8879 copies/ml whole blood with a clearance half-life of 3.9 hours (std. dev. 0.84). From an ulcer, pre-treatment, 67,400 T. pallidum DNA copies and 7.08 x 107 16S rRNA copies were detected per absorbance strip and the clearance half-lives were 3.2 and 4.1 hours, respectively. Overall, T. pallidum nucleic acids were not detected in any sample collected more than 56 hours (range 20-56) after treatment. All patients achieved serologic cure. In patients with active early syphilis, measuring T. pallidum levels in blood and ulcer exudate may be a useful measure of treatment success in therapeutic trials. These laboratory findings need confirmation on a larger scale and in patients receiving different therapies.

  14. Progressive painless lower limbs weakness in a dialyzed patient: undiagnosed tertiary syphilis: a case report

    PubMed Central

    2010-01-01

    Introduction Syphilis is a sexually transmitted disease, remaining under-estimated, under-recognized due to the variability of clinical presentation and ageing of the population with chronic comorbidities. Hence, some manifestations of the past are nowadays superimposed on the course of chronic diseases. Clinical suspicion should be guided by past medical history of contracting any other sexual disease in a heterosexual person or man who has sex with man. Case presentation We describe a rare case of tertiary syphilis in a hemodialyzed diabetic patient whom was career of chronic liver disease due to the evolution of chronic hepatitis B virus infection complicated by a hepatocellular carcinoma. Initial orientation in diagnosing this rare presentation of progressive painless lower limbs weakness was attributed to possible side effects of ongoing anti viral therapy including lamivudine and adefovir. We continued administering both drugs while patient notified a spectacular improvement under Ceftriaxone therapy introduced empirically for a possible chest infection. Routine ophthalmologic examination realized in a teaching hospital, scheduled without knowing the course of late infection showed the presence of a syphilitic uveitis. Conclusion This case emphasizes the need for a high index of clinical suspicion for syphilis before the occurrence of symptoms related to its end organ damage dominated by neurosyphilis form. Early diagnosis is the key to preventing significant morbidity and mortality and improving prognosis. However, in the setting of chronic diseases such as chronic kidney diseases either before setting up methods of renal replacement therapy or under immune-suppressive therapy; clinical presentation might resemble any disease, delaying the certitude of the diagnosis by prescribing a rapid plasma reagin. PMID:20180955

  15. [Syphilis in addicted pregnant women: better care through more awareness and contract between organizations involved].

    PubMed

    Schneider, A J; Bosman, A

    1999-11-13

    Three women, aged 21, 20 and 30 years, were cocaine users and pregnant. There had been no prenatal monitoring until they reported with uterine contractions. Blood of the first two women was then tested; serology revealed active syphilis infections: their children had died in utero. The blood of the third woman had been tested as part of a street project; it revealed an active syphilitic infection but she could not be found for treatment. After delivery, the child showed withdrawal symptoms. The first and third women and the child of the third woman were treated with benzylpenicillin. The system for screening and treating drug-addicted pregnant women should be intensified.

  16. Recommendations for partner services programs for HIV infection, syphilis, gonorrhea, and chlamydial infection.

    PubMed

    2008-11-07

    This report provides updated, integrated recommendations for services provided to partners of persons with human immunodeficiency virus (HIV) infection and three other sexually transmitted diseases (STDs) (i.e., syphilis, gonorrhea, and chlamydial infection) and replaces the CDC 2001 Program Operations Guidelines for STD Prevention---Partner Services and the 1998 HIV Partner Counseling and Referral Services Guidance. These recommendations are intended for health department program managers responsible for overseeing partner services programs for HIV infection and the three other STDs at the state and local levels. The recommendations also might be beneficial for HIV prevention community planning groups, STD program advisory bodies, technical assistance providers, community-based organizations, and clinical care providers. The value of partner services in the control of syphilis and gonorrhea is widely accepted. However, such services are underused among partners of persons with HIV infection. On the basis of evidence of effectiveness and cost-effectiveness of these services, CDC strongly recommends that all persons with newly diagnosed or reported HIV infection or early syphilis receive partner services with active health department involvement. Persons with a diagnosis of, or who are reported with, gonorrhea or chlamydial infection also are suitable candidates for partner services; however, resource limitations and the numerous cases of these infections might preclude direct health department involvement in certain instances. Health departments might need to limit direct involvement in partner services for gonorrhea and chlamydial infection to selected high-priority cases and use other strategies for the remainder (e.g., expedited partner therapy). These recommendations highlight the importance of program collaboration and service integration in the provision of partner services. Because coinfection with HIV and one or more other STDs is common, all persons with a

  17. [Seroprevalence of antibodies for toxoplasmosis, rubella, cytomegalovirus, syphilis and HIV among pregnant women in Sergipe].

    PubMed

    Inagaki, Ana Dorcas de Melo; Oliveira, Lívia Albuquerque Resende de; Oliveira, Maria Fabiana Batista de; Santos, Ricardo Cley Silvestre; Araújo, Raquel Melo; Alves, José Antonio Barreto; Pinheiro, Kariny Souza; Gurgel, Ricardo Queiroz; Mussi-Pinhata, Marisa Márcia

    2009-01-01

    The seroprevalence of antibodies for HIV, syphilis, toxoplasmosis, cytomegalovirosis and rubella and its association with age and origin was investigated among pregnant women in Sergipe, northeastern Brazil. A total of 9,550 pregnant women (2,112 from the state capital and 7,438 from other municipalities) were enrolled in the study and consecutively tested during their first antenatal care visit in 2007. The following serum prevalences were found: syphilis (0.9%; 95% CI 0.7%-1.6%), HIV (0.14%; 95% CI 0.08%-0.2%), toxoplasmosis (IgG 69.3%; 95% CI 68.3%-70.2%; IgM 0.4%, 95% CI 0.3%-0.6%), cytomegalovirosis (IgG 76.6%, 95% CI 75.7%-77.5%; IgM 0.2%, 95% CI 0.09%-0.3%) and rubella (IgG 71.6%, 95% CI 70.7%-72.6%; IgM 0.1%, 95% CI 0.04%-0.2%). Toxoplasmosis seropositivity increased with age. The prevalences of IgG antibodies for toxoplasmosis, cytomegalovirus and rubella were higher in Aracaju (state capital) than in other municipalities in the State of Sergipe. The results showed that a large proportion of the pregnant women, particularly in municipalities other than the state capital, were susceptible to toxoplasmosis, rubella and cytomegalovirus, with a risk for their infants.

  18. Origin of modern syphilis and emergence of a pandemic Treponema pallidum cluster.

    PubMed

    Arora, Natasha; Schuenemann, Verena J; Jäger, Günter; Peltzer, Alexander; Seitz, Alexander; Herbig, Alexander; Strouhal, Michal; Grillová, Linda; Sánchez-Busó, Leonor; Kühnert, Denise; Bos, Kirsten I; Davis, Leyla Rivero; Mikalová, Lenka; Bruisten, Sylvia; Komericki, Peter; French, Patrick; Grant, Paul R; Pando, María A; Vaulet, Lucía Gallo; Fermepin, Marcelo Rodríguez; Martinez, Antonio; Centurion Lara, Arturo; Giacani, Lorenzo; Norris, Steven J; Šmajs, David; Bosshard, Philipp P; González-Candelas, Fernando; Nieselt, Kay; Krause, Johannes; Bagheri, Homayoun C

    2016-12-05

    The abrupt onslaught of the syphilis pandemic that started in the late fifteenth century established this devastating infectious disease as one of the most feared in human history(1). Surprisingly, despite the availability of effective antibiotic treatment since the mid-twentieth century, this bacterial infection, which is caused by Treponema pallidum subsp. pallidum (TPA), has been re-emerging globally in the last few decades with an estimated 10.6 million cases in 2008 (ref. 2). Although resistance to penicillin has not yet been identified, an increasing number of strains fail to respond to the second-line antibiotic azithromycin(3). Little is known about the genetic patterns in current infections or the evolutionary origins of the disease due to the low quantities of treponemal DNA in clinical samples and difficulties in cultivating the pathogen(4). Here, we used DNA capture and whole-genome sequencing to successfully interrogate genome-wide variation from syphilis patient specimens, combined with laboratory samples of TPA and two other subspecies. Phylogenetic comparisons based on the sequenced genomes indicate that the TPA strains examined share a common ancestor after the fifteenth century, within the early modern era. Moreover, most contemporary strains are azithromycin-resistant and are members of a globally dominant cluster, named here as SS14-Ω. The cluster diversified from a common ancestor in the mid-twentieth century subsequent to the discovery of antibiotics. Its recent phylogenetic divergence and global presence point to the emergence of a pandemic strain cluster.

  19. Meta-analysis of ceftriaxone compared with penicillin for the treatment of syphilis.

    PubMed

    Liang, Zhen; Chen, Ya-Ping; Yang, Chun-Sheng; Guo, Wen; Jiang, Xiao-Xiao; Xu, Xi-Feng; Feng, Shou-Xin; Liu, Yan-Qun; Jiang, Guan

    2016-01-01

    Penicillin is the gold standard for treating syphilis. However, allergic reactions, poor drug tolerance and limited efficacy in patients remain a challenging problem. The objective of this meta-analysis was to compare the efficacy of ceftriaxone and penicillin based on data obtained from published randomised controlled trials (RCTs). The Cochrane Library, Medline, EBSCO, EMBASE and Ovid databases were searched for RCTs of ceftriaxone vs. penicillin for the treatment of syphilis. Estimated risk ratios (RRs) and 95% confidence intervals (CIs) were used to investigate the following outcome measures: 3-month response rate; 6-month response rate; 12-month response rate; relapse rate; serofast rate; and failure rate. Seven RCTs involving 281 participants (159 patients who received ceftriaxone and 122 patients who received penicillin) were included in the meta-analysis. There were no significant differences in 3-month response rate (RR=1.12, 95% CI 0.89-1.42), 6-month response rate (RR=1.02, 95% CI 0.75-1.38), 12-month response rate (RR=1.04, 95% CI 0.82-1.32), relapse rate (RR=0.91, 95% CI 0.45-1.84), serofast rate (RR=0.69, 95% CI 0.22-2.12) or failure rate (RR=0.66, 95% CI 0.03-15.76) in patients treated with ceftriaxone compared with those treated with penicillin. In conclusion, there is no evidence in the literature that ceftriaxone is less efficient than penicillin.

  20. Sex and the capital city: the political framing of syphilis and prostitution in early republican Ankara.

    PubMed

    Evered, Emine Ö; Evered, Kyle T

    2013-04-01

    In its initial years, the nascent Turkish republic established the Ministry of Health and Social Assistance in order to promote public health. Beyond simply facilitating its modernizing agenda for the emergent nation-state as it sought to define itself against an Ottoman past, this institution was also geared toward remedying a self-defined population crisis by prioritizing and confronting particular diseases and health conditions. One of the maladies of utmost concern was syphilis. Based upon an analysis of official primary sources, this article engages with how the developing republic distinguished and consequently politically constructed-or framed-the syphilis problem from the vantage of its new forward capital, Ankara. Integral to this project of confronting this sexually transmitted disease, public health officials projected upon both this ailment and their understanding of the suitable means for its treatment their own views of what constituted appropriate sexual practices and relations. In doing so, certain subgroups of the population, especially prostitutes, were particularized as targets for surveillance and policing through regimes of licensing and compulsory medical examinations. Stemming from the state's framing of the disease-and its definition of appropriate sexual practices-this article also examines the subsequent legislative and public health education projects that followed.

  1. Efforts in blood safety: Integrated approach for serological diagnosis of syphilis

    PubMed Central

    Sommese, Linda; De Pascale, Maria Rosaria; Capuano, Maria; Napoli, Claudio

    2016-01-01

    Recent efforts in transfusion medicine are focused on improving blood safety as well as establishing effective and efficient diagnostic algorithms for donor screening. To date, syphilis is a transfusion-transmitted infection re-emerged in many countries as a public health threat especially among populations at specific risk. This task requires new diagnostic tools and hemovigilance programs. The current diagnostic methodologies are debated, since presenting limitations and unresolved issues with special regard to the clinical interpretation of serological patterns, especially in asymptomatic patients and in blood donors. Furthermore, the switch from the traditional to alternative diagnostic algorithms underlines the lack of a gold standard, which has not been supported by shared guidelines. Besides, a lot of ongoing clinical trials on the performance of diagnostic assays, on the serological response associated with different pharmacological treatments, as well as on the prevention programs are currently under investigation. Here, we review the recent literature about the diagnosis of syphilis especially for low-risk populations proposing the adoption of an algorithm for blood donor screening that should satisfy the need of increasing safety for transfusion-transmitted infections in the modern blood transfusion centers. PMID:27011666

  2. Neurological Findings in Early Syphilis: a Comparison Between HIV Positive and Negative Patients.

    PubMed

    González-Duarte, Alejandra; López, Zaira Medina

    2013-01-01

    After a decade of steady decline, syphilis has reemerged within the past few years and it is seeping back into the HIV negative population. We describe herein 16 consecutive cases of neurosyphilis and compare its clinical characteristics. Of the 16 patients, 14 (87%) were men. Mean age at onset was 43 years old (range: 23-82). Twelve patients (75%) were HIV positive; stage was B2 in 2 patients, B3 and C2 in one patient each, and C3 in 8 patients. The clinical presentation was meningitis in 6 (40%), stroke in 3 (18%), ocular manifestations in 4 (27%), and psychiatric manifestations in 2 (13%) cases. Five additional patients had ocular involvement after a formal ophthalmologic examination. High venereal disease research laboratory test (VDRL) titers in serum and cerebrospinal fluid (CSF) were found. Patients in C3 stage of HIV had less CSF pleocytosis (<5 cells/mm(3)) than patients in earlier stages (P=0.018). Disease onset was earlier in patients older than 50 years old with HIV (P=0.049). We found that meningitis, ocular manifestations and stroke were the most common clinical findings in early syphilis. Moreover, stroke included the carotid and cerebrobasilar vascular territories. CSF VDRL continues to be a crucial test in all idiopathic cases of meningitis, stroke and uveitis, regardless of the HIV status or CSF pleocytosis. Except for less pleocytosis, there were no important differences between HIV positive and HIV negative patients.

  3. A Quality Improvement Project to Increase Early Detection of Syphilis Infection or Re-infection in HIV-infected Men Who Have Sex With Men.

    PubMed

    Cheeks, Miyesha A; Fransua, Mesfin; Stringer, Harold G; Silva, Susan; Relf, Michael

    2016-01-01

    Our quality improvement project evaluated whether testing for syphilis every 3 to 6 months with routine HIV laboratory monitoring had an effect on early detection of asymptomatic syphilis infection/re-infection in HIV-infected men who have sex with men. Retrospective analysis of syphilis testing and infections in a sample of this population (N = 245) was conducted after establishing a change-of-practice quality improvement initiative in a not-for-profit, community-based, grant-funded clinic. We compared the clinic's annual rates of syphilis before and after intervention implementation. The detection rate was 6.6% in the preintervention practice change group and 15.5% in the postintervention group. Increased testing identified 27 syphilis cases that would not otherwise have been identified until the annual comprehensive examination. Increased testing frequency led to earlier detection of syphilis, which was clinically significant, showing a potential to decrease the number of new syphilis and HIV infections and to decrease health care expenditures.

  4. The syphilis care cascade: tracking the course of care after screening positive among men and transgender women who have sex with men in Lima, Peru

    PubMed Central

    Tang, Eric C; Segura, Eddy R; Clark, Jesse L; Sanchez, Jorge; Lama, Javier R

    2015-01-01

    Objectives Syphilis is endemic among men who have sex with men (MSM) and transgender women in Latin America. The objective of this study was to assess if those who screen positive for syphilis are receiving appropriate care and treatment. Methods We use data from the 2011 Peruvian National HIV Sentinel Surveillance to describe the syphilis care cascade among high-risk MSM and transgender women. Medical records from participants who had a positive syphilis screening test at two of the enrolment sites in Lima were reviewed to determine their subsequent course of care. Results We identified a cohort of 314 syphilis seropositive participants (median age: 30, 33.7% self-identified as transgender). Only 284/314 (90.4%) participants saw a physician for evaluation within 28 days of their positive test. Of these, 72/284 (25.4%) were asked to return for confirmatory results before deciding whether or not to start treatment; however, 45/72 (62.5%) of these participants did not follow up within 28 days. Of the people prescribed three weekly doses of penicillin, 34/63 (54%) received all three doses on time. Conclusions Many MSM and transgender women with a positive syphilis screening test are lost at various steps along the syphilis care cascade and may have persistent infection. Interventions in this population are needed to increase testing, link seropositive patients into care and ensure that they receive appropriate and timely treatment. PMID:26384725

  5. Unexpectedly high prevalence of Treponema pallidum infection in the oral cavity of human immunodeficiency virus-infected patients with early syphilis who had engaged in unprotected sex practices.

    PubMed

    Yang, C-J; Chang, S-Y; Wu, B-R; Yang, S-P; Liu, W-C; Wu, P-Y; Zhang, J-Y; Luo, Y-Z; Hung, C-C; Chang, S-C

    2015-08-01

    Between 2010 and 2014, we obtained swab specimens to detect Treponema pallidum, with PCR assays, from the oral cavities of 240 patients with 267 episodes of syphilis who reported engaging in unprotected sex practices. The detected treponemal DNA was subjected to genotyping. All of the syphilis cases occurred in men who have sex with men (MSM), and 242 (90.6%) occurred in human immunodeficiency virus-infected patients. The stages of syphilis included 38 cases (14.2%) of primary syphilis of the genital region, 76 (28.5%) of secondary syphilis, 21 (7.9%) of primary and secondary syphilis, 125 (46.8%) of early latent syphilis, and seven (2.6%) others. Concurrent oral ulcers were identified in 22 cases (8.2%). Treponemal DNA was identified from the swabs of 113 patients (42.2%), including 15 (68.2%) with oral ulcers. The most common genotype of T. pallidum was 14f/f. The presence of oral ulcers was associated with identification of T. pallidum in the swab specimens (15/22 (68.2%) vs. 98/245 (40.0%)) (p = 0.01). In multivariate analysis, secondary syphilis (adjusted OR 6.79; 95% CI 1.97-23.28) and rapid plasma reagin (RPR) titres of ≥1: 32 (adjusted OR 2.23; 95% CI 1.02-4.89) were independently associated with the presence of treponemal DNA in patients without oral ulcers. We conclude that detection of treponemal DNA in the oral cavity with PCR assays is not uncommon in MSM, most of whom reported having unprotected oral sex. Although the presence of oral ulcers is significantly associated with detection of treponemal DNA, treponemal DNA is more likely to be identified in patients without oral ulcers who present with secondary syphilis and RPR titres of ≥1: 32.

  6. HIV and Syphilis Co-Infection Increasing among Men Who Have Sex with Men in China: A Systematic Review and Meta-Analysis

    PubMed Central

    Chow, Eric P. F.; Wilson, David P.; Zhang, Lei

    2011-01-01

    Background This study aims to estimate the magnitude and changing trends of HIV, syphilis and HIV-syphilis co-infections among men who have sex with men (MSM) in China during 2003–2008 through a systematic review of published literature. Methodology/Principal Findings Chinese and English literatures were searched for studies reporting HIV and syphilis prevalence among MSM from 2003 to 2008. The prevalence estimates were summarized and analysed by meta-analyses. Meta-regression was used to identify the potential factors that are associated with high heterogeneities in meta-analysis. Seventy-one eligible articles were selected in this review (17 in English and 54 in Chinese). Nationally, HIV prevalence among MSM increased from 1.3% during 2003–2004 to 2.4% during 2005–2006 and to 4.7% during 2007–2008. Syphilis prevalence increased from 6.8% during 2003–2004 to 10.4% during 2005–2006 and to 13.5% during 2007–2008. HIV-syphilis co-infection increased from 1.4% during 2005–2006 to 2.7% during 2007–2008. Study locations and study period are the two major contributors of heterogeneities of both HIV and syphilis prevalence among Chinese MSM. Conclusions/Significance There have been significant increases in HIV and syphilis prevalence among MSM in China. Scale-up of HIV and syphilis screening and implementation of effective public health intervention programs should target MSM to prevent further spread of HIV and syphilis infection. PMID:21857952

  7. Medical and Social Aspects of Syphilis in the Balkans from the mid-19th Century to the Interwar.

    PubMed

    Tsiamis, Costas; Vrioni, Georgia; Poulakou-Rebelakou, Effie; Gennimata, Vasiliki; Murdjeva, Mariana А; Tsakris, Athanasios

    2016-03-01

    The current study presents some aspects of syphilis in the Balkan Peninsula from the 19th century until the Interwar. Ever since the birth of modern Balkan States (Greece, Bulgaria, Turkey and Serbia), urbanization, poverty and the frequent wars have been considered the major factors conducive to the spread of syphilis. The measures against sex work and sexually transmitted diseases (STDs) were taken in two aspects, one medical and the other legislative. In this period, numerous hospitals for venereal diseases were established in the Balkan countries. In line with the international diagnostic approach and therapeutic standards, laboratory examinations in these Balkan hospitals included spirochete examination, Wassermann reaction, precipitation reaction and cerebrospinal fluid examination. Despite the strict legislation and the adoption of relevant laws against illegal sex work, public health services were unable to curb the spread of syphilis. Medical and social factors such as poverty, citizen's ignorance of STDs, misguided medical perceptions, lack of sanitary control of prostitution and epidemiological studies, are highlighted in this study. These factors were the major causes that helped syphilis spread in the Balkan countries during the 19th and early 20th century. The value of these aspects as a historic paradigm is diachronic. Failure to comply with the laws and the dysfunction of public services during periods of war or socioeconomic crises are both factors facilitating the spread of STDs.

  8. The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV Education and AIDS Risk Education Programs in the Black Community.

    ERIC Educational Resources Information Center

    Thomas, Stephen B.; Quinn, Sandra Crouse

    1991-01-01

    The Tuskegee study of untreated syphilis in black males caused distrust by blacks of the public health system that has implications for Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) studies. AIDS prevention among blacks may require openness about the Tuskegee study to allay fears of repetition. (SLD)

  9. Attributes of diagnostic tests to increase uptake of dual testing for syphilis and HIV in Port-au-Prince, Haiti.

    PubMed

    Bristow, Claire C; Lee, Sung-Jae; Severe, Linda; William Pape, Jean; Javanbakht, Marjan; Scott Comulada, Warren; Klausner, Jeffrey D

    2017-03-01

    Introduction Syphilis and HIV screening is highly recommended for pregnant women and those at risk for infection. We used conjoint analysis to identify factors associated with testing preferences for HIV and syphilis infection. Methods We recruited 298 men and women 18 years and over seeking testing or care at GHESKIO (Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections) clinics. We created eight hypothetical dual HIV-syphilis test profiles varying across six dichotomous attributes. Participants were asked to rate each profile using Likert preference scales. An impact score was generated for each attribute by taking the difference between the preference scores for the preferred and non-preferred level of each attribute. Two-sided one-sample t-test was used to generate p values. Results Of 298 study participants, 61 (20.5%) were male. Of 237 females, 49 (20.7%) were pregnant. Cost (free vs. US$4; p < .0001) had the highest impact on willingness to test, followed by number of blood draws (1 vs. 2; p < .0001), blood draw method (fingerprick vs. venipuncture; p < .0001), test type (rapid vs. laboratory; p = .0005), and time-to-result (20 minutes vs. 1 week; p = .0139). Conclusion HIV and syphilis testing preferences for this study sample in Port-au-Prince prioritized cost, single fingerprick, laboratory-based testing and timeliness.

  10. Risk for HIV following a diagnosis of syphilis, gonorrhoea or chlamydia: 328,456 women in Florida, 2000-2011.

    PubMed

    Peterman, Thomas A; Newman, Daniel R; Maddox, Lorene; Schmitt, Karla; Shiver, Stacy

    2015-02-01

    Several effective interventions are available for preventing HIV in women. Targeting interventions requires understanding their risk of acquiring HIV. We used surveillance data to estimate risks of HIV acquisition for 13-59-year-old women following a diagnosis of syphilis, gonorrhoea or chlamydia in Florida during 2000-2009. We excluded women reported with HIV before their STI, and measured HIV reported subsequent to STI (through 2011). Rates were compared to women with no reported STI. A total of 328,456 women had: syphilis (3325), gonorrhoea (67,784) or chlamydia (257,347). During 2,221,944 person-years of follow-up, 2118 of them were diagnosed with HIV. For women with no STI reported, during 64,763,832 person-years, 19,531 were reported with HIV. The crude rate of subsequent HIV diagnosis (per 100,000 person-years) was higher for women diagnosed with syphilis (597.9), gonorrhoea (171.3) or chlamydia (66.3) than women with no STI (30.2). Annual rates of HIV decreased over-all by 61.8% between 2001 and 2011. Women with syphilis or gonorrhoea were at highest risk for HIV and therefore might benefit from intensive counselling. However, they represented only a small fraction of the women who acquired HIV. Most cases of HIV infection among women occurred among the large group of women who were not at highest risk.

  11. A systematic review and meta-analysis of the prevalence of chlamydia, gonorrhoea and syphilis in incarcerated persons.

    PubMed

    Kouyoumdjian, F G; Leto, D; John, S; Henein, H; Bondy, S

    2012-04-01

    Communicable diseases are common in people who are incarcerated. We aimed to define the prevalence of chlamydia, gonorrhoea and syphilis in people who are incarcerated and to identify subgroups with the highest risk of infection. We searched for prevalence studies of chlamydia, gonorrhoea or syphilis in incarcerated populations. Pooled estimates were generated, and meta-regression was conducted. Random effects models yielded pooled prevalence estimates of 5.75% (95% confidence interval [CI] 5.01, 6.48) and 12.31% (95% CI 10.61, 14.01) for chlamydia in men and women, 1.4% (95% CI 1.09, 1.70) and 5.73% (4.76, 6.69) for gonorrhoea in men and women, and 2.45% (95% CI 2.08, 2.82) and 6.10% (95% CI 4.75, 7.46) for syphilis in men and women, respectively. Each infection was associated with female gender in meta-regression models. Chlamydia, gonorrhoea and syphilis are highly prevalent in these populations. Primary and secondary prevention efforts could improve individual and population health.

  12. Metaanalysis of the Performance of a Combined Treponemal and Nontreponemal Rapid Diagnostic Test for Syphilis and Yaws

    PubMed Central

    Marks, Michael; Yin, Yue-Ping; Chen, Xiang-Sheng; Castro, Arnold; Causer, Louise; Guy, Rebecca; Wangnapi, Regina; Mitjà, Oriol; Aziz, Abdul; Castro, Rita; da Luz Martins Pereira, Filomena; Taleo, Fasihah; Guinard, Jérôme; Bélec, Laurent; Tun, Ye; Bottomley, Christian; Ballard, Ronald C.; Mabey, David C.W.

    2016-01-01

    Background. The human treponematoses are important causes of disease. Mother-to-child transmission of syphilis remains a major cause of stillbirth and neonatal death. There are also almost 100 000 cases of endemic treponemal disease reported annually, predominantly yaws. Rapid diagnostic tests (RDTs) would improve access to screening for these diseases. Most RDTs cannot distinguish current and previous infection. The Dual Path Platform (DPP) Syphilis Screen & Confirm test includes both a treponemal (T1) and nontreponemal (T2) component and may improve the accuracy of diagnosis. Methods. We conducted a metaanalysis of published and unpublished evaluations of the DPP-RDT for the diagnosis of syphilis and yaws. We calculated the sensitivity, specificity, and overall agreement of the test compared with reference laboratory tests. Results. Nine evaluations, including 7267 tests, were included. Sensitivity was higher in patients with higher titer rapid plasma reagin (≥1:16) for both the T1 (98.2% vs 90.1%, P < .0001) and the T2 component (98.2% vs 80.6%, P < .0001). Overall agreement between the DPP test and reference serology was 85.2% (84.4%–86.1%). Agreement was highest for high-titer active infection and lowest for past infection. Conclusions. The RDT has good sensitivity and specificity of the treponemal and nontreponemal components both in cases of suspected syphilis and yaws, although the sensitivity is decreased at lower antibody titers. PMID:27217216

  13. Rapid Syphilis Testing Is Cost-Effective Even in Low-Prevalence Settings: The CISNE-PERU Experience

    PubMed Central

    Mallma, Patricia; Garcia, Patricia; Carcamo, Cesar; Torres-Rueda, Sergio; Peeling, Rosanna; Mabey, David; Terris-Prestholt, Fern

    2016-01-01

    Studies have addressed cost-effectiveness of syphilis testing of pregnant women in high-prevalence settings. This study compares costs of rapid syphilis testing (RST) with laboratory-based rapid plasma reagin (RPR) tests in low-prevalence settings in Peru. The RST was introduced in a tertiary-level maternity hospital and in the Ventanilla Network of primary health centers, where syphilis prevalence is approximately 1%. The costs per woman tested and treated with RST at the hospital were $2.70 and $369 respectively compared with $3.60 and $740 for RPR. For the Ventanilla Network the costs per woman tested and treated with RST were $3.19 and $295 respectively compared with $5.55 and $1454 for RPR. The cost per DALY averted using RST was $46 vs. $109 for RPR. RST showed lower costs compared to the WHO standard costs per DALY ($64). Findings suggest syphilis screening with RST is cost-effective in low-prevalence settings. PMID:26949941

  14. Rapid Syphilis Testing Is Cost-Effective Even in Low-Prevalence Settings: The CISNE-PERU Experience.

    PubMed

    Mallma, Patricia; Garcia, Patricia; Carcamo, Cesar; Torres-Rueda, Sergio; Peeling, Rosanna; Mabey, David; Terris-Prestholt, Fern

    2016-01-01

    Studies have addressed cost-effectiveness of syphilis testing of pregnant women in high-prevalence settings. This study compares costs of rapid syphilis testing (RST) with laboratory-based rapid plasma reagin (RPR) tests in low-prevalence settings in Peru. The RST was introduced in a tertiary-level maternity hospital and in the Ventanilla Network of primary health centers, where syphilis prevalence is approximately 1%. The costs per woman tested and treated with RST at the hospital were $2.70 and $369 respectively compared with $3.60 and $740 for RPR. For the Ventanilla Network the costs per woman tested and treated with RST were $3.19 and $295 respectively compared with $5.55 and $1454 for RPR. The cost per DALY averted using RST was $46 vs. $109 for RPR. RST showed lower costs compared to the WHO standard costs per DALY ($64). Findings suggest syphilis screening with RST is cost-effective in low-prevalence settings.

  15. Risk of syphilis in STI clinic patients: a cross‐sectional study of 11 500 cases in Guangxi, China

    PubMed Central

    Wong, Susan P Y; Yin, Yue‐Ping; Gao, Xing; Wei, Wan‐Hui; Shi, Mei‐Qin; Huang, Pei‐Yong; Wang, Hong; Chen, Qiang; Liu, MuSang; Tucker, Joseph D; Chen, Xiang‐Sheng; Cohen, Myron S

    2007-01-01

    Objective To measure prevalence of syphilis among the STI clinic population in Guangxi, China, and to assess the socioeconomic and behavioural characteristics associated with the infection. Methods We undertook a cross‐sectional survey and syphilis and HIV serologic testing among 11 473 patients attending 14 community and hospital‐based dermatovenereal clinics across eight cities in Guangxi between December 2004 and February 2006. Results 1297 (11.9%) patients demonstrated positive toludine red unheated serum test and Treponema pallidum particle agglutination results with serologic testing. A total of 58% (752) of seropositive subjects presented with a genital ulcer, palmar/plantar rash or inguinal lymphadenopathy. Female sex (OR = 2.23, 95% confidence intervals (CI) = 1.69 to 3.00, p<0.001), less education (middle school, OR = 1.70, 95% CI = 1.11 to 2.62, p = 0.023; primary school or less, OR = 1.98, 95% CI = 1.13 to 3.46, p = 0.017) and high annual income (OR = 1.91, 95% CI = 1.18 to 3.10, p = 0.009 for >30 000 RMB yuan) were associated with serologically positive status. Syphilis infection was significantly more prevalent in city 2 (19.5%, OR = 3.07, 95% CI = 1.83 to 5.16, p<0.001), city 4 (16.6%, OR = 1.90, 95% CI = 1.10 to 3.28, p = 0.011) and city 8 (13.8%, OR = 1.83, 95% CI = 1.13 to 2.97, p = 0.006). A total of 40.1% (532) of infected subjects engaged in commercial sex and increased rates of the infection was associated with multiple sexual partners (OR = 1.54, 95% CI = 1.16 to 2.06, p = 0.003). A total of 1.2% (133) of participants carried laboratory markers for HIV and 1.8% (23) of patients with syphilis were positive for HIV. Conclusions Syphilis infection has reached alarming rates in China's STI clinic population, suggesting a generalised spread of the disease through commercial sex and bridging populations. Syphilis control is deserving of China's highest

  16. Syphilis incidence among men who have sex with men in China: results from a meta-analysis.

    PubMed

    Chen, Guohong; Cao, Ya; Yao, Yuan; Li, Ming; Tang, Weiming; Li, Jianjun; Babu, Giridhara R; Jia, Yue; Huan, Xiping; Xu, Genxing; Yang, Haitao; Fu, Gengfeng; Li, Lei

    2017-02-01

    The recent upsurge of syphilis infections among men who have sex with men (MSM) is one of the major challenges facing China. However, the overall burden is still not clear. This study aims to summarize the incidence of syphilis among MSM in China by using meta-analysis. We comprehensively searched PubMed-MEDLINE, China National Knowledge Infrastructure and Chinese Wanfang databases. Articles published between December 2009 and March 2015 that met the inclusion criteria were considerably involved in this meta-analysis. Two reviewers performed a quality assessment of the studies and extracted data for estimating the overall syphilis incidence. STATA 12.0 was used to summarize the overall incidence of syphilis. In all, 14 studies from 13 papers were included in this study. Follow-up duration of these studies ranged from six to 36 months, while drop-out rates ranged from 11.9% to 83.6%. The individual incidence rates of the included studies varied from 3.1/100 person-years (95% CI, 0.8-5.3/100 person-years) to 38.5/100 person-years (95% CI, 28.9-48.1/100 person-years), with a pooled incidence of 9.6/100 person-years (95% CI, 7.0-12.2/100 person-years). The subgroup meta-analysis revealed that incidence estimates were 38.5/100 person-years (95% CI, 28.9-48.1/100 person-years), 12.1/100 person-years (95% CI, 7.0-17.2/100 person-years), 11.2/100 person-years (95% CI, 0.7-23.1/100 person-years), 8.9/100 person-years (95% CI, 6.5-11.2/100 person-years), 5.7/100 person-years (95% CI, 3.4-8.0/100 person-years) and 3.1/100 person-years (95% CI, 0.8-5.3/100 person-years) in Northeast, North, Southwest, East, South and Northwest China, respectively. Syphilis incidence among Chinese MSM is high, and this may increase the spread of other sexually transmitted infections, including human immunodeficiency virus. It is essential to integrate syphilis control programs with HIV control programs. This can be achieved by establishing public health response systems to monitor and control

  17. Underreporting of Congenital Syphilis as a Cause of Fetal and Infant Deaths in Northeastern Brazil

    PubMed Central

    Cardoso, Ana Rita Paulo; Araújo, Maria Alix Leite; Andrade, Roumayne Fernandes Vieira; Saraceni, Valéria; Miranda, Angelica E.; Dourado, Maria Inês Costa

    2016-01-01

    Introduction Of all syphilis-related pregnancy outcomes, fetal death is certainly the most common one, being directly related to the availability, accessibility and quality of prenatal care. The present study aimed to analyze the underreporting of fetal and infant deaths and other maternal factors associated with congenital syphilis (CS) death. Methods This cross-sectional study integrated data of infants that were diagnosed and/or died of CS from the Sistema de Informação de Agravos de Notificação–Sinan (Notifiable Diseases Information System) and the Sistema de Informação de Mortalidade–SIM (Mortality Information System) in Fortaleza, Northeastern Brasil to identify unreported cases of congenital syphilis. We assessed data during the period from 2007 to 2013. Results The underreporting of CS as a cause of fetal or infant death increased from 41 to 415 cases (90.1%) during 2007–2013. Exactly 3,209 cases of CS were identified in Sinan and 6,578 deaths in SIM. After database linkage, we identified 382 cases that were reported in the SIM and SINAN databases consisting of 309 fetal deaths and 73 infant deaths related to CS. From the children notified at Sinan that born alive, 3.0% (78/2,542) died; Out of these, 39 (50.0%) were early and 25 (32.1%) were late neonatal deaths. The proportion of death by CS increased from 0.62 to 5.8 from 2007 to 2013. At logistic regression, the variable that maintained statistical significance with fetal and infant death outcomes was the presence of CS signs and/or symptoms at birth (OR = 3.20; IC 95% 1.54–6.62; p = 0.002). Conclusions Neonatal and Infant deaths following CS-associated live births are underreported in Northeastern Brazil. Data base linkage identified unreported fetal and neonatal deaths due to CS leading to an increased awareness of fetal/infant mortality due to this infection. PMID:27941983

  18. [Analysis of syphilis and gonorrhoea cases, based on data from the National STD Centre, Department of Dermatology and Venerology, Semmelweis University (2005-2008)].

    PubMed

    Pónyai, Katinka; Marschalkó, Márta; Schöffler, Mária; Ostorházi, Eszter; Rozgonyi, Ferenc; Várkonyi, Viktória; Kárpáti, Sarolta

    2009-09-20

    The STD Department of Semmelweis University Budapest is the National Centre of Hungary, which is responsible for screening and care of sexually transmitted diseases (STD), including syphilis and gonorrhoea. 42,114 patients attended the STD Department and 25,362 anonymous screening (HIV: 12,337, syphilis: 13,025) were done between January 2005 and December 2008. During this period 600 syphilitic and 339 gonorrhoea infections were diagnosed. The obligatory HIV screening of patients with sexually transmitted infections (STI) resulted positive result in 47 cases, and 63 patients infected with HIV acquired new syphilitic or gonorrhoea infection. Contact tracing was successful in around 400 syphilis cases, and 150-200 gonorrhoea cases per year. We present our statistical data in order to call attention to the resurgence of syphilis and gonorrhoea and the importance of STD co-infections.

  19. The Tuskegee Study of Untreated Syphilis and public perceptions of biomedical research: a focus group study.

    PubMed Central

    Bates, Benjamin R.; Harris, Tina M.

    2004-01-01

    African Americans are less likely than European Americans to participate in biomedical research. Researchers often attribute nonparticipation to the "Tuskegee effect." Using critical qualitative analysis of focus group data, we examined the public's use of the Tuskegee Study of Untreated Syphilis (TSUS) to discuss biomedical research. Our participants articulated three primary themes in relation to TSUS: 1) that TSUS made them suspicious about biomedical research; 2) that other values had to weigh against concerns about TSUS; and 3) that African Americans could take steps to resolve their concerns about TSUS. African Americans were more likely to discuss TSUS than were European Americans. African Americans did not use TSUS to express simple fear. African Americans suggested issues other than TSUS that influence the decision to participate in research. African Americans indicated specific reforms that would increase participation in research. We discuss how a better understanding of African Americans' use of TSUS can enhance research participation and allay concerns about "another Tuskegee." PMID:15303410

  20. Evaluation of three serological tests manufactured in Belarus for the diagnosis of syphilis.

    PubMed

    Shimanskaya, Iryna; Zhurauskaya, Larisa; Pankratov, Oleg; Unemo, Magnus; Ballard, Ronald C; Domeika, Marius

    2011-05-01

    The performance of three serological tests manufactured in Belarus for the diagnosis of syphilis, i.e. a microprecipitation reaction (MPR) and two enzyme-linked immunosorbent assays (ELISAs) were compared with internationally recognized assays, namely the rapid plasma reagin test and the Treponema pallidum passive particle agglutination assay (TPPA). Sera from 392 consecutive patients attending Brest (Belarus) regional dermatovenereological dispensaries were tested. The sensitivity of the MPR test was low (77.3%) compared with the rapid plasma reagin test, while the specificity was high (100%). In contrast, both Belarusian ELISAs performed well when compared with the TPPA (sensitivities of 99.2% and 100%, specificities of 98.7% and 99.0%, respectively). There is a clear need to improve the sensitivity of the existing Belarusian MPR test or to use a more sensitive screening test in order to improve diagnosis of the disease in Belarus.

  1. Syphilis Test

    MedlinePlus

    ... been developed, making them convenient for screening purposes. Direct detection of bacteria —these tests are less commonly ... highly sensitive; can be used to exclude neurosyphilis. Direct detection tests (much less common): Microscopic Exam, Darkfield ...

  2. Antenatal Syphilis Screening Using Point-Of-Care Testing in Low- and Middle-Income Countries in Asia and Latin America: A Cost-Effectiveness Analysis

    PubMed Central

    Kuznik, Andreas; Muhumuza, Christine; Komakech, Henry; Marques, Elsa M. R.; Lamorde, Mohammed

    2015-01-01

    Background Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. In low- and middle-income countries in Asia and Latin America, 20%-30% of women are not tested for syphilis during pregnancy. We evaluated the cost-effectiveness of increasing the coverage for antenatal syphilis screening in 11 Asian and 20 Latin American countries, using a point-of-care immunochromatographic strip (ICS) test. Methods The decision analytical cost-effectiveness models reported incremental costs per disability-adjusted life years (DALYs) averted from the perspectives of the national health care payer. Clinical outcomes were stillbirths, neonatal deaths, and congenital syphilis. DALYs were computed using WHO disability weights. Costs included the ICS test, three injections of benzathine penicillin, and nurse wages. Country-specific inputs included the antenatal prevalence of syphilis and the proportion of women in the antenatal care setting that are screened for syphilis infection as reported in the 2014 WHO baseline report on global sexually transmitted infection surveillance. Country-specific data on the annual number of live births, proportion of women with at least one antenatal care visit, and per capita gross national income were also included in the model. Results The incremental cost/DALY averted of syphilis screening is US$53 (range: US$10-US$332; Prob<1*per capita GDP=99.71%) in Asia and US$60 (range: US$5-US$225; Prob<1*per capita GDP=99.77%) in Latin America. Universal screening may reduce the annual number of stillbirths by 20,344 and 4,270, neonatal deaths by 8,201 and 1,721, cases of congenital syphilis by 10,952 and 2,298, and avert 925,039 and 197,454 DALYs in the aggregate Asian and Latin American panel, respectively. Conclusion Antenatal syphilis screening is highly cost-effective in all the 11 Asian and 20 Latin American countries assessed. Our findings support the decision to expand syphilis screening in countries with currently

  3. Contribution of a Comparative Western Blot Method to Early Postnatal Diagnosis of Congenital Syphilis

    PubMed Central

    Foschi, Claudio; Capretti, Maria Grazia; Nardini, Paola; Compri, Monica; Corvaglia, Luigi Tommaso; Faldella, Giacomo; Cevenini, Roberto

    2016-01-01

    Serology has a pivotal role in the diagnosis of congenital syphilis (CS), but problems arise because of the passive transfer of IgG antibodies across the placenta. The aim of this study was to assess the diagnostic value of a comparative Western blot (WB) method finalized to match the IgG immunological profiles of mothers and their own babies at birth in order to differentiate between passively transmitted maternal antibodies and antibodies synthesized by the infants against Treponema pallidum. Thirty infants born to mothers with unknown or inadequate treatment for syphilis were entered in a retrospective study, conducted at St. Orsola-Malpighi Hospital, Bologna, Italy. All of the infants underwent clinical, instrumental, and laboratory examinations, including IgM WB testing. For the retrospective study, an IgG WB assay was performed by blotting T. pallidum antigens onto nitrocellulose sheets and incubating the strips with serum specimens from mother-child pairs. CS was diagnosed in 11 out of the 30 enrolled infants; 9/11 cases received the definitive diagnosis within the first week of life, whereas the remaining two were diagnosed later because of increasing serological test titers. The use of the comparative IgG WB testing performed with serum samples from mother-child pairs allowed a correct CS diagnosis in 10/11 cases. The CS diagnosis was improved by a strategy combining comparative IgG WB results with IgM WB results, leading to a sensitivity of 100%. The comparative IgG WB test is thus a welcome addition to the conventional laboratory methods used for CS diagnosis, allowing identification and adequate treatment of infected infants and avoiding unnecessary therapy of uninfected newborns. PMID:26961856

  4. Evaluation of the automated ADVIA centaur® XP syphilis assay for serological testing.

    PubMed

    Saw, Sharon; Zhao, Huiqin; Tan, Phyllis; Saw, Betty; Sethi, Sunil

    2017-02-20

    We evaluated the performance of the ADVIA Centaur XP Syphilis assay (Siemens Healthcare Diagnostics, Tarrytown, NY, USA) using samples previously tested on the ARCHITECT i4000SR system (Abbott Diagnostics, Lake Forest, IL, USA) and confirmed by the Treponema pallidum particle agglutination assay (TPPA) (SERODIA-TPPA, Fujirebio Diagnostics Inc., Malvern, PA, USA). Clinical patient information was included to aid resolution of discordant samples where available. Precision, interference, and cross-reactivity were also assessed. Relative to patient clinical status, the sensitivity of both the ADVIA Centaur XP and the ARCHITECT assays was 100% (95% CI, 93.9-100), and the specificity of the ADVIA Centaur XP assay was 95.5% (95% CI, 90.4-98.3), which was slightly higher than that of the ARCHITECT assay at 93.9% (95% CI, 88.4-97.3). Overall agreement relative to patient clinical status was 96.9% (95% CI, 93.3-98.8) for the ADVIA Centaur XP assay and 95.8% (95% CI, 91.9-98.2) for the ARCHITECT assay. Overall agreement between the two automated assays was 96.9% (95% CI, 93.3-98.8). ADVIA Centaur XP assay precision was <5% at all index values tested. No significant interference was observed for lipemia or hemolysis; a small effect was seen with some samples for bilirubin. The assay exhibited no significant cross-reactivity with a number of potential interfering factors. The ADVIA Centaur XP Syphilis assay can be considered a sensitive and accurate assay for identification of treponemal antibodies in screening populations as well as patients presenting with suspicion of syphilitic infection.

  5. Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study

    PubMed Central

    McGready, Rose; Kang, Joy; Watts, Isabella; Tyrosvoutis, Mary Ellen G; Torchinsky, Miriam B.; Htut, Aung Myo; Tun, Nay Win; Keereecharoen, Lily; Wangsing, Chirapat; Hanboonkunupakarn, Borimas; Nosten, François H.

    2015-01-01

    Objective: The antenatal prevalence of syphilis and HIV/AIDS in migrants and refugees is poorly documented. The aim of this study was to audit the first year of routine syphilis screening in the same population and reassess the trends in HIV rates. Methods: From August 2012 to July 2013, 3600 pregnant women were screened for HIV (ELISA) and syphilis (VDRL with TPHA confirmation) at clinics along the Thai-Myanmar border. Results: Seroprevalence for HIV 0.47% (95% CI 0.30-0.76) (17/3,599), and syphilis 0.39% (95% CI 0.23-0.65) (14/3,592), were low. Syphilis was significantly lower in refugees (0.07% 95% CI 0.01-0.38) (1/1,469), than in migrants (0.61% 95% CI 0.36-1.04) (13/2,123). The three active (VDRL≥1:8 and TPHA reactive) syphilis cases with VDRL titres of 1:32 were easy to counsel and treat. Women with low VDRL titres (>75% were < 1:8) and TPHA reactive results, in the absence of symptoms and both the woman and her husband having only one sexual partner in their lifetime, and the inability to determine the true cause of the positive results presented ethical difficulties for counsellors. Conclusion: As HIV and syphilis testing becomes available in more and more settings, the potential impact of false positive results should be considered, especially in populations with low prevalence for these diseases. This uncertainty must be considered in order to counsel patients and partners accurately and safely about the results of these tests, without exposing women to increased risk for abuse or abandonment. Our findings highlight the complexities of counselling patients about these tests and the global need for more conclusive syphilis testing strategies. PMID:26664698

  6. Syphilis epidemiology in 1994-2013, molecular epidemiological strain typing and determination of macrolide resistance in Treponema pallidum in 2013-2014 in Tuva Republic, Russia.

    PubMed

    Khairullin, Rafil; Vorobyev, Denis; Obukhov, Andrey; Kuular, Ural-Herel; Kubanova, Anna; Kubanov, Alexey; Unemo, Magnus

    2016-07-01

    The incidence of syphilis in the Tuva Republic (geographical centre of Asia), Russia has been exceedingly high historically. No detailed examinations and no molecular investigations of Treponema pallidum strains transmitted in the Tuva Republic, or in general, in Russia, were published internationally. We examined the syphilis epidemiology in 1994-2013, and the molecular epidemiology and macrolide resistance in T. pallidum strains in 2013-2014 in the Tuva Republic. Among 95 mainly primary or secondary syphilis patients, the arp, tpr, tp0548 and 23S rRNA genes in 85 polA gene-positive genital ulcer specimens were characterized. The syphilis incidence in Tuva Republic peaked in 1998 (1562), however declined to 177 in 2013. Among the 70 (82%) completely genotyped specimens, six molecular strain types were found. Strain type 14d/f accounted for 91%, but also 14c/f, 14d/g, 14b/f, 14i/f, 9d/f, and 4d/f were identified. Two (2.4%) specimens contained the 23S rRNA A2058G macrolide resistance mutation. This is the first internationally published typing study regarding T. pallidum in Russia, performed in the Tuva Republic with the highest syphilis incidence in Russia. The two molecular strain types 4d/f and 9d/f have previously been described only in Eastern and Northern China and for the first time, macrolide-resistant syphilis was described in Russia.

  7. A serosurvey of Haemophilus ducreyi, syphilis, and herpes simplex virus type 2 and their association with human immunodeficiency virus among female sex workers in Lagos, Nigeria.

    PubMed

    Dada, A J; Ajayi, A O; Diamondstone, L; Quinn, T C; Blattner, W A; Biggar, R J

    1998-05-01

    Cross-sectional standard serologic assays were used to determine the prevalence of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus type 2 (HSV-2) antibodies among 796 female commercial sex workers from Lagos, Nigeria, and their association with HIV antibody status. The seroprevalence rates were 86% for anti-H. ducreyi IgG and 69% for anti-H. ducreyi IgA, 4% for rapid plasma reagin and Treponema palladium hemagglutination assay confirmed syphilis, 59% for HSV-2, 12% for HIV-1, and 2% for HIV-2. Lower-class sex workers were significantly more likely than upper-class sex workers to be H. ducreyi-positive and to have current or past syphilis infection. The presence of syphilis increased significantly with older age. Non-Nigerian sex workers had significantly higher reactivity to chancroid and borderline reactivity to syphilis. A history of sex with non-Nigerian Africans was significantly associated with chancroid reactivity and borderline significant with syphilis serostatus. H. ducreyi seropositivity was significantly more likely in female sex workers with HSV-2 and syphilis. Chancroid and HSV-2 antibodies were also more common in HIV-infected sex workers. The high prevalence of H. ducreyi antibodies detected in this study underscores the importance of an effective program to control genital ulcerative disease as part of the strategy to prevent the spread of HIV in Nigeria.

  8. Syphilis serology in pregnancy: an eight-year study (2005-2012) in a large teaching maternity hospital in Dublin, Ireland.

    PubMed

    McGettrick, Padraig; Ferguson, Wendy; Jackson, Valerie; Eogan, Maeve; Lawless, Mairead; Ciprike, Vaneta; Varughese, Alan; Coulter-Smith, Sam; Lambert, John S

    2016-03-01

    All cases of positive syphilis serology detected in antenatal and peripartum screening in a large teaching maternity hospital in inner city Dublin, Ireland over an eight-year period (2005-2012 inclusive) were reviewed and included in our study. Demographic, antenatal registration, laboratory (including co-infections), partner serology, treatment and delivery data were recorded in our database. Infant follow-up, treatment and outcome data were also collected. During this period, 194 women had positive syphilis serology, of which 182 completed their pregnancies at the institution. This accounts for 0.28% of the total number of women completing their pregnancies during this time (N = 66038); 79 had no previous diagnosis of infection. There was one case of re-infection during pregnancy. Thirty-two women were co-infected with human immunodeficiency virus, hepatitis B or hepatitis C. There was one case suggestive of congenital syphilis infection. Our study is a comprehensive analysis of the diagnosis, management and clinical outcomes of women testing positive for syphilis infection in pregnancy. It reveals the relatively high prevalence of syphilis infection in the population utilising the maternity services in north inner-city Dublin. It re-enforces the importance of continued active surveillance to prevent morbidity and mortality associated with maternal syphilis infection. It also highlights the importance of strategies such as re-testing high-risk groups and definitive screening of spouse serology.

  9. Yaws, syphilis, sexuality, and the circulation of medical knowledge in the British Caribbean and the Atlantic world.

    PubMed

    Paugh, Katherine

    2014-01-01

    This history of the disease categories "yaws" and "syphilis" explores the interplay between European and African medical cultures in the early modern Atlantic world. The assertion made by both early modern and modern medical authorities, that yaws and syphilis are the same disease, prompts a case study of the history of disease that reflects on a variety of issues in the history of medicine: the use of ideas about contagion to demarcate racial and sexual difference at sites around the British Empire; the contrast between persistently holistic ideas about disease causation in the Black Atlantic and the growth of ontological theories of disease among Europeans and Euro-Americans; and the controversy over the African practice of yaws inoculation, which may once have been an effective treatment but was stamped out by plantation owners who viewed it as a waste of their enslaved laborers' valuable time.

  10. Changing trend of HIV, Syphilis and Hepatitis C among Men Who Have Sex with Men in China

    PubMed Central

    Qin, Qianqian; Tang, Weiming; Ge, Lin; Li, Dongmin; Mahapatra, Tanmay; Wang, Liyan; Guo, Wei; Cui, Yan; Sun, Jiangping

    2016-01-01

    Dearth of information regarding the trend and correlates of HIV, syphilis and Hepatitis C (HCV) in a country-wide sample of understudied though high-risk Chinese men who have sex with men (MSM) called for a comprehensive serial cross-sectional study. Using a multistage mixed-method strategy, 171,311 MSM from 107 selected cities/counties in 30 provinces of mainland China, were interviewed and tested. Descriptive, bivariate, multivariate and Cochran-Armitage trend analyses were conducted using SAS 9.2. During 2009-13, recent (71.5% to 78.6%, p < 0.001) and consistent (40.4% to 48.8%, p < 0.001) condom use as well as condom use during commercial anal sex (46.5% to 55.0%, p < 0.001) were increasing. In contrast, commercial anal sex with male (11.9% to 7.1%, p < 0.001) and drug use (1.9% to 0.8%, p < 0.001) were decreasing over time. HIV prevalence increased gradually (5.5% to 7.3%, p < 0.001), while syphilis (9.0% to 6.3%, p < 0.001) and HCV prevalence (1.5% to 0.7%, p < 0.001) decreased over time. A positive correlation was observed between HIV and syphilis prevalence (r = 0.38). HIV infection was associated with HIV-related knowledge, services and injecting drug use. An increasing trend of HIV prevalence was observed during 2009–13 among MSM in China. While gradual reduction of risk behaviors along with syphilis and HCV prevalence supported expansion of testing and prevention services, increasing HIV burden called for deeper thematic investigations. PMID:27535092

  11. [The impact of HIV infection on the incidence of syphilis and gonorrhea at a university hospital (1985-1994)].

    PubMed

    Griemberg, G; Pizzimenti, M C; Famiglietti, A M; Belli, L; Vay, C; García, S; Cardinalli, A; Costa, M A; Marcenac, F; Casco, R H

    1997-01-01

    Syphilis and gonorrhea are two sexually transmitted diseases (STD) which still persist in spite of the existence of effective treatment. In this paper the incidence of these two diseases was evaluated between 1985-1994, a decade during which the problem of HIV infection arose. Every patient who attended the STD Program at the Hospital and was suspected of having syphilis and/or gonorrhea was clinically evaluated and was subjected to the following tests: a) search for Neisseria gonorrhoeae (Ng) and penicinilase producers (PPNG) identification, b) search for Treponema pallidum (Tp) by darkfield microscopy, c) serological studies for syphilis. From 1985 to 1991 the average of positive cases for Ng was 14.8% while from 1992 to 1994 it was 4.0% (p < 0.0001) showing a dramatic decrease between 1991 and 1992. PPNG increased from 8.7% in 1985 to 44.6% in 1988 and then slowly decreased down to 26.9% in 1994. From 1985 to 1990 the average of positive darkfield examinations was 20.7% while from 1991 to 1994 it was 12.2% (p < 0.0001). Between 1985 to 1988 syphilis serological studies showed 45.7% positive cases dropping to 34.3% between 1989 and 1994 (p < 0.0001). HIV infection appearance had a wide repercussion throughout the world generating behavioral and sexual habit changes which have probably helped to prevent these two STD. Gonorrhea incidence was also influenced by the appearance of new effective treatments, even against PPNG, such as fluorated quinolones and third generation cephalosporines. The population studied belongs to the most crowded area in Argentina, so that these observations should not be extrapolated to the rest of the country.

  12. HIV, HCV, HBV and syphilis rate of positive donations among blood donations in Mali: lower rates among volunteer blood donors.

    PubMed

    Diarra, A; Kouriba, B; Baby, M; Murphy, E; Lefrere, J-J

    2009-01-01

    Good data on background seroprevalence of major transfusion transmitted infections is lacking in Mali. We gathered data on the rate of positive donations of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis among blood donations in Mali for calendar year 2007. Donations with repeatedly reactive results on screening enzyme immunoassay (EIA) were considered to be seropositive. Rate of positive donations per blood unit collected was 2.6% for HIV, 3.3% for HCV, 13.9% for hepatitis B surface antigen (HBsAg) and 0.3% for syphilis. For HIV, HBsAg and syphilis, rate of positive donations was significantly (p<0.001) higher among donations from replacement donors than those from volunteer donors, while HCV rate of positive donations was similar in the two groups. Rate of positive donations was also significantly (p<0.0001) lower in blood units from regular than from first-time donors. These data reinforce WHO recommendations for increasing the number of regular, volunteer blood donors in Africa.

  13. Macrolide Resistance in the Syphilis Spirochete, Treponema pallidum ssp. pallidum: Can We Also Expect Macrolide-Resistant Yaws Strains?

    PubMed Central

    Šmajs, David; Paštěková, Lenka; Grillová, Linda

    2015-01-01

    Treponema pallidum ssp. pallidum (TPA) causes over 10 million new cases of syphilis worldwide whereas T. pallidum ssp. pertenue (TPE), the causative agent of yaws, affects about 2.5 million people. Although penicillin remains the drug of choice in the treatment of syphilis, in penicillin-allergic patients, macrolides have been used in this indication since the 1950s. Failures of macrolides in syphilis treatment have been well documented in the literature and since 2000, there has been a dramatic increase in a number of clinical samples with macrolide-resistant TPA. Scarce data regarding the genetics of macrolide-resistant mutations in TPA suggest that although macrolide-resistance mutations have emerged independently several times, the increase in the proportion of TPA strains resistant to macrolides is mainly due to the spread of resistant strains, especially in developed countries. The emergence of macrolide resistance in TPA appears to require a two-step process including either A2058G or A2059G mutation in one copy of the 23S rRNA gene and a subsequent gene conversion unification of both rRNA genes. Given the enormous genetic similarity that was recently revealed between TPA and TPE strains, there is a low but reasonable risk of emergence and spread of macrolide-resistant yaws strains following azithromycin treatment. PMID:26217043

  14. Hepatitis B virus, human immunodeficiency virus type-1, and syphilis among women attending prenatal clinics in Belize, Central America.

    PubMed

    Scott-Wright, A; Hakre, S; Bryan, J P; Jaramillo, R; Reyes, L G; Cruess, D; Macarthy, P O; Gaydos, J C

    1997-03-01

    Women and their infants may benefit from therapeutic interventions when hepatitis B, human immunodeficiency virus (HIV), or syphilis are detected during the prenatal period. We initiated hepatitis B and HIV screening of women attending prenatal clinics in Belize. Risk factor assessment information for hepatitis B infection and demographic data were determined by interview. Of 543 evaluable women, 81 (14.9%) were seropositive for hepatitis B core antibody (anti-HBc); one woman had asymptomatic hepatitis B surface antigenemia. Antibodies to HIV-1 were detected in one woman. Reactive syphilis serologies were detected in 15 (2.8%) women. Anti-HBc seroprevalence varied by district (range 3.1-43.5%) and by ethnicity (range 0.0-40.9%). Significant identified risks for anti-HBc seropositivity from univariate analyses included being of the Garifuna ethnic group, residence or birth in the Stann Creek or Toledo districts, a reactive syphilis serology, a household size of eight or greater, and five or more lifetime sexual partners. Multivariate analyses identified ethnicity and a reactive rapid plasma reagin as the best predictors of anti-HBc seropositivity. Highly variable differences in anti-HBc prevalence by district may permit the targeting of limited public health resources for education, screening, and prevention programs.

  15. A study on usefulness of a set of known risk factors in predicting maternal syphilis infections in three districts of Western Province, Zambia

    PubMed Central

    Sakala, Jacob; Chizuni, Nellisiwe; Nzala, Selestine

    2016-01-01

    Introduction Despite roll-out of cost-effective point-of-care tests, less than half antenatal attendees in rural western Zambia are screened for syphilis. This study formulated a clinical, risk-based assessment criteria and evaluated its usefulness as a non-biomedical alternative for identifying high-risk prenatal cases. Methods We conducted a cross-sectional survey of antenatal clinic attendees in Kaoma, Luampa and Nkeyema districts to collect data on exposure to nine pre-selected syphilis risk factors. These factors were classified into major and minor factors based on their observed pre-study association strengths to maternal syphilis. Clinical disease was defined as exposure to either two major factors, one major with two minor factors or three minor factors. Sensitivity, specificity and predictive values of the clinical protocol were then calculated in comparison to rapid plasmin reagin results. Results The observed syphilis prevalence was 9.3% (95% CI: 7.4 - 11.6%) and the overall sensitivity of the study criteria was 62.3% with positive predictive value of 72.9%. Sensitivities of individual case-defining categories were even lower; from 17.4% to 33.3%. Results confirmed that abortion history, still birth, multiple sexual partners, previous maternal syphilis infection, partner history of sexually transmitted infection and maternal co-morbid conditions of HIV and genital ulcer disease were significantly associated to maternal syphilis in study population as well. Conclusion The criteria was not as effective as biomedical tests in identifying maternal syphilis. However, it could be a useful adjunct/alternative in antenatal clinics when biomedical tests are either inadequate or unavailable. PMID:27703597

  16. Bisexual behavior and infection with HIV and syphilis among men who have sex with men along the east coast of China.

    PubMed

    Liao, Meizhen; Kang, Dianming; Jiang, Baofa; Tao, Xiaorun; Qian, Yueshen; Wang, Tongzhan; Bi, Zhenqiang; Xiao, Yan; Li, Chunmei; Wu, Pingsheng; Vermund, Sten H; Jia, Yujiang

    2011-11-01

    This study examined the correlates of bisexual behavior and infection with HIV/syphilis among men who have sex with men only (MSM-only) and those who have sex with both men and women (MSMW) in Shandong, China. Cross-sectional surveys probed sociodemographic information, sexual and drug use behaviors, knowledge, and use of prevention services; blood samples were tested for HIV/syphilis status. Of 2996 participants, 39.5% acknowledged being MSMW; 60.5% being MSM-only; 2.5% were HIV-infected with similar rates for MSMW (2.5%) and MSM-only (2.6%); 5.5% syphilis-infected with comparable rates for MSMW (5.6%) and MSM-only (5.5%). In multivariable models, MSMW were more likely than MSM-only to be older, local residents, recruited from outdoor cruising area, drug users, and less likely to have used a condom during last anal sex with a male partner. HIV-infected MSMW were more likely to have syphilis and other sexually transmitted diseases (STDs) and less likely to have received peer education. HIV-infected MSM-only were more likely to be older, nonlocal residents, and have syphilis and other STDs. MSMW with syphilis were more likely to be recruited from Jinan, Qingdao, and Zibo (versus Yantai), infected with HIV, and less likely to have received lubricant promotion. MSM-only with syphilis were more likely to be recruited from Jinan and Qingdao (versus Yantai), drug users, infected with HIV, and have had sex with male partners in the past 6 months. High prevalence of bisexual behavior and HIV/other STDs with common unprotected sex and multiple sexual partners among Shandong's gay community revealed in this study highlighted the importance of bisexuals as a potential epidemiologic bridge. Further research is needed to investigate the impact of bisexual behaviors on population transmission.

  17. Syphilis and Its Correlates among Heterosexual Males Attending Sexually Transmitted Infection Clinics – Observation from a Multicity Cohort in Jiangsu Province, China

    PubMed Central

    Liu, Xiao-Yan; Hao, Chao; Jiang, Hui; Sun, Lin; Zhou, Jian-Bo; Yin, Yue-Ping; Tang, Weiming; Jiang, Ning; Mahapatra, Tanmay; Mahapatra, Sanchita; Chen, Xiang-Sheng; Yang, Hai-Tao; Fu, Geng-Feng; Huan, Xi-Ping

    2014-01-01

    Objectives To estimate the prevalence of HIV and syphilis, incidence of syphilis and to identify the correlates of syphilis infection among heterosexual male attendees of sexually transmitted infection (STI) clinics (MSC). Methods A cohort study of one-year duration was conducted in Yangzhou and Changzhou cities in Jiangsu province of China. The baseline survey commenced in June 2009, recruited 1225 consenting adult MSCs (609 in Yangzhou and 617 in Changzhou) through STI-clinic based convenience sampling. Results Baseline HIV and syphilis prevalence were 0.49% and 17.29% respectively. Syphilis incidence rate was 7.22 per 100 person-years (6.53 in Yangzhou and 7.76 in Changzhou) during the 6-month follow-up with retention fractions of 27.38% and 35.15% for Yangzhou and Changzhou respectively. Majority of the participants were middle-aged, high school educated, married, living with partners and non-migrants. Very few subjects reported recent and consistent condom-use with regular partners. Although considerable number of MSCs reported recent sexual exposure with female sex workers (FSW) and non-FSW casual partners, the proportion of reported condom use was very low during those exposures. In multivariate analyses higher age, having recent sex with FSWs and being HIV-positive were associated with higher syphilis sero-positivity while higher education was protective. In bivariate analyses, being married, divorced/widowed, official residency of the study cities and non-use of condom with regular partners predicted higher risk. Conclusions Considering the potential bridging role of MSCs between high and low-risk populations, effective intervention strategies among them targeting the correlates of syphilis infection are urgently called for in Jiangsu province of China. PMID:24743839

  18. Evaluation of FlaB1, FlaB2, FlaB3, and Tp0463 of Treponema pallidum for serodiagnosis of syphilis.

    PubMed

    Jiang, Chuanhao; Xiao, Jinhong; Xie, Yafeng; Xiao, Yongjian; Wang, Chuan; Kuang, Xingxing; Xu, Man; Li, Ranhui; Zeng, Tiebing; Liu, Shuanquan; Yu, Jian; Zhao, Feijun; Wu, Yimou

    2016-02-01

    Syphilis is a multistage disease caused by the invasive spirochete Treponema pallidum subsp. pallidum, and accurate diagnosis is important for the prevention and treatment of syphilis. Here, to identify appropriate diagnostic antigens for serodiagnosis of syphilis, 6 recombinant proteins were expressed in Escherichia coli and purified, including flagellins (FlaB1 [Tp0868], FlaB2 [Tp0792], and FlaB3 [Tp0870]), Tp0463, Tp0751, and Tp1038. The sensitivities were determined by screening sera from individuals with primary (n=82), secondary (n=115), latent (n=105), and congenital (n=65) syphilis. The specificities were determined by screening sera from uninfected controls (n=30) and potentially cross-reactive infections including Lyme disease (n=30), leptospirosis (n=5), and hepatitis B (n=30). Our data showed that FlaB1, FlaB2, FlaB3, Tp0463, and Tp1038 exhibited higher overall sensitivities and specificities for detecting IgG antibody, with 95.4% and 98.9%, 92.6% and 95.8%, 95.1% and 95.8%, 92.6% and 97.9%, and 95.9% and 98.9%, respectively. In contrast, Tp0751 demonstrated only an overall sensitivity of 39.2%. For comparison, the sensitivity and specificity of Architect Syphilis TP were determined to be 98.1% and 93.7%, respectively. In addition, FlaB1, FlaB2, FlaB3, and Tp0463 demonstrated excellent performance for detecting IgM antibody in primary and congenital syphilis, with sensitivities of 76.8% and 83.1%, 72.0% and 87.7%, 74.4% and 89.2%, and 64.6% and 75.3%, respectively. These results indicate that FlaB1, FlaB2, FlaB3, and Tp0463 could be as novel diagnostic candidates for serodiagnosis of syphilis.

  19. Drug-Related Behaviors Independently Associated with Syphilis Infection among Female Sex Workers in two Mexico-U.S. Border Cities

    PubMed Central

    Loza, O.; Patterson, T.L.; Rusch, M.; Martínez, G.A.; Lozada, R.; Staines-Orozco, H.; Magis-Rodríguez, C.; Strathdee, S.A.

    2012-01-01

    AIMS To identify correlates of active syphilis infection among female sex workers (FSWs) in Tijuana and Ciudad Juarez. DESIGN Cross-sectional analyses of baseline interview data. Correlates of active syphilis (antibody titers >1:8) were identified by logistic regression. SETTING Tijuana and Ciudad Juarez, two Mexican cities on the U.S. border that are situated on major drug trafficking routes and where prostitution is quasi-legal. PARTICIPANTS 914 FSWs aged ≥18 years without known HIV infection who had recent unprotected sex with clients. MEASUREMENTS Baseline interviews and testing for syphilis antibody using Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) tests. FINDINGS Median age and duration in sex work were 32 and 4 years, respectively. Overall, 18.0% had ever injected drugs, 14.2% often or always used illegal drugs before or during sex in the past month, 37.7% had clients who injected drugs in the last 6 months, and 68.6% reported having clients from the U.S. Prevalence of HIV and active syphilis were 5.9% and 10.3%, respectively. Factors independently associated with active syphilis included injecting drugs (AOR: 2.39; 95% CI: 1.40, 4.80), using illegal drugs before or during sex (AOR: 2.06; 95% CI: 1.16, 3.65), and having any U.S. clients (AOR: 2.85; 95% CI: 1.43, 5.70). CONCLUSIONS Among female sex workers in Tijuana and Ciudad Juarez, drug-using behaviors were more closely associated with active syphilis than were sexual behaviors, suggesting the possibility of parenteral transmission of T. pallidum. Syphilis eradication programs should consider distributing sterile syringes to drug injectors and assisting FSWs with safer-sex negotiation in the context of drug use. PMID:20456292

  20. Syphilis superinfection activates expression of human immunodeficiency virus I in latently infected rabbits.

    PubMed Central

    Tseng, C. K.; Hughes, M. A.; Hsu, P. L.; Mahoney, S.; Duvic, M.; Sell, S.

    1991-01-01

    Superinfection of latently human immunodeficiency virus (HIV)-infected rabbits with either Treponema pallidum or Shope fibroma virus (SFV) activates HIV expression. In addition, HIV-infected rabbits demonstrate prolonged cutaneous lesions (chancres) after intracutaneous challenge with T. pallidum, the causative agent of syphilis. Rabbits were infected by intravenous inoculation of 3 x 10(7) human T-cell lymphotrophic virus type III (HTLV-III)/B10 (HIV-1)-infected H9 (human) cells. Five weeks after initial infection, integrated HIV-1-specific DNA sequences were detected in the DNA of the peripheral blood lymphocytes of only one of eight rabbits using polymerase chain reactions (PCR); human DNA could not be detected at this time. Furthermore HIV infection could not be demonstrated by either seroconversion or PCR during the next 6 months. All HIV-infected rabbits remained clinically healthy and had normal white blood cell counts. Six months after HIV infection, four HIV-infected and two noninfected controls were superinfected with 10(6) T. pallidum in eight skin sites in the shaved skin of the back, and four infected and two control animals were challenged with an intradermal injection with SFV. After infection with either syphilis or SFV, the DNA from the white blood cells of all eight HIV-infected rabbits contained HIV sequences, and HIV sequences were demonstrated in dermal mononuclear cells of the syphilitic lesions by in situ hybridization. The SFV-induced tumors were rejected normally in the HIV-infected rabbits, but four of the four rabbits challenged with T. pallidum had delayed development of cutaneous lesions and three of four demonstrated larger and more prolonged lesions. White blood counts, mitogen responses, and interleukin-2 production remained within normal limits, and seroconversion for HIV was not detected. Three of four rabbits in a second group, challenged with T. pallidum 4 months after HIV-inoculation, also had delayed healing of syphilitic

  1. Respondent-driven sampling of injection drug users in two U.S.-Mexico border cities: recruitment dynamics and impact on estimates of HIV and syphilis prevalence.

    PubMed

    Frost, Simon D W; Brouwer, Kimberly C; Firestone Cruz, Michelle A; Ramos, Rebeca; Ramos, Maria Elena; Lozada, Remedios M; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2006-11-01

    Respondent-driven sampling (RDS), a chain referral sampling approach, is increasingly used to recruit participants from hard-to-reach populations, such as injection drug users (IDUs). Using RDS, we recruited IDUs in Tijuana and Ciudad (Cd.) Juárez, two Mexican cities bordering San Diego, CA and El Paso, TX, respectively, and compared recruitment dynamics, reported network size, and estimates of HIV and syphilis prevalence. Between February and April 2005, we used RDS to recruit IDUs in Tijuana (15 seeds, 207 recruits) and Cd. Juárez (9 seeds, 197 recruits), Mexico for a cross-sectional study of behavioral and contextual factors associated with HIV, HCV and syphilis infections. All subjects provided informed consent, an anonymous interview, and a venous blood sample for serologic testing of HIV, HCV, HBV (Cd. Juárez only) and syphilis antibody. Log-linear models were used to analyze the association between the state of the recruiter and that of the recruitee in the referral chains, and population estimates of the presence of syphilis antibody were obtained, correcting for biased sampling using RDS-based estimators. Sampling of the targeted 200 recruits per city was achieved rapidly (2 months in Tijuana, 2 weeks in Cd. Juárez). After excluding seeds and missing data, the sample prevalence of HCV, HIV and syphilis were 96.6, 1.9 and 13.5% respectively in Tijuana, and 95.3, 4.1, and 2.7% respectively in Cd. Juárez (where HBV prevalence was 84.7%). Syphilis cases were clustered in recruitment trees. RDS-corrected estimates of syphilis antibody prevalence ranged from 12.8 to 26.8% in Tijuana and from 2.9 to 15.6% in Ciudad Juárez, depending on how recruitment patterns were modeled, and assumptions about how network size affected an individual's probability of being included in the sample. RDS was an effective method to rapidly recruit IDUs in these cities. Although the frequency of HIV was low, syphilis prevalence was high, particularly in Tijuana. RDS

  2. Opt-Out and Opt-In Testing Increases Syphilis Screening of HIV-Positive Men Who Have Sex with Men in Australia

    PubMed Central

    Guy, Rebecca; El-Hayek, Carol; Fairley, Christopher K.; Wand, Handan; Carr, Andrew; McNulty, Anna; Hoy, Jenny; Bourne, Christopher; McAllister, John; Tee, B. K.; Baker, David; Roth, Norman; Stoove, Mark; Chen, Marcus

    2013-01-01

    Background Since 2005, Australian clinicians were advised to undertake quarterly syphilis testing for all sexually active HIV-positive men who have sex with men (MSM). We describe differences in syphilis testing frequency among HIV-positive MSM by clinic testing policies since this recommendation. Methods Three general practices, two sexual health clinics and two hospital HIV outpatient clinics provided data on HIV viral load and syphilis testing from 2006–2010. Men having ≥1 viral load test per year were included; >95% were MSM. We used Chi-2 tests to assess changes in syphilis testing frequency over time, and differences by clinic testing policy (opt-out, opt-in and risk-based). Results The proportion of men having HIV viral loads with same-day syphilis tests increased from 37% in 2006 to 63% in 2007 (p<0.01) and 68–69% thereafter. In 2010, same-day syphilis testing was highest in four clinics with opt-out strategies (87%, range:84–91%) compared with one clinic with opt-in (74%, p = 0.121) and two clinics with risk-based strategies (22%, range:20–24%, p<0.01). The proportion of men having ≥3 syphilis tests per year increased from 15% in 2006 to 36% in 2007 (p<0.01) and 36–38% thereafter. In 2010, the proportion of men having ≥3 syphilis tests in a year was highest in clinics with opt-out strategies (48%, range:35–59%), compared with opt-in (39%, p = 0.121) and risk-based strategies (8.4%, range:5.4–12%, p<0.01). Conclusion Over five years the proportion of HIV-positive men undergoing syphilis testing at recommended frequencies more than doubled, and was 5–6 times higher in clinics with opt-out and opt-in strategies compared with risk-based policies. PMID:24009661

  3. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China.

    PubMed

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-05-01

    Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous drug use. Clients

  4. Respondent-Driven Sampling of Injection Drug Users in Two U.S.–Mexico Border Cities: Recruitment Dynamics and Impact on Estimates of HIV and Syphilis Prevalence

    PubMed Central

    Brouwer, Kimberly C.; Firestone Cruz, Michelle A.; Ramos, Rebeca; Ramos, Maria Elena; Lozada, Remedios M.; Magis-Rodriguez, Carlos; Strathdee, Steffanie A.

    2006-01-01

    Respondent-driven sampling (RDS), a chain referral sampling approach, is increasingly used to recruit participants from hard-to-reach populations, such as injection drug users (IDUs). Using RDS, we recruited IDUs in Tijuana and Ciudad (Cd.) Juárez, two Mexican cities bordering San Diego, CA and El Paso, TX, respectively, and compared recruitment dynamics, reported network size, and estimates of HIV and syphilis prevalence. Between February and April 2005, we used RDS to recruit IDUs in Tijuana (15 seeds, 207 recruits) and Cd. Juárez (9 seeds, 197 recruits), Mexico for a cross-sectional study of behavioral and contextual factors associated with HIV, HCV and syphilis infections. All subjects provided informed consent, an anonymous interview, and a venous blood sample for serologic testing of HIV, HCV, HBV (Cd. Juárez only) and syphilis antibody. Log-linear models were used to analyze the association between the state of the recruiter and that of the recruitee in the referral chains, and population estimates of the presence of syphilis antibody were obtained, correcting for biased sampling using RDS-based estimators. Sampling of the targeted 200 recruits per city was achieved rapidly (2 months in Tijuana, 2 weeks in Cd. Juárez). After excluding seeds and missing data, the sample prevalence of HCV, HIV and syphilis were 96.6, 1.9 and 13.5% respectively in Tijuana, and 95.3, 4.1, and 2.7% respectively in Cd. Juárez (where HBV prevalence was 84.7%). Syphilis cases were clustered in recruitment trees. RDS-corrected estimates of syphilis antibody prevalence ranged from 12.8 to 26.8% in Tijuana and from 2.9 to 15.6% in Ciudad Juárez, depending on how recruitment patterns were modeled, and assumptions about how network size affected an individual’s probability of being included in the sample. RDS was an effective method to rapidly recruit IDUs in these cities. Although the frequency of HIV was low, syphilis prevalence was high, particularly in Tijuana. RDS

  5. Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features

    PubMed Central

    Singh, Ameeta E.; Romanowski, Barbara

    1999-01-01

    Syphilis is a chronic disease with a waxing and waning course, the manifestations of which have been described for centuries. It occurs worldwide, and the incidence varies significantly with geographic location. Transmission is mainly by sexual contact. The causative organism, Treponema pallidum, was first described in 1905, but because of the inability to culture the organism and the limitations of direct microscopy, serologic testing is the mainstay of laboratory diagnosis. The disease has been arbitrarily divided into several stages. The primary stage is defined by a chancre at the site of inoculation. The secondary stage is characterized by a polymorphic rash, lymphadenopathy, and other systemic manifestations. A variable asymptomatic latent period follows, which for epidemiologic purposes is divided into early (<1 year) and late (>1 year) stages. The early stages (primary, secondary, and early latent) are potentially infectious. The tertiary stage is the most destructive and is marked by cardiovascular and neurologic sequelae and gummatous involvement of any organ system. Congenital infection may result in protean early or late manifestations. Unlike many other bacteria causing infectious diseases, the organism remains sensitive to penicillin, and this remains the mainstay of therapy. PMID:10194456

  6. Neonate Human Remains: A Window of Opportunity to the Molecular Study of Ancient Syphilis

    PubMed Central

    Montiel, Rafael; Solórzano, Eduvigis; Díaz, Nancy; Álvarez-Sandoval, Brenda A.; González-Ruiz, Mercedes; Cañadas, Mari Pau; Simões, Nelson; Isidro, Albert; Malgosa, Assumpció

    2012-01-01

    Ancient DNA (aDNA) analysis can be a useful tool in bacterial disease diagnosis in human remains. However, while the recovery of Mycobacterium spp. has been widely successful, several authors report unsuccessful results regarding ancient treponemal DNA, casting doubts on the usefulness of this technique for the diagnosis of ancient syphilis. Here, we present results from an analysis of four newborn specimens recovered from the crypt of “La Ermita de la Soledad” (XVI–XVII centuries), located in the province of Huelva in the southwest of Spain. We extracted and analyzed aDNA in three independent laboratories, following specific procedures generally practiced in the aDNA field, including cloning of the amplified DNA fragments and sequencing of several clones. This is the most ancient case, reported to date, from which detection of DNA from T. pallidum subspecies pallidum has been successful in more than one individual, and we put forward a hypothesis to explain this result, taking into account the course of the disease in neonate individuals. PMID:22567153

  7. Neonate human remains: a window of opportunity to the molecular study of ancient syphilis.

    PubMed

    Montiel, Rafael; Solórzano, Eduvigis; Díaz, Nancy; Álvarez-Sandoval, Brenda A; González-Ruiz, Mercedes; Cañadas, Mari Pau; Simões, Nelson; Isidro, Albert; Malgosa, Assumpció

    2012-01-01

    Ancient DNA (aDNA) analysis can be a useful tool in bacterial disease diagnosis in human remains. However, while the recovery of Mycobacterium spp. has been widely successful, several authors report unsuccessful results regarding ancient treponemal DNA, casting doubts on the usefulness of this technique for the diagnosis of ancient syphilis. Here, we present results from an analysis of four newborn specimens recovered from the crypt of "La Ermita de la Soledad" (XVI-XVII centuries), located in the province of Huelva in the southwest of Spain. We extracted and analyzed aDNA in three independent laboratories, following specific procedures generally practiced in the aDNA field, including cloning of the amplified DNA fragments and sequencing of several clones. This is the most ancient case, reported to date, from which detection of DNA from T. pallidum subspecies pallidum has been successful in more than one individual, and we put forward a hypothesis to explain this result, taking into account the course of the disease in neonate individuals.

  8. EXPERIMENTAL OBSERVATIONS ON THE "CURE" OF SYPHILIS IN THE RABBIT WITH ARSPHENAMINE.

    PubMed

    Chesney, A M; Kemp, J E

    1924-03-31

    1. The intravenous administration of six doses of arsphenamine to syphilitic rabbits in amounts of 10 mg. per kilo, 127 days after inoculation is sufficient to render the popliteal nodes of such animals incapable of transmitting the infection to normal animals. 2. Syphilitic rabbits that have been treated in this manner and whose popliteal nodes 32 to 38 days after treatment have been shown to be incapable of transmitting the infection to normal animals are, as far as can be judged by the absence of a local lesion, refractory to a second inoculation of active virus of the same strain, if the inoculation be made intradermally at the base of the ear and carried out 209 days after the first inoculation. 3. Untreated syphilitic rabbits are also refractory toward a second inoculation made in a similar manner and at a similar interval following the first inoculation. 4. Evidence is offered in favor of the view that the most satisfactory method of evaluation of antisyphilitic agents in experimental syphilis of the rabbit is that of lymph node transfer. 5. Evidence is offered in support of the view that the state of refractoriness toward a second inoculation exhibited by syphilitic rabbits may be explainable upon the basis of either an acquired immunity or persistence of a focus of living treponemata in the body.

  9. Application of Goldmag immune probe in timely detection of syphilis based on GIS platform.

    PubMed

    Tang, Zhong; Liang, Zhisheng; Nong, Yi; Wu, Xiaochun; Luo, Hui; Gao, Kun

    2017-05-01

    The purpose of this study was to apply goldmag immunoprobes into establishment of nanoparticles-based colorimetric assay as well as construction of immunochromatography quantitative and qualitative system by exploring point-of-care testing of syphilis with goldmag particles carrier-based immunoprobe and analysis of spatial data of Geographic Information System (GIS) platform. Goat anti-rabbit immunoglobulin G (IgG) was coupled on the surface of modified nanoparticles, taking N-(3-dimethylaminopropyl)-N'-ethyl-carbodiimide as the connector. Then the nanoparticles were used for colorimetric detection of goat-anti-rabbit IgG in liquid phase system. Based on the analysis of spatial data in GIS platform, we found the probe constructed based on MUA-Fe304/Au nanoparticles responded more sensitive to detection objects compared with the probe designed based on PAA-Fe3O4/Au nanoparticles, and its reaction rate constant was two times that of PAA-Fe3O4/Au nanoparticles based goldmag immunoprobe. Goldmag particles not only can be coupled with biomolecules such as antibody/antigen and glycoprotein but also possess superparamagnetism.

  10. Operations research study to implement HIV and syphilis point-of-care tests and assess client perceptions in a marginalised area of Lima, Peru.

    PubMed

    Flores, Elaine C; Lluque, Maria E; Chiappe, Marina; Lino, Rosabel; Bayer, Angela M

    2015-09-01

    In Peru, a significant proportion of people tested for HIV and syphilis do not receive timely results. Our objective was to assess the institutional feasibility of implementing simultaneous HIV/syphilis point-of-care tests and client perceptions regarding these point-of-care tests. Point-of-care tests were implemented in a hospital consultation room in a marginalised zone of Lima. A time-series design was used to compare the proportion of tested clients who received timely results, with and without the point-of-care test intervention. Experience and satisfaction with point-of-care tests was evaluated with 149 people. In the 6 months without intervention, 69% and 61% of clients tested for HIV and syphilis, respectively, received their results within the required 45-minute window. During the 2-month point-of-care test intervention, all clients tested for HIV (n = 387) and syphilis (n = 398) received their results within 45 minutes. All clients surveyed were completely satisfied (52%) or satisfied (48%) with the simultaneous HIV/syphilis point-of-care test screening process. Additionally, 73% strongly agreed with the statement 'I feel satisfied with the rapid testing process.' Screening using point-of-care tests represents an important opportunity to reduce the time, resource and cost burden for users and institutions and increase the proportion of users receiving their test results in a timely manner.

  11. Prevention of mother-to-child transmission of syphilis and HIV in China: What drives political prioritization and what can this tell us about promoting dual elimination?

    PubMed Central

    Wu, Dadong; Hawkes, Sarah; Buse, Kent

    2015-01-01

    Objective The present study aims to identify reasons behind the lower political priority of mother-to-child transmission (MTCT) of syphilis compared with HIV, despite the former presenting a much larger and growing burden than the latter, in China, over the 20 years prior to 2010. Methods We undertook a comparative policy analysis, based on informant interviews and documentation review of control of MTCT of syphilis and HIV, as well as nonparticipant observation of relevant meetings/trainings to investigate agenda-setting prior to 2010. Results We identified several factors contributing to the lower priority accorded to MTCT of syphilis: relative neglect at a global level, dearth of international financial and technical support, poorly unified national policy community with weak accountability mechanisms, insufficient understanding of the epidemic and policy options, and a prevailing negative framing of syphilis that resulted in significant stigmatization. Conclusion A dual elimination goal will only be reached when prioritization of MTCT of syphilis is enhanced in both the international and national agendas. PMID:25968490

  12. A negative nontreponemal and/or specific antitreponemal IgM test does not exclude active infectious syphilis: evidence from a rabbit infectivity test

    PubMed Central

    Lin, Li-Rong; Tong, Man-Li; Gao, Kun; Zhu, Xiao-Zhen; Fan, Jin-Yi; Zheng, Wei-Hong; Li, Shu-Lian; Lin, Hui-Ling; Liu, Li-Li; Yang, Tian-Ci

    2016-01-01

    Abstract Background: The diagnostic criteria for active infectious syphilis in the clinic are important matter of controversy and debate. So far, clinicians habitually do use the negative results of the nontreponemal and/or the specific antitreponemal IgM as the evidences of disease-free or active infection-free status. Method: We present a case study involving a patient who was admitted to Zhongshan Hospital because of cerebral infarct. Clinical examination indicated he had a history of latent syphilis with negative nontreponemal and specific antitreponemal IgM tests. The cerebrospinal fluid sample from the patient was inoculated into seronegative New Zealand rabbit. Results: Motile Treponema pallidum was detected by a rabbit infectivity test in the patient's cerebrospinal fluid. This syphilis strain was confirmed by DNA subtyping form of “centers for disease control subtype/tp0548 sequence type”, and the strain type was 14d/f. Treatment with benzathine penicillin provided no apparent benefit, but treatment with aqueous crystalline penicillin G, especially recommended for neurosyphilis, led to disease regression. No evidence of cerebral infarct was observed during a 2-year follow-up period. Conclusion: The definitive differential diagnosis of active infectious syphilis should be reconsidered. Moreover, selecting the appropriate penicillin preparation is important because T pallidum can reside in sequestered sites. It is necessary to treat a patient with known invasion of the central nervous system with aqueous crystalline penicillin G, if previous treatment for syphilis failed and patients had some clinical neurological presentation that is otherwise unexplained, but that could represent neurosyphilis. Additional studies are needed to confirm the results in other syphilis patients. PMID:27495107

  13. Infection status and risk factors of HIV, HBV, HCV, and syphilis among drug users in Guangdong, China - a cross-sectional study

    PubMed Central

    2010-01-01

    Background China has witnessed a remarkable increase in sexually transmitted infections (STIs) and HIV. The study is to assess the prevalence of HIV, HBV, HCV and syphilis and related risk factors among drug users in mandatory detoxification center Qingyuan, Guangdong, China. Method A cross-sectional study on drug use behaviors, sex behaviors, and presence of antibodies to HIV, HCV, Treponema pallidum, and surface antigen of HBV (HBsAg) was conducted among drug users recruited from 3 detoxification centers in Qingyuan, Guangdong, China. Risk factors for each of four infections were analyzed with logistic regression model. Results A total of 740 subjects were recruited, the median age was 31 years old (range 24-38). The seroprevalence rates of HIV, HBsAg, HCV and syphilis were 4.6%, 19.3%, 71.6% and 12.6%, respectively. Risk factors for HIV were intravenous drug use and co-infection with syphilis. Having a regular sexual partner who was a drug user was considered to be a risk factor for HBV. Intravenous drug use was a risk factor for HCV. However, the consistent use of condoms with commercial sex partners was protective for HCV infection. Compared to drug users living in urban area, those living in rural areas were more likely to be infected with syphilis, and there was an association between commercial sex and syphilis. Conclusion The prevalence of HIV, HBV, HCV and syphilis were high among drug users in detoxification centers in Qingyuan, thus, risk reduction programs for the drug user population is urgently required. PMID:21040549

  14. Rates of HIV, syphilis, and HCV infections among different demographic groups of female sex workers in Guangxi China: evidence from 2010 national sentinel surveillance data.

    PubMed

    Zhou, Yuejiao; Li, Xiaoming; Zhang, Chen; Tan, Guangjie; Stanton, Bonita; Zhang, Xiaojuan; Cui, Yan

    2013-01-01

    To examine the prevalence of HIV, syphilis, and hepatitis C virus (HCV) infections by demographic characteristics and identify the subgroups of female sex workers (FSW) who are at a higher risk of the infections. Secondary analysis of the 2010 National Sentinel Surveillance (NSS) data was conducted in the current study. A total of 12,622 FSW recruited from 35 NSS sites in Guangxi, China were included in the analysis. FSW were tested for HIV, syphilis, and HCV. The overall prevalence of HIV, syphilis, and HCV infections were 1.0, 6.1, and 1.0%, respectively. The prevalence of HIV and syphilis infections was significantly higher among women who were 40 years of age or older, worked in small commercial sex venues or on the street, were divorced or widowed, or had no formal schooling. A very high HIV infection prevalence (8.2%) was observed among a small number of cross-border foreign FSW (n=49). The prevalence of HCV infection did not differ by most of the demographic characteristics. Living in other provinces or being a Zhuang-ethnic served as protective factors for HCV. The multivariable analyses confirmed the bivariate results suggesting higher prevalence of HIV and syphilis infections among FSW who were older, divorced or widowed, or had no formal schooling. Future HIV intervention prevention efforts among FSW need to pay particular attention to these women in order to effectively curtail the infections among this most-at-risk population as well as to prevent the further spread of HIV and syphilis to other populations.

  15. Conventional systemic treatments associated with therapeutic sites of local lesions of secondary syphilis in the oral cavity in patients with AIDS.

    PubMed

    Giovani, Elcio Magdalena; de Paula Neto, Edson Rodrigues; Vieira, Bruno Caputo; de Andrade, Daniela Miranda Richarte

    2012-01-01

    Patients with HIV infection may develop common diseases with atypical clinical features. HIV infection can change the classic clinical course of syphilis and increase the incidence of malignant syphilis. Malignant syphilis is a rare subtype of secondary syphilis that presents special clinical and histological features and has been associated with several processes characterized by variable degrees of immunosuppression. It is necessary to consider the possibility of this entity in the differential diagnoses in HIV-infected patients with cutaneous lesions. The dental surgeon (or oral surgeon) is vital to the medical team for promoting the health and improving the quality of life of syphilis patients. A patient with HIV infection was referred to us for complaints of a white patch on the tongue, stinging and burning sensation on the tongue, loss of taste, and dryness of the mouth. On clinical examination, the patient was found to have a tabetic gait (the Prussian soldier gait) associated with Charcot arthropathy. We also identified bilateral lesions with ulceration and exposure of the tissue that were tender, characterized by discrete necrosis. The treatment that was initiated at that time involved cleaning the area with gauze to remove all the white patches, followed by rinsing with bicarbonate in water (one teaspoon of baking soda dissolved in half a glass of water) four times a day. Additionally, fluconazole (100 mg/day for 7 days) was prescribed. We diagnosed secondary malignant syphilis of approximately 5 days duration. As an adjunctive therapy, we performed low-intensity laser treatment using a GaAsAl (gallium-aluminum arsenide) laser at 790 nm. With this treatment there was progressive resolution of the lesions.

  16. High frequency of the 23S rRNA A2058G mutation of Treponema pallidum in Shanghai is associated with a current strategy for the treatment of syphilis.

    PubMed

    Lu, Haikong; Li, Kang; Gong, Weimin; Yan, Limeng; Gu, Xin; Chai, Ze; Guan, Zhifang; Zhou, Pingyu

    2015-02-01

    The preferred drugs for the treatment of syphilis, benzathine and procaine penicillin, have not been available in Shanghai for many years, and currently, the incidence of syphilis is increasing. Alternative antibiotics for patients with syphilis during the benzathine and procaine penicillin shortage include macrolides. The failure of macrolide treatment in syphilis patients has been reported in Shanghai, but the reason for this treatment failure remains unclear. We used polymerase chain reaction technology to detect a 23S rRNA A2058G mutation in Treponema pallidum in 109 specimens from syphilis patients. The use of azithromycin/erythromycin in the syphilis patients and the physicians' prescription habits were also assessed based on two questionnaires regarding the use of macrolides. A total of 104 specimens (95.4%) were positive for the A2058G mutation in both copies of the 23S rRNA gene, indicating macrolide resistance. A questionnaire provided to 122 dermatologists showed that during the penicillin shortage, they prescribed erythromycin and azithromycin for 8.24±13.95% and 3.21±6.37% of their patients, respectively, and in the case of penicillin allergy, erythromycin and azithromycin were prescribed 15.24±22.89% and 7.23±16.60% of the time, respectively. A second questionnaire provided to the syphilis patients showed that 150 (33.7%), 106 (23.8%) and 34 (7.6%) individuals had used azithromycin, erythromycin or both, respectively, although the majority did not use the drugs for syphilis treatment. Our findings suggest that macrolide resistance in Treponema pallidum is widespread in Shanghai. More than half of the syphilis patients had a history of macrolide use for other treatment purposes, which may have led to the high prevalence of macrolide resistance. Physicians in China are advised to not use azithromycin for early syphilis.

  17. Non-human Immunodeficiency Virus-related Ocular Syphilis in a Korean Population: Clinical Manifestations and Treatment Outcomes

    PubMed Central

    Kim, Yonguk; Kwak, Hyung Woo

    2016-01-01

    Purpose To describe the clinical manifestations and treatment outcomes of ocular syphilis in patients without human immunodeficiency virus (HIV) infection. Methods A total of 45 eyes from 39 patients with ocular syphilis confirmed by serologic tests were reviewed retrospectively. The included cases were all non-HIV-infected patients presenting with intraocular inflammation from 2002 to 2014 at Kyung Hee University Hospital. Medical records of 45 eyes were analyzed and included best-corrected visual acuity and ophthalmologic examination findings of the anterior and posterior segments to determine the focus of inflammation. Optical coherence tomography and fluorescein angiography findings as well as both medical and surgical management were also analyzed. Results The mean patient age was 61.0 years (range, 37 to 89 years). Bilateral ocular involvement occurred in 6 patients (15.4%), and diagnoses at presentation were most frequently related to posterior uveitis (38%), followed by panuveitis (29%) and optic neuritis (11%). Isolated interstitial keratitis and intermediate uveitis were uncommon (4%, both). Twenty-eight eyes (62.2%) were treated with penicillin, and 11 eyes (24.4%) underwent surgical treatment. The mean baseline best corrected visual acuity was 0.79 ± 0.59 (mean ± standard deviation, logarithm of the minimum angle of resolution) and significantly improved to 0.60 ± 0.63 at the final follow-up after treatment (p = 0.019). Mean visual improvement was significantly greater in the penicillin-treated group (p = 0.001). Visual impairment at the final visit occurred in 11 eyes (24.4%). Among the visual impairment group, 10 eyes (90.1%) had posterior segment-involving uveitis. Conclusions Visual outcomes of treated, non-HIV-related ocular syphilis were favorable regardless of time to presentation. Posterior segment-involving uveitis at presentation was associated with poor visual outcome. PMID:27729756

  18. Test Positivity for Chlamydia, Gonorrhea and Syphilis Infection Among a Cohort of Individuals Released from Jail in Marion County, Indiana

    PubMed Central

    Wiehe, Sarah E.; Barai, Nikita; Rosenman, Marc B.; Aalsma, Matthew C.; Scanlon, Michael L.; Fortenberry, J. Dennis

    2014-01-01

    Background Individuals entering jails have high rates of sexually transmitted infections (STI) but there are few data on STI in the post-incarceration period. This study aimed to describe rates of chlamydia, gonorrhea and syphilis infection among individuals released from Marion County (Indianapolis), Indiana jails. Methods We conducted a retrospective cohort study of individuals incarcerated in Marion County, Indiana jails from 2003–2008 (N=118,670). We linked county jail and public health data to identify individuals with positive STI test results in the one-year following release from jail. Rates per 100,000 individuals and cox proportional hazard analyses were performed for each STI, stratified by demographic, STI and jail characteristics. Results We found significantly higher rates of STI in this cohort than in the general population, with rates in the one-year following release being 2 to 7 times higher for chlamydia, 5 to 24 times higher for gonorrhea, and 19 to 32 times higher for syphilis compared to rates in the general population. Characteristics most associated with increased risk of a positive STI test among this cohort were younger age for chlamydia and gonorrhea, older age for syphilis, black race for men, being jailed for prostitution for women, history of STI, and history of prior incarceration. Conclusions This study found high rates of STIs among a cohort of individuals recently released from jail and identified a number of risk factors. Further study is needed to improve targeted STI testing and treatment among this high-risk population. PMID:25504298

  19. Prevalence and sociodemographic risk factors of chlamydia, gonorrhoea and syphilis: a national multicentre STI survey in New Caledonia, 2012

    PubMed Central

    Corsenac, Philippe; Noël, Martine; Rouchon, Bernard; Hoy, Damian; Roth, Adam

    2015-01-01

    Objectives To estimate prevalence and identify sociodemographic risk factors for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and Treponema pallidum infections in New Caledonia. Method A national cross-sectional survey was undertaken using a three-stage random sampling of general practice surgeries and public dispensaries. Participants were included through opportunistic screening and using a systematic step for selection. The study sample was weighted to the general population aged 18–49 years. Prevalence and risk factors were calculated by logistic regression. Results CT was the most common sexually transmitted infection, with a prevalence of 9% (95% CI 6.6% to %11.4), followed by NG 3.5% (95% CI 1.9% to 5.1%), previous or latent syphilis 3% (95% CI 1.7% to 4.3%), NG and CT co-infection 2.1% (95% CI 0.8% to 3.3%) and active syphilis 0.4% (95% CI 0.0% to 0.9%). Being from a young age group (18–25 years), being single, having a low level of education and province of residence were all associated with higher prevalence of all three STIs. Being of Melanesian origin was associated with higher prevalence of both CT and NG. There was a significant interaction between ethnic group and province of residence for prevalence of CT. Female gender was associated with higher prevalence of CT. Conclusions The prevalence of CT was similar to estimates from other healthcare-based surveys from the Pacific, but higher for NG and lower for active syphilis infection. All sexually transmitted infections estimates were much higher than those found in population-based surveys from Europe and the USA. The sociodemographic risk factors identified in this study will help guide targeted prevention and control strategies in New Caledonia. PMID:26353867

  20. Misinformation and misbeliefs in the Tuskegee Study of Untreated Syphilis fuel mistrust in the healthcare system.

    PubMed Central

    White, Robert M.

    2005-01-01

    The Tuskegee Study of Untreated Syphilis (TSUS) is an important issue in research, healthcare, ethics and race relations. The assumed consequences of knowledge of this study on the African-American community include mistrust of the healthcare system. In the July 2005 issue of the Journal of the National Medical Association, Brandon, Isaac and LaVeist (the authors), who were at the Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, reported the results of black-white differences in awareness of and knowledge about the TSUS and the effect of that awareness and knowledge on medical mistrust. The study surveyed blacks, whites and others in the Baltimore, MD community about their knowledge of and attitudes about the TSUS. The respondents who were aware of the TSUS were asked survey items to assess specific factual information about the TSUS. The respondents who were not aware of the TSUS were read a brief description of the TSUS taken from the CDC website. Both groups were asked if a similar study was possible today. The authors performed a regression analysis of mistrust of medical care based on race, knowledge of the TSUS and demographic variables. The editorial identified and explained challenges in the article, i.e., challenges in calculations, demographic analysis by race, knowledge of TSUS, cultural sensitivity and methodology. The authors miscalculated the "similar proportions" of blacks and whites who were aware of the TSUS; the recalculated proportions, favoring whites, were different than reported by others. There was no demographic analysis by race in their article--also different than other published reports. Most respondents--blacks and whites--who were aware of the TSUS at baseline answered incorrectly the author-selected questions about the TSUS, particularly the fact-based question of whether the TSUS researchers gave syphilis to the men-not dissimilar to one other report. The source for TSUS information (the CDC

  1. Prevalence of HIV and other sexually transmitted infections and factors associated with syphilis among female sex workers in Panama

    PubMed Central

    Hakre, Shilpa; Arteaga, Griselda; Núñez, Aurelio E; Bautista, Christian T; Bolen, Aimee; Villarroel, Maria; Peel, Sheila A; Paz-Bailey, Gabriela; Scott, Paul T; Pascale, Juan M

    2013-01-01

    Objectives Biological and behavioural surveillance of HIV and sexually transmitted infections (STIs) among populations at highest risk have been used to monitor trends in prevalence and in risk behaviours. Sex work in Panama is regulated through registration with the Social Hygiene Programme, Ministry of Health. We estimated prevalence of HIV and STIs, and factors associated with active syphilis among female sex workers (FSWs). Methods A cross-sectional study using venue-based, time-space sampling was conducted among FSWs in Panama from 2009 to 2010. FSWs were interviewed about sociodemographic characteristics, sexual risk behaviour, health history and drug use using an anonymous structured questionnaire. Blood was collected for serological testing of HIV and other STIs. Factors associated with active syphilis were studied using logistic regression analysis. Results The overall HIV-1 prevalence of 0.7% varied by FSW category; 1.6% in 379 unregistered, and 0.2% in 620 registered FSWs. Overall prevalence (and 95% CI) of STIs were: syphilis antibody, 3.8% (2.7% to 5.2%); herpes simplex virus type 2 antibody (anti-HSV-2), 74.2% (71.4% to 76.9%); hepatitis B surface antigen, 0.6% (0.2% to 1.3%); hepatitis B core antibody, 8.7% (7.0% to 10.6%); and hepatitis C antibody, 0.2% (0.0% to 0.7%). In multivariate analysis, registration (adjusted OR (AOR)=0.35; 95% CI 0.16 to 0.74), having a history of STI (AOR=2.37; 95% CI 1.01 to 5.58), forced sex (AOR=2.47; 95% CI 1.11 to 5.48), and anti-HSV-2 (AOR=10.05; 95% CI 1.36 to 74.38) were associated with active syphilis. Conclusions Although HIV prevalence is low among FSWs in Panama, unregistered FSWs bear a higher burden of HIV and STIs than registered FSWs. Programmes aimed at overcoming obstacles to registration, and HIV, STI and harm reduction among unregistered FSWs is warranted to prevent HIV transmission, and to improve their sexual and reproductive health. PMID:23002191

  2. Incidence of HIV and the Prevalence of HIV, Hepatitis B and Syphilis among Youths in Maputo, Mozambique: A Cohort Study

    PubMed Central

    Macovela, Eulália; Gonçalves, Emília; Augusto, Orvalho; Ismael, Nália; Sitoe, Nádia; De Schacht, Caroline; Bhatt, Nilesh; Meggi, Bindiya; Araujo, Carolina; Sandström, Eric; Biberfeld, Gunnel; Nilsson, Charlotta; Andersson, Sören; Jani, Ilesh; Osman, Nafissa

    2015-01-01

    Background Prevalence of HIV in Mozambique among individuals aged 15–49 years is 11.5%. The HIV prevalence is higher in women than in men across the country, peaking at ages 25–29 years and 35–39 years, respectively. In this study, we aimed at determining the prevalence and incidence of HIV, prevalence of Hepatitis B (HBV), and prevalence of syphilis in youths. We also characterized a cohort of youths for future participation in phase I/II HIV vaccine trials. Methods The study was conducted at a youth clinic in Maputo Central Hospital from August 2009 to October 2011. Youths of both genders aged 18–24 years (n = 1380) were screened for HIV using a sequential algorithm of two immunochromatographic assays, HBV using an enzyme linked immunosorbant test, and syphilis using a treponemal immunochromatographic strip test. The HIV seronegative participants (n = 1309) were followed-up for 12 months with quarterly study visits. The clinical and behavioral data were collected using structured questionnaires. The HIV seroconversions were confirmed by a molecular assay. Results The study population was female dominant (76.8%). All participants had a formal education, with 44.6% studying for technical or higher education degrees. The mean age at sexual debut was 16.6 years (SD: ±1.74), with 85.6% reporting more than one sexual partner in life. The screening showed the prevalence of HIV, HBV, and syphilis at 5.1% (95% CI: 3.97–6.31), 12.2% (95% CI 10.5%–14.0%), and 0.36% (95% CI 0.15%–0.84%), respectively. The HIV incidence rate was found to be 1.14/100 person years (95% CI: 0.67–1.92). Retention rates were stable throughout the study being 85.1% at the last visit. Conclusion Incidence of HIV in this cohort of youths in Maputo was relatively low. Also, the prevalence of HIV and syphilis was lower than the national values in this age group. However, the HBV prevalence was higher than in previous reports in the country. PMID:25798607

  3. Treatment of late syphilis with 2.4 million units benzathine penicillin G (BPG): tolerance of single versus divided doses.

    PubMed

    Janier, Michel; Libar, Eliane; Bonnet, Annie; Meunier, Patrick; Tabet, Magda; Mathourais, Monique; Paterour, Christine; Porcher, Raphael

    2012-05-01

    Although there is no data in the literature, some textbooks recommend fractioning the injection of benzathine penicillin G (BPG) for alleviating the pain. In a monocentric study done in 50 consecutive patients with late syphilis. Patients were assigned to receive 1 dose of 2.4 million units BPG intramuscularly the first week and 2 doses of 1.2 million units BPG in each buttock the second week. In the third week, patients were asked to choose between the 2 options. It was demonstrated that the 2 techniques were equally well tolerated and equally preferred by patients.

  4. Prevalence of Hepatitis B, C, HIV and syphilis markers among refugees in Bari, Italy

    PubMed Central

    2010-01-01

    Background The aim of this study was to assess the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) serological markers and the prevalence of VDRL positive subjects in a population of refugees of various nationalities, living in the Asylum Seeker Centre in Bari Palese, Southern Italy. Methods The study was carried out in the period May-July 2008 and recruited only voluntarily enrolled healthy refugees. HBsAg, anti-HBc, anti-HCV and anti-HIV virus antibodies were detected. VDRL syphilis screening was also carried out on the serum samples. Results A total of 529 refugees, 442 males and 87 females, aged between 7 and 52 years, were studied. Of these, 510 were from Africa and 19 from Asia. Forty-four individuals (8.3%) were HBsAg positive and 241 (45.6%) were anti-HBc positive. A total of 24 (4.5%) individuals were anti-HCV positive. Eight asylum seekers (1.5%) were HIV positive. VDRL tests were performed on 269 subjects and 4 (1.5%) were positive. 12.3% of the study population had serological markers of chronic and transmissible infections with potential blood-borne or sexual transmission. Conclusions In Italy, a suitable protocol is necessary for the early diagnosis of infectious diseases on entering Asylum Centres, so allowing the adoption of prevention measures to safeguard the health of the individuals, the residents and workers in the Centres and the general population. PMID:20646306

  5. Bridging the Epidemic: A Comprehensive Analysis of Prevalence and Correlates of HIV, Hepatitis C, and Syphilis, and Infection among Female Sex Workers in Guangxi Province, China

    PubMed Central

    Chen, Yi; Shen, Zhiyong; Morano, Jamie P.; Khoshnood, Kaveh; Wu, Zunyou; Lan, Guanghua; Zhu, Qiuying; Zhou, Yuejiao; Tang, Shuai; Liu, Wei; Chen, Jie; Tang, Zhenzhu

    2015-01-01

    Introduction Female sex workers (FSWs) are at highest risk for contracting HIV and facilitating the current heterosexual HIV epidemic in Guangxi, China, yet little is known of the impact of recent harm reduction campaigns in the province. We analyzed sentinel surveillance data collected between 2010 and 2012 in Guangxi to explore correlations between the prevalence of HIV, hepatitis C (HCV), and syphilis and risk behaviors of different categories of FSWs in Guangxi. Methods The sentinel surveillance data for 5,1790 FSWs in all 14 prefectures and 64 city/county regions of Guangxi, China from 2010 to 2012 were collected. Differences between three categories of FSWs (grouped by venue) and disease trends (HIV, HCV, and syphilis) by year were analyzed using bivariate and multivariate logistic regression analyses as to evaluate risk factors correlated with HIV, HCV, or syphilis infection. Results HIV and HCV prevalence remained constant across the three FSW categories; however, syphilis prevalence showed a significant increase from 5.7% to 7.3% for low-tier FSWs. Most cases with HIV, HCV, syphilis and intravenous drug use were seen in low-tier FSWs. Testing positive for HIV and syphilis were most correlated with being HCV positive (AOR 4.12 and AOR 4.36), only completing elementary school (AOR 3.71 and AOR 2.35), low tier venues (AOR 2.02 and AOR 2.00), and prior STI (AOR 1.40 and AOR 3.56), respectively. HCV infection was correlated with ever injecting drugs (AOR 60.65) and testing positive for syphilis (AOR 4.16) or HIV (AOR 3.74). Conclusions This study highlights that low tier FSWs with lower formal education levels are the most vulnerable population at risk for acquiring and transmitting HIV, HCV, and syphilis in Guangxi, China. Condom distribution with evolution to safer sex practices are the reasons to explain the non-increasing prevalence of HIV, HCV in Guangxi for 2010–2012. PMID:25723548

  6. [Juan Marin Rojas M.D., First Professor of History of Medicine at Universidad de Chile and his "Essay about the origin of syphilis"].

    PubMed

    Laval, Enrique

    2014-06-01

    Dr. Juan Marín Rojas, M.D., was the first Professor of History of Medicine at Universidad de Chile, navy doctor, diplomat, writer and literary critic. Member of the International Society of History of Medicine, and Correspondent Member for Chile of the "Office de Documentation de Médecine et Pharmacie Militaire", Liege, Belgium, from which his "Essay about the origin of syphilis" is transcribed with interesting historical facts and little known arguments that affirm the non-american origin of syphilis, but "aspire to leave a doubt, given not a contrary conviction".

  7. Syphilis and human experimentation from the first appearance of the disease to World War II: a historical perspective and reflections on ethics.

    PubMed

    Cuerda-Galindo, E; Sierra-Valentí, X; González-López, E; López-Muñoz, F

    2014-10-01

    Physicians have conducted research on syphilis for centuries, seeking to understand its etiology and the means of transmission as well as find ways to prevent and cure the disease. Their research practices often strayed from today's ethical standards. In this paper we review ethical aspects of the long history of research on syphilis with emphasis on the experiments performed in the 20th century. The description of research around the time of World War II covers medical experiments carried out in US prisons and in the experimentation centers established by Japanese doctors in occupied territory, as well as experiments in Nazi Germany and the treatment of syphilitics there.

  8. [Laboratory diagnosis of Treponema pallidum infection in patients with early syphilis and neurosyphilis through a PCR-based test].

    PubMed

    García, Patricia; Grassi, Bruno; Fich, Félix; Salvo, Aurelio; Araya, Luis; Abarzúa, Fernando; Soto, Julia; Poggi, Helena; Lagos, Marcela; Vásquez, Patricia; León, Eugenia P; Pérez, Carlos; Wozniak, Aniela

    2011-08-01

    Syphilis is a sexually transmitted disease caused by Treponema pallidum. The diagnosis is based mainly in clinical presentation and non-specific assays. PCR-based diagnosis has been suggested as an attractive alternative method. The aim of this study was the validation of a PCR-based test for the diagnosis of early syphilis (ES) and neurosyphilis (NS). Clinical samples of mucocutaneous lesions and cerebrospinal fluid (CSF) specimens from patients previously diagnosed for ES and NS respectively using an enlarged gold standard, were tested by PCR. The reaction was done using primers targeting the tpN47 gene. Twenty out of 21 mucocutaneous samples from patients diagnosed with ES were positive by PCR, with a clinical sensitivity of 95%. Four out of 8 CSF samples from patients previously diagnosed with NS were positive by PCR, with a clinical sensitivity of 50%. The clinical specificity for both ES and NS was 100%. The PCR sensitivity and specificity for mucocutaneous samples allowed us to implement this assay in our laboratory for routine diagnosis. Although the sensitivity of the PCR in CSF was low, it may be useful to support clinical diagnosis.

  9. Treponema pallidum (syphilis) antigen TpF1 induces angiogenesis through the activation of the IL-8 pathway

    PubMed Central

    Pozzobon, Tommaso; Facchinello, Nicola; Bossi, Fleur; Capitani, Nagaja; Benagiano, Marisa; Di Benedetto, Giulietta; Zennaro, Cristina; West, Nicole; Codolo, Gaia; Bernardini, Marialina; Baldari, Cosima Tatiana; D’Elios, Mario Milco; Pellegrini, Luca; Argenton, Francesco; de Bernard, Marina

    2016-01-01

    Over 10 million people every year become infected by Treponema pallidum and develop syphilis, a disease with broad symptomatology that, due to the difficulty to eradicate the pathogen from the highly vascularized secondary sites of infection, is still treated with injections of penicillin. Unlike most other bacterial pathogens, T. pallidum infection produces indeed a strong angiogenic response whose mechanism of activation, however, remains unknown. Here, we report that one of the major antigen of T. pallidum, the TpF1 protein, has growth factor-like activity on primary cultures of human endothelial cells and activates specific T cells able to promote tissue factor production. The growth factor-like activity is mediated by the secretion of IL-8 but not of VEGF, two known angiogenic factors. The pathogen’s factor signals IL-8 secretion through the activation of the CREB/NF-κB signalling pathway. These findings are recapitulated in an animal model, zebrafish, where we observed that TpF1 injection stimulates angiogenesis and IL-8, but not VEGF, secretion. This study suggests that the angiogenic response observed during secondary syphilis is triggered by TpF1 and that pharmacological therapies directed to inhibit IL-8 response in patients should be explored to treat this disease. PMID:26728351

  10. Comparison of a recombinant-antigen enzyme immunoassay with Treponema pallidum hemagglutination test for serological confirmation of syphilis.

    PubMed

    Rodríguez, Islay; Alvarez, Elvio L; Fernández, Carmen; Miranda, Alina

    2002-04-01

    A recombinant-antigen enzyme immunoassay (EIA), BioSCREEN anti-Treponema pallidum, was compared favorably with the T. pallidum hemagglutination test, in the detection of specific antibodies in different groups of sera from patients with primary (n = 38), secondary (n = 10), early latent (n = 28) and congenital syphilis (n = 2), patients with leptospirosis ( n= 8), infectious mononucleosis (n = 7), hepatitis (n = 9), diabetes mellitus (n = 11), rheumatoid arthritis (n = 13), leprosy (n = 11), tuberculosis (n = 9), HIV/Aids ( n= 12), systemic lupus erythematosus (n = 4), rheumatic fever (n = 3), old-persons (n = 9), pregnant women (n = 29) and blood donors (n = 164). The coincidence between them was 95.1%. The sensitivity and specificity of the EIA were 93.3% and 95.5%, respectively. Fifteen serum specimens belonging to old-persons, pregnant women, blood donors, and patients with human leptospirosis, hepatitis, diabetes mellitus, tuberculosis and rheumatic fever gave false-positive results by Venereal Disease Research Laboratory and/or Rapid Plasma Reagin. The EIA can be used as alternative method for the serological confirmation of syphilis.

  11. Treponema pallidum putative novel drug target identification and validation: rethinking syphilis therapeutics with plant-derived terpenoids.

    PubMed

    Dwivedi, Upendra N; Tiwari, Sameeksha; Singh, Priyanka; Singh, Swati; Awasthi, Manika; Pandey, Veda P

    2015-02-01

    Syphilis, a slow progressive and the third most common sexually transmitted disease found worldwide, is caused by a spirochete gram negative bacteria Treponema pallidum. Emergence of antibiotic resistant T. pallidum has led to a search for novel drugs and their targets. Subtractive genomics analyses of pathogen T. pallidum and host Homo sapiens resulted in identification of 126 proteins essential for survival and viability of the pathogen. Metabolic pathway analyses of these essential proteins led to discovery of nineteen proteins distributed among six metabolic pathways unique to T. pallidum. One hundred plant-derived terpenoids, as potential therapeutic molecules against T. pallidum, were screened for their drug likeness and ADMET (absorption, distribution, metabolism, and toxicity) properties. Subsequently the resulting nine terpenoids were docked with five unique T. pallidum targets through molecular modeling approaches. Out of five targets analyzed, D-alanine:D-alanine ligase was found to be the most promising target, while terpenoid salvicine was the most potent inhibitor. A comparison of the inhibitory potential of the best docked readily available natural compound, namely pomiferin (flavonoid) with that of the best docked terpenoid salvicine, revealed that salvicine was a more potent inhibitor than that of pomiferin. To the best of our knowledge, this is the first report of a terpenoid as a potential therapeutic molecule against T. pallidum with D-alanine:D-alanine ligase as a novel target. Further studies are warranted to evaluate and explore the potential clinical ramifications of these findings in relation to syphilis that has public health importance worldwide.

  12. Geographical information systems-based spatial analysis and implications for syphilis interventions in Jiangsu province, People's Republic of China.

    PubMed

    Cheng, Yue-Jia; Norris, Jessie; Bao, Chang-Jun; Liang, Qi; Hu, Jian-Li; Wu, Ying; Tang, Fen-Yang; Liu, Wen-Dong; Ding, Ke-Qin; Zhao, Yang; Peng, Zhi-Hang; Yu, Rong-Bin; Wang, Hua; Shen, Hong-Bing; Chen, Feng

    2012-11-01

    Spatial distribution rules and risk factors for syphilis were studied in Jiangsu province, People's Republic of China during 2005 and 2009. Trend surface analysis, spatial autocorrelation analysis and spatio-temporal clustering were applied with the incidence rates of the various counties in the province to determine spatial distribution rules and risk factors. Syphilis was found to be most severe in the southern region of the province where many counties could be shown to be hotspots with positive autocorrelation. Clusters were detected in the south-western region of Jiangsu with the county-level city of Yixing as the centre. Temperature, distance from railways and highways, and the normalised difference vegetation index were determined as supporting variables with regard to the transmission of the disease by both univariate and multivariate spatial correlation analyses. Interventions, including health education and awareness campaigns, should be strengthened throughout the province targeting the south-western areas, especially the clusters and hotspots detected in order to improve the situation.

  13. Usefulness in clinical practice of a point-of-care rapid test for simultaneous detection of nontreponemal and Treponema pallidum-specific antibodies in patients suffering from documented syphilis.

    PubMed

    Guinard, Jérôme; Prazuck, Thierry; Péré, Hélène; Poirier, Claire; LeGoff, Jérôme; Boedec, Erwan; Guigon, Aurélie; Day, Nesrine; Bélec, Laurent

    2013-12-01

    The usefulness of a point-of-care immunochromatographic dual test for the simultaneous detection of both nontreponemal and Treponema pallidum-specific antibodies (Chembio Diagnostics Systems Inc., Medford, NY, USA) was assessed in various situations related to syphilis, by reference to conventional syphilis serology. Thawed sera were obtained from 100 adults including 36 primary syphilis, 6 secondary syphilis, 6 re-infection, 9 recently-treated syphilis, and 43 old syphilis. Doubtful reactivities for the treponemal line were considered positive; doubtful reactivities for the nontreponemal line were considered positive only when the treponemal line was present. The sensitivity, the specificity, and its concordance to gold standard serology of treponemal line were high, around 90%. The sensitivity of nontreponemal line was 96.3%, its specificity 76.7%, and its concordance 83.4%. In conclusion, the dual rapid test from Chembio Diagnostics Systems Inc. is useful for rapid point-of-care diagnosis in the various situations encountered with patients suffering from syphilis.

  14. Prevalence and determinants of HSV-2/syphilis co-infection and HSV-2 mono-infection among HIV-positive men who have sex with men: a cross-sectional study in Northeast China.

    PubMed

    Hu, Qing-Hai; Xu, Jun-Jie; Chu, Zhen-Xing; Zhang, Jing; Yu, Yan-Qiu; Yu, Huan; Ding, Hai-Bo; Jiang, Yong-Jun; Geng, Wen-Qing; Wang, Ning; Shang, Hong

    2016-10-31

    We aimed to assess the prevalence and determinants of herpes simplex virus type 2 (HSV-2) mono-infection and HSV-2/syphilis co-infection in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) in China. A cross-sectional study was conducted on 545 HIV-positive MSM in Shenyang between February 2009 and October 2014. Participants received physical examinations and serological tests for HSV-2 and syphilis. A multinomial logistic regression was used to identify risk factors associated with HSV-2/syphilis co-infection and HSV-2 mono-infection. The HSV-2 mono-infection, syphilis mono-infection, and HSV-2/syphilis co-infection prevalence (95% confidence interval) was 48.6% (44.4-52.8%), 34.3% (30.3-38.3%), and 22.9% (19.4-26.5%), respectively. In regression analysis, after controlling within HSV-2/syphilis-seronegative cases, related factors for HSV-2/syphilis co-infection were age (25-50 years vs. ≤24 years, aOR: 4.55; >50 years vs. ≤24 years, aOR: 43.02), having regular female sexual partner(s) in the past 6 months (aOR: 0.43) and age at first MSM experience (>18 years vs ⩽18 years, aOR: 2.59) (all P < 0.05).The high prevalence of HSV-2 infection and HSV-2/syphilis co-infection in HIV-positive MSM indicates high HIV secondary transmission risk. A campaign for detection and treatment of HSV-2 and syphilis is urgently required for HIV-positive MSM in China.

  15. Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature

    PubMed Central

    Al Turk, Bashar; Mohan, Girish

    2016-01-01

    Syphilis is a sexually transmitted infection that remains fairly commonplace. The introduction of penicillin aided in curbing the incidence of disease; however, with the advent of the human immunodeficiency virus (HIV), syphilis is now on a resurgence with sometimes curious presentations. We present a case of a 36-year-old Caucasian gentleman with untreated HIV who complained of a skin eruption and joint pains for 6 weeks, prompting the diagnosis of secondary syphilis osteitis. Skin lesions were reminiscent of “malignant” syphilis. CD4 count was 57 cells/μL. RPR was elevated with 1 : 64 titer and positive confirmatory TP-PA. Radiography of the limbs revealed polyostotic cortical irregularities corroborated on bone scintigraphy. The patient had an unknown penicillin allergy and was unwilling to conduct a trial of penicillin-based therapy. He was subsequently treated with doxycycline 100 mg twice daily for 6 weeks and commenced antiretroviral therapy, noting dramatic improvement in both the skin lesions and joint pains. Unfortunately, he defaulted on follow-up, precluding serial RPR and bone imaging. Penicillin allergies have proven to be quite a conundrum in such patients, without much recourse for alternative therapy. Doxycycline with/without azithromycin is other options worth considering. PMID:27313920

  16. Syphilis 1855 and HIV-AIDS 2007: Historical reflections on the tendency to blame human anatomy for the action of micro-organisms.

    PubMed

    Darby, Robert

    2015-01-01

    In this paper, I discuss the parallels between responses to syphilis in nineteenth century Britain and HIV/AIDS in contemporary Africa. In each case, an incurable disease connected with sexual behaviour aroused fear, stigmatisation and moralistic responses, as well as a desperate scramble to find an effective means of control. In both cases, circumcision of adult males, and then of children or infants, was proposed as the key tactic. In the ensuing debates over the effectiveness and propriety of this approach, three questions occupied health authorities in both Victorian Britain and the contemporary world: (1) Were circumcised men at significantly lower risk of these diseases? (2) If there was evidence pointing to an affirmative answer, was it altered anatomy or different behaviour that explained the difference? (3) Given that circumcision was a surgical procedure with attendant risks of infection, was it possible that circumcision spread syphilis or HIV? I show that in both situations the answers to these questions were inconclusive, argue that circumcision played little or no role in the eventual control of syphilis and suggest that attention to nineteenth century debates may assist contemporary policy-makers to avoid the treatment dead-ends and ethical transgressions that marked the war on syphilis.

  17. Comparison of the diagnostic accuracy of a rapid immunochromatographic test and the rapid plasma reagin test for antenatal syphilis screening in Mozambique.

    PubMed Central

    Montoya, Pablo J.; Lukehart, Sheila A.; Brentlinger, Paula E.; Blanco, Ana J.; Floriano, Florencia; Sairosse, Josefa; Gloyd, Stephen

    2006-01-01

    OBJECTIVE: Programmes to control syphilis in developing countries are hampered by a lack of laboratory services, delayed diagnosis, and doubts about current screening methods. We aimed to compare the diagnostic accuracy of an immunochromatographic strip (ICS) test and the rapid plasma reagin (RPR) test with the combined gold standard (RPR, Treponema pallidum haemagglutination assay and direct immunofluorescence stain done at a reference laboratory) for the detection of syphilis in pregnancy. METHODS: We included test results from 4789 women attending their first antenatal visit at one of six health facilities in Sofala Province, central Mozambique. We compared diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of ICS and RPR done at the health facilities and ICS performed at the reference laboratory. We also made subgroup comparisons by human immunodeficiency virus (HIV) and malaria status. FINDINGS: For active syphilis, the sensitivity of the ICS was 95.3% at the reference laboratory, and 84.1% at the health facility. The sensitivity of the RPR at the health facility was 70.7%. Specificity and positive and negative predictive values showed a similar pattern. The ICS outperformed RPR in all comparisons (P<0.001). CONCLUSION: The diagnostic accuracy of the ICS compared favourably with that of the gold standard. The use of the ICS in Mozambique and similar settings may improve the diagnosis of syphilis in health facilities, both with and without laboratories. PMID:16501726

  18. Characterizing the Syphilis-Causing Treponema pallidum ssp. pallidum Proteome Using Complementary Mass Spectrometry

    PubMed Central

    Houston, Simon; Lithgow, Karen V.; Meehan, Conor J.; Strouhal, Michal; Šmajs, David; Cameron, Caroline E.; Van Ostade, Xaveer; Kenyon, Chris R.; Van Raemdonck, Geert A.

    2016-01-01

    Background The spirochete bacterium Treponema pallidum ssp. pallidum is the etiological agent of syphilis, a chronic multistage disease. Little is known about the global T. pallidum proteome, therefore mass spectrometry studies are needed to bring insights into pathogenicity and protein expression profiles during infection. Methodology/Principal Findings To better understand the T. pallidum proteome profile during infection, we studied T. pallidum ssp. pallidum DAL-1 strain bacteria isolated from rabbits using complementary mass spectrometry techniques, including multidimensional peptide separation and protein identification via matrix-assisted laser desorption ionization-time of flight (MALDI-TOF/TOF) and electrospray ionization (ESI-LTQ-Orbitrap) tandem mass spectrometry. A total of 6033 peptides were detected, corresponding to 557 unique T. pallidum proteins at a high level of confidence, representing 54% of the predicted proteome. A previous gel-based T. pallidum MS proteome study detected 58 of these proteins. One hundred fourteen of the detected proteins were previously annotated as hypothetical or uncharacterized proteins; this is the first account of 106 of these proteins at the protein level. Detected proteins were characterized according to their predicted biological function and localization; half were allocated into a wide range of functional categories. Proteins annotated as potential membrane proteins and proteins with unclear functional annotations were subjected to an additional bioinformatics pipeline analysis to facilitate further characterization. A total of 116 potential membrane proteins were identified, of which 16 have evidence supporting outer membrane localization. We found 8/12 proteins related to the paralogous tpr gene family: TprB, TprC/D, TprE, TprG, TprH, TprI and TprJ. Protein abundance was semi-quantified using label-free spectral counting methods. A low correlation (r = 0.26) was found between previous microarray signal data and

  19. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    PubMed

    Shelley, Katharine D; Ansbro, Éimhín M; Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Tembo Mumba, Grace; Gill, Michelle M; Strasser, Susan; Peeling, Rosanna W; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in

  20. Burden of HIV, Syphilis, and Hepatitis B and C Among Inmates in a Prison State System in Mexico.

    PubMed

    Belaunzaran-Zamudio, Pablo F; Mosqueda-Gomez, Juan L; Macias-Hernandez, Alejando; Rodríguez-Ramírez, Sonia; Sierra-Madero, Juan; Beyrer, Chris

    2017-03-06

    We studied the prevalence of HIV, syphilis, hepatitis B virus (HBV), and hepatitis C virus (HCV) infection and associated risk behaviors in the prison state system of Guanajuato, Mexico between September 2011 and February 2012. Blood samples were drawn from adult inmates in all State prisons who agreed to participate in this cross-sectional study. Data on risk behaviors were collected by using self-administered questionnaires. The prevalence of HIV, syphilis, HBV, and HCV infection was 0.6% [95% confidence interval (CI) = 0.2-1.1], 0.7% (95% CI = 0.4-1.0), 0.4 (95% CI = 0.04-0.74), and 4.8 (95% CI = 3.6-5.9), respectively. Female inmates had a higher prevalence of HIV (1.5% vs. 0.6%, p = .05), whereas male inmates had a higher prevalence of HCV (1% vs. 5%, p = .008). Twenty percent (n = 443, 95% CI = 15-26) of the participants were tattooed during incarceration, and most of them were tattooed with recycled materials. Around 60% (57%, 95% CI = 49-65) used drugs before incarceration, and 9.2% (n = 205) used injected drugs. During incarceration, 30% (95% CI = 23-39) used drugs and 43 continued injecting (20% of users). Consistent condom use was low among men before incarcerations but decreased by half during incarceration. The highest consistent condom use before incarceration was among men who have sex with men (MSM) (17.7%, 95% CI = 14-22), but it decreased (9%, 95% CI = 3-14) during incarceration. The prevalence of HIV, HBV, HCV, and syphilis in these inmates is higher than that of the local adult population. Most inmates had sex in prison, but few used condoms consistently. Access to condoms is apparently harder for MSM. Interventions to increase condom use, reduce use of shared or recycled materials for tattooing and injecting drugs, and treatment for drug abuse are needed.

  1. Circumscribed lenticular anetoderma in an HIV-infected man with a history of syphilis and lichen planus.

    PubMed

    Hunt, Raegan; Chu, Julie; Patel, Rishi; Sanchez, Miguel

    2011-10-15

    Anetoderma is an uncommon dermatosis that manifests as discrete foci of well-circumscribed, atrophic skin. The condition can be idiopathic or can be secondary to a number of associated cutaneous diseases. Whereas the pathophysiologic mechanisms remain unknown, anetoderma results from diminished elastic fibers in the dermis. We present an unusual case of localized, lenticular anetoderma in a man with HIV, a history of syphilis, and lichen planus. Both of these infections have been associated with anetoderma. Although his lesions are vaguely reminiscent of a variant of syphilitic anetoderma described in the 1930s, they are confined to a smaller anatomic distribution, differ in size, and have a papular appearance. As anetoderma can develop in the context of infectious disease, a diagnosis of anetoderma should trigger a thorough examination and evaluation for treatable concomitant illnesses.

  2. The Rationalization of Unethical Research: Revisionist Accounts of the Tuskegee Syphilis Study and the New Zealand "Unfortunate Experiment".

    PubMed

    Paul, Charlotte; Brookes, Barbara

    2015-10-01

    Two studies, widely condemned in the 1970s and 1980s-the Tuskegee study of men with untreated syphilis and the New Zealand study of women with untreated carcinoma in situ of the cervix-received new defenses in the 21st century. We noted remarkable similarities in both the studies and their defenses. Here we evaluate the scientific, political, and moral claims of the defenders. The scientific claims are largely based on incomplete or misinterpreted evidence and exaggeration of the uncertainties of science. The defenders' political arguments mistakenly claim that identity politics clouded the original critiques; in fact such politics opened the eyes of the public to exploitation. The moral defenses demonstrate an overreliance on codes of conduct and have implications for research ethics today.

  3. Treponema pallidum Putative Novel Drug Target Identification and Validation: Rethinking Syphilis Therapeutics with Plant-Derived Terpenoids

    PubMed Central

    Tiwari, Sameeksha; Singh, Priyanka; Singh, Swati; Awasthi, Manika; Pandey, Veda P.

    2015-01-01

    Abstract Syphilis, a slow progressive and the third most common sexually transmitted disease found worldwide, is caused by a spirochete gram negative bacteria Treponema pallidum. Emergence of antibiotic resistant T. pallidum has led to a search for novel drugs and their targets. Subtractive genomics analyses of pathogen T. pallidum and host Homo sapiens resulted in identification of 126 proteins essential for survival and viability of the pathogen. Metabolic pathway analyses of these essential proteins led to discovery of nineteen proteins distributed among six metabolic pathways unique to T. pallidum. One hundred plant-derived terpenoids, as potential therapeutic molecules against T. pallidum, were screened for their drug likeness and ADMET (absorption, distribution, metabolism, and toxicity) properties. Subsequently the resulting nine terpenoids were docked with five unique T. pallidum targets through molecular modeling approaches. Out of five targets analyzed, D-alanine:D-alanine ligase was found to be the most promising target, while terpenoid salvicine was the most potent inhibitor. A comparison of the inhibitory potential of the best docked readily available natural compound, namely pomiferin (flavonoid) with that of the best docked terpenoid salvicine, revealed that salvicine was a more potent inhibitor than that of pomiferin. To the best of our knowledge, this is the first report of a terpenoid as a potential therapeutic molecule against T. pallidum with D-alanine:D-alanine ligase as a novel target. Further studies are warranted to evaluate and explore the potential clinical ramifications of these findings in relation to syphilis that has public health importance worldwide. PMID:25683888

  4. The Epidemic of HIV, Syphilis, Chlamydia and Gonorrhea and the Correlates of Sexual Transmitted Infections among Men Who Have Sex with Men in Jiangsu, China, 2009

    PubMed Central

    Fu, Geng-Feng; Jiang, Ning; Hu, Hai-Yang; Mahapatra, Tanmay; Yin, Yue-Ping; Mahapatra, Sanchita; Wang, Xiao-Liang; Chen, Xiang-Sheng; Babu, Giridhar R.; Xu, Xiao-Qin; Ding, Ping; Qiu, Tao; Liu, Xiao-Yan; Guo, Hongxiong; Huan, Xi-Ping; Tang, Weiming

    2015-01-01

    Background In China, the HIV/AIDS epidemic is expanding among men who have sex with men (MSM). As independent risk factors of HIV infection, the epidemics of Chlamydia (CT) and Gonorrhea (NG) in MSM were not well studied, particular for the risk factors of these infectious. The objectives of current reported study were to understand the dynamics of HIV and other sexual transmitted infections (STIs) among MSM in Jiangsu, China, and to measure factors that correlated with STIs. Methods In order to gain more participants, a multisite cross-sectional study design was used in our study, by using convenience-sampling to recruit MSM in two Changzhou and Yangzhou, Jiangsu, China, between the July and October of 2009. Results In this comprehensive survey involving MSM in two cities of Jiangsu province of China, the prevalence of STIs of CT (6.54%), NG (3.63%), syphilis (20.34%) and HIV (11.62%) were measured. Overall, the STIs prevalence (CT, NG or syphilis) for the participants in our study was 26.39%, meanwhile, 3.4% (14 out of the 413) participants had at least two kinds of STIs. Meeting casual partners at parks, public restrooms or other public areas, having had anal sex with men in the past six months, having had STI symptoms in the past year were positively correlated with STIs positive, with adjusted ORs of 4.61(95%CI 1.03–20.75), 1.91(95%CI 1.14–3.21) and 2.36(95%CI 1.07,5.24). Conclusion Our study findings reiterate the fact that Chinese MSM are highly susceptible to acquiring syphilis, CT, NG and HIV, and there is an urgent need for intervention targeted towards this population. Behavioral measures should constitute an important part of the targeted intervention. Furthermore, the already implemented preventive and diagnostic services for HIV should be expanded to include syphilis CT and NG, too. PMID:25775451

  5. Erythematous candidiasis leading to systemic manifestations of human immunodeficiency virus co-infection with secondary syphilis: A diagnostic and therapeutic dilemma.

    PubMed

    Suvirya, Swastika; Gandhi, Rahul; Agarwal, Jyotsana; Patil, Ranjitkumar

    2015-01-01

    The intensification of human immunodeficiency virus (HIV) and rising frequency of immunocompromised individuals have resulted in a resurgence of opportunistic infections. The most common opportunistic oral fungal infection in HIV-positive individuals is oral candidiasis. The classical presentation is as white scrapable form called as thrush, which is easily diagnosed and treated. The clinician is presented with a diagnostic and management dilemma when these lesions appear in new facades such as erythematous candidiasis, the latter's prevalence with HIV and AIDS being well established. In this case report, we present a case of Erythematous Candidiasis, which was associated with type 1 HIV co-infected with syphilis. We highlight the diagnostic importance of a naive looking manifestation of the tongue which was followed by a series of challenging presentations of secondary syphilis. Since the patient had a negative Veneral Disease Research Laboratory and left us with a management dilemma, the article also features the importance of prozone phenomenon (seen in 2% cases of secondary syphilis), and it's higher association with HIV co-infected individuals. With confusing clinical oral manifestations associated with these diseases, the dentist might be the first person to encounter such lesions, who should be able to recognize erythematous candidiasis and correlate them with the underlying pathology.

  6. Characterizing the syphilis epidemic among men who have sex with men in Lima, Peru to identify new treatment and control strategies

    PubMed Central

    2013-01-01

    Background Syphilis is an important sexually transmitted infection (STI) with serious public health consequences. Among men who have sex with men (MSM) in Lima, the prevalence and incidence are extraordinarily high. Current syndromic approaches, however, fail to identify asymptomatic cases, and in settings where large proportions of individuals test positive again after treatment, it is frequently difficult to distinguish treatment failure from re-infection. Thus, new approaches are needed to improve treatment strategies and public health control efforts. Methods/Design Study participants will undergo baseline testing for syphilis infection along with a behavioral survey covering demographics, sexual behavior, drug and alcohol abuse and health-care seeking behavior. The cohort will be followed for 18 months at three-month intervals. Blood and earlobe scrapings will also be collected for T. pallidum DNA testing, to create molecular markers for subtyping. We will also perform cytokine testing on collected samples in order to create host immunologic profiles associated with recurrence, re-infection, treatment failure and success. Discussion Advances in social epidemiology, molecular typing and characterization of host immune responses will offer promise in developing new understandings of syphilis management. We will share our findings with the Peruvian Ministry of Health and other public health organizations, to identify new approaches of case detection and successful treatment. PMID:24016185

  7. Erythematous candidiasis leading to systemic manifestations of human immunodeficiency virus co-infection with secondary syphilis: A diagnostic and therapeutic dilemma

    PubMed Central

    Suvirya, Swastika; Gandhi, Rahul; Agarwal, Jyotsana; Patil, Ranjitkumar

    2015-01-01

    The intensification of human immunodeficiency virus (HIV) and rising frequency of immunocompromised individuals have resulted in a resurgence of opportunistic infections. The most common opportunistic oral fungal infection in HIV-positive individuals is oral candidiasis. The classical presentation is as white scrapable form called as thrush, which is easily diagnosed and treated. The clinician is presented with a diagnostic and management dilemma when these lesions appear in new facades such as erythematous candidiasis, the latter's prevalence with HIV and AIDS being well established. In this case report, we present a case of Erythematous Candidiasis, which was associated with type 1 HIV co-infected with syphilis. We highlight the diagnostic importance of a naive looking manifestation of the tongue which was followed by a series of challenging presentations of secondary syphilis. Since the patient had a negative Veneral Disease Research Laboratory and left us with a management dilemma, the article also features the importance of prozone phenomenon (seen in 2% cases of secondary syphilis), and it's higher association with HIV co-infected individuals. With confusing clinical oral manifestations associated with these diseases, the dentist might be the first person to encounter such lesions, who should be able to recognize erythematous candidiasis and correlate them with the underlying pathology. PMID:26430379

  8. Changes in Prevalence of HIV or Syphilis among Male Sex Workers and Non-Commercial Men Who Have Sex with Men in Shenzhen, China: Results of a Second Survey

    PubMed Central

    Huang, Yuanwei; Zhang, Yanting; Li, Ke; Zhao, Jin

    2016-01-01

    Background A previous time-location sampling survey (TLS) was performed in 2008 to evaluate the HIV or syphilis infection rate among male sex workers (MSWs) and non-commercial men who have sex with men (ncMSM) in Shenzhen, China. This is a second TLS performed in 2014. This article describes the findings and changes in the prevalence of HIV and syphilis. Methods TLS was used to collect information as a second cross-sectional survey to an earlier TLS assessment. Data on behavior (e.g., sexual history and sexual behavior) were analyzed. Blood specimens were drawn for HIV and syphilis testing. To determine the changes in the prevalence of HIV and syphilis, we analyzed these results and compared them to the results of our first survey. Results A total of 965 participants were recruited, including 489 MSWs and 476 ncMSM. Overall, the prevalence of HIV was 9.7%: 2.9% for MSWs and 16.8% for ncMSM (P<0.001). 10.9% of the 965 participants tested positive for syphilis: 4.5% among MSWs and 17.4% among ncMSM (P<0.001). The HIV prevalence in MSWs decreased from 4.5% in 2008 to 2.9% in 2014 (P = 0.143) but increased in ncMSM (7.0% in 2008 vs 16.8% in 2014, P<0.001). Decreased syphilis rates were observed in both MSWs (12.9% in 2008 vs 4.5% in 2014, P<0.001) and ncMSM (20.2% in 2008 vs 17.4% in 2014, P = 0.221). Conclusions Overall, there was a decline in the prevalence of HIV and syphilis in MSWs but not in ncMSM. The study indicated the need for continued efforts to improve public health, particularly to counter the rising rate of HIV in ncMSM. PMID:27935980

  9. [From the Belle Époque to the city of vice: the fight against syphilis in Belém, Pará, 1921-1924].

    PubMed

    Henrique, Márcio Couto; Amador, Luiza Helena Miranda

    2016-01-26

    This article analyzes the fight against syphilis in Belém, capital of the Brazilian state of Pará, between 1921 and 1924. When Instituto de Profilaxia e Doenças Venéreas (Institute for Prophylaxis and Venereal Diseases) was founded, headed by Dr. Heraclídes de Souza Araújo, many restrictions were imposed on prostitution in a bid to make prostitutes partners in the city's sanitation reform. The documents produced by the institute and published in newspapers of the day reveal the various clashes that occurred between doctors, the civil police force, and prostitutes, highlighting the prostitutes' attitudes to state intervention in their activities.

  10. Prevalence of human immunodeficiency virus, hepatitis C virus, hepatitis B virus and syphilis among individuals attending anonymous testing for HIV in Luanda, Angola.

    PubMed

    Guimarães Nebenzahl, H; Lopes, A; Castro, R; Pereira, F

    2013-01-24

    Human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis remain major infections around the world. In Angola there are about 166 000 individuals living with HIV, representing a prevalence of 1.98% in adults between 15 and 49 years of age. In a 2003 study in Luanda, 4.5% of pregnant women had antibodies to HIV and 8.1% to HBV, and 5.4% were infected with Treponema pallidum. Objectives. The aim of this study was to determine the prevalence of HIV-1 and 2, HBV, HCV and T. pallidum serological markers, and hence the prevalence of these infections, in individuals attending a sexually transmitted disease clinic in Luanda, Angola, and the burden of these infections in the Angolan population. Methods. Individuals attending a centre for anonymous testing for HIV were randomly included in the study. All samples were tested for HBV surface antigen (HBsAg), anti-HCV and anti-HIV-1 and 2 antibodies and antibodies to T. pallidum. Results. A total of 431 individuals (262 women and 169 men) were studied, of whom 10.0% (43/431) were seropositive for T. pallidum and 4.6% had active syphilis; 8.8% (38/431) were seropositive for HIV-1 and/or HIV-2 (of these, 78.9% were HIV-1-positive, 2.6% HIV-2-positive and 18.4% co-infected); 9.3% (40/431) were HBsAg-positive, while 8.1% (35/431) had antibodies to HCV. Of 102 patients with positive results, 26 (25.5%, or 6.0% of the total of 431 patients) were positive for more than one of the organisms studied. Rates of co-infection were as follows: 2.3% (10/431) for HIV/HBV, 0.9% (4/431) for HIV/HCV, and 0.9% (4/431) for HCV/HBV. Three individuals with active syphilis had viral co-infection, hepatitis B in 1 case and HIV in 2. Five individuals (1.2% of the total) were seropositive for three infections, HIV, hepatitis B and hepatitis C in 3 cases and HIV, hepatitis C and syphilis in 2. Conclusions. A high prevalence of co-infection with the infections studied was found in this population, including HIV

  11. Narrative constructions of health care issues and policies: the case of President Clinton's apology-by-proxy for the Tuskegee syphilis experiment.

    PubMed

    Carmack, Heather J; Bates, Benjamin R; Harter, Lynn M

    2008-06-01

    The Tuskegee Syphilis Experiment (TSE) has shaped African Americans' views of the American health care system, contributing to a reluctance to participate in biomedical research and a suspicion of the medical system. This essay examines public discourses surrounding President Clinton's attempt to restore African Americans' trust by apologizing for the TSE. Through a narrative reading, we illustrate the failure of this text as an attempt to reconcile the United States Public Health Service and the African American public. We conclude by noting the limitations of rhetoric when equal prominence is not given to policy proposals in national apologies.

  12. Serological markers for treponemal infection in children in rural Kilimanjaro, Tanzania: evidence of syphilis or non-venereal treponematoses?

    PubMed Central

    Klouman, E; Masenga, E J; Sam, N E

    1997-01-01

    OBJECTIVE: To determine the seroprevalence of treponemal infection and possible risk factors among children aged 0-14 in the general population of a rural Tanzanian village. METHODS: The survey was conducted as a part of a cross section study of a total village population on HIV and sexually transmitted disease. Among 1708 registered children aged 0-14, the 553 first attending were tested for treponemal infection with both rapid plasma reagin test (RPR) and Treponema pallidum Haemagglutination test (TPHA). These children belonged to a household cohort--also including their parents, siblings, and other household members--with 1339 members; 1224 (91.4% participated in the survey and 82.1% of these were tested for treponemal infection. RESULTS: The overall prevalence for the TPHA test was 6.4% among girls and 1.1% among boys (odds ratio, OR = 6.5; 95% confidence interval, CI: 1.9-22.3). The sex difference was most pronounced in the age group 10-14; 11.1% among girls versus 1.0% among boys (OR = 12.8; CI: 1.6-101.9). Among the 20 children who were TPHA positive, we found two cases of active, congenital syphilis. There was a lack of association between positive serology in children and positive serology in their parents. CONCLUSION: The highly significant predominance of girls testing positive for TPHA, and the concomitant lack of association between parents' and children's serostatus might point to sexual transmission as being the most common route of transmission of treponemal infection in girls during childhood in this village. The sources of infection for the seropositive girls are possibly found outside the family. PMID:9582474

  13. Seroprevalence of other antibodies (herpes, CMV, rubella, varicella, hepatitis B and C, syphilis, chlamydia, mumps, toxoplasmosis) in HIV-positive patients.

    PubMed

    Ajayi, G O; Omilabu, S A; Alamu, D; Balogun, Y; Badaru, S

    2011-01-01

    We attempted to determine the seropositivity of HIV-positive patients to other antibodies (herpes, CMV, rubella, varicella, hepatitis B, hepatitis C, syphilis, chlamydia, mumps, toxoplasmosis). The study was carried out at the Prenatal Diagnosis and Therapy Centre of a Tertiary Hospital in Lagos, Nigeria. A total of 70 patients (50 females and 20 males) attending the centre between June 1997 and December 2005 who were screened and found to be HIV-seropositive were further screened for herpes simplex IgG/IgM, CMV IgG/IgM, rubella IgG/IgM, varicella IgG/IgM, mumps IgG/IgM, toxoplasmosis IgG/IgM, chlamydia IgG/IgM, hepatitis B and hepatitis C IgG/IgM using ELISA kits and syphilis (THPA) using the HAE method. Our study showed that a large number of HIV-positive patients are carriers of other antibodies and should be screened for them before therapy.

  14. HIV, hepatitis B/C and syphilis prevalence and risk behaviors among gay, transsexuals and men who have sex with men, Dominican Republic.

    PubMed

    Johnston, L G; Vaillant, T C; Dolores, Y; Vales, H M

    2013-04-01

    This study investigated HIV, hepatitis B (HBV) and C (HCV) and syphilis prevalence and associated behavioural correlates to HIV infection among gay, transsexuals and men who have sex with men (GTMSM) in the Dominican Republic using respondent-driven sampling. Eligible men were aged ≥15 years, reported engaging in anal/oral sex with another man within the past six months and living in one of the four cities sampled. GTMSM were recruited in Santo Domingo (n = 510), Barahona (n = 281), La Altagracia (n = 270) and Santiago (n = 327). HIV seroprevalence ranged from 5.1% to 7.6%. HBV ranged from 0.6% to 3.5%, HCV from 0.8% to 6.9% and syphilis from 3.5% to 6.9%. GTM practice numerous risky sexual behaviours including having multiple sex partners and practising inconsistent condom use with male and female, including transactional, sex partners. Although we found lower HIV prevalence compared with previous studies, the high level of extremely risky sexual behaviours practised by GTM in the Dominican Republic will most likely result in increases in HIV and other infections if action is not taken to scale-up effective prevention programmes for this population.

  15. [Retrospective evaluation of HBsAg, anti-HCV, anti-HIV and syphilis reagin antibody seropositivity in blood donors at the Trabzon Farabi Hospital].

    PubMed

    Aydin, Faruk; Cubukçu, Kivanç; Yetişkul, Serpil; Yazici, Yelda; Kaklikkaya, Neşe

    2002-01-01

    Transfusion of blood and blood products is a widely used method for therapy in medicine, however it may result with the transmission of infectious agents from donor to recipient. In order to achieve safe blood transfusions and to minimize post-transfusion infections, several screening tests for infectious agents are routinely done all around the world as well as in our country. In this study, HBsAg, anti-HCV, anti-HIV and syphilis reagin antibody tests results have been retrospectively evaluated for 33.766 blood donors during January 1, 1997 to December 31, 2000 in Blood Center of Farabi Hospital, Black Sea Technical University. Testing for HBsAg, anti-HIV and anti-HCV has been done by using commercially available micro and/or macro enzyme immunoassays, and syphilis reagin antibody test by latex agglutination (RPR) method. The indeterminate results were confirmed by retesting of sera with microparticle enzyme immunoassay and Western blot methods. As a result, in 1331 (3.94%) subjects HBsAg, in 250 (0.74%) subjects anti-HCV, and in 161 (0.47%) subjects RPR were found positive. Twenty samples which have had the results in gray-zone for anti-HIV, have been found negative with the confirmation tests.

  16. Quarantine as a public health measure against an emerging infectious disease: syphilis in Zurich at the dawn of the modern era (1496–1585)

    PubMed Central

    Gall, Gabriella Eva Cristina; Lautenschlager, Stephan; Bagheri, Homayoun C.

    2016-01-01

    Syphilis is considered as one of the most devastating sexually transmitted diseases in human history. Based on historical records, the “Böse Blattern” (German for “Evil Pocks”) spread through Europe after 1495 and shared symptoms with what we know today as syphilis. Many cities took measures to protect their population. Here, transliterations of archival documents from the 15th and 16th century (provided in the appendix) are used to trace the steps taken by the governing authorities in Zurich to deal with this emerging infectious disease. One of the central measures taken by the city was to establish a quarantine facility referred to as the “Blatternhaus”. The city doctors, including the well-known physician and naturalist Conrad Gessner, oversaw the obligatory quarantine and treatment of patients with symptoms. Treatment could range from better nutrition, herbal remedies and skin ointments to aggressive heat therapy and “smoking”. Furthermore, the affliction was suspected as a sexually acquired disease, hence prostitutes and infected foreigners were extradited from the city. Meanwhile, the church used its social influence to promote a more “Christian” behavior. In several respects, the public health measures taken in the 16th century against a new and menacing epidemic do not diverge in their basic rationale from approaches used during the 20th century and today. PMID:27303653

  17. Population-based prevalence of hepatitis B and C virus, HIV, syphilis, gonorrhoea and chlamydia in male injection drug users in Lagos, Nigeria.

    PubMed

    Tun, W; Vu, L; Adebajo, S B; Abiodun, L; Sheehy, M; Karlyn, A; Njab, J; Ahonsi, B; Issa, B K; Idogho, O

    2013-08-01

    There is little research on injecting drug use in Nigeria. We investigated the prevalence of HIV, hepatitis B and C, and sexually transmitted infections (STIs) among male injection drug users (IDUs) in Lagos. Male IDUs (N = 328) were recruited through respondent-driven sampling. Participants completed an interview about their sexual and injecting risk behaviours and were tested for hepatitis B surface antigen (HBV), hepatitis C antibody (HCV), HIV and syphilis, as well as genital chlamydia and gonorrhoea infections. Three-quarters of IDUs (74%) reported injecting drugs in the past one month although most did not share needles (92%) and the majority obtained sterile needles from pharmacists (87%). Estimated HBV, HCV, HIV, syphilis, gonorrhoea and chlamydia prevalences were 7.8%, 7.7%, 0.9%, 1.9%, 0.0%, and 3.7%, respectively. The burden of HIV is presently low among IDUs in Lagos. Changes in accessibility to sterile needles at pharmacists would likely have a deleterious effect on IDUs' health. HBV vaccination and HCV prevention programmes for IDUs are urgently needed.

  18. [Positive serology of syphilis, toxoplasmosis and Chagas' disease in pregnant women in their first visit to health centers in a metropolitan area, Brazil].

    PubMed

    Vaz, A J; Guerra, E M; Ferratto, L C; de Toledo, L A; Azevedo Neto, R S

    1990-10-01

    The diagnosis of some infectious diseases contracted during pregnancy is very important, as these diseases can be transmitted to the fetus. Four hundred and eighty-one pregnant women were studied, of an average 24.5 years of age (from 14 to 46), during their first prenatal visit to the State of S. Paulo's Health Care Centres in the subdistrict of Paz (Butantan), City of S. Paulo, Brazil, between April and October, 1988. Classified by trimester of pregnancy, 230 patients (47.8%) fell into the first, 203 (42.2%) into the second and 48 (10%) into the third trimester. Of the 474 patients that declared their income, 309 (65.2%) earned 1 MSPC (minimum salary per capita) per month, which gives some indication of the low socioeconomic status of our patients is. The serologic tests for syphilis, toxoplasmosis and Chagas' disease were analysed for each patient, more than one technique being used for each. The results were as follows: 25 patients (5.2%) had a positive test for syphilis; in 67 patients (13.9%) active toxoplasmosis was diagnosed (Presence of IgM antibodies in 6); 14 patients (2.9%) were positive for Chagas' disease, among which 10 (71.4%) came from the States of Bahia and Minas Gerais, where this disease has a high prevalence.

  19. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.

    PubMed

    Ansbro, Éimhín M; Gill, Michelle M; Reynolds, Joanna; Shelley, Katharine D; Strasser, Susan; Sripipatana, Tabitha; Tshaka Ncube, Alexander; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W; Mabey, David

    2015-01-01

    Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new

  20. Socialization patterns and their associations with unprotected anal intercourse, HIV, and syphilis among high-risk men who have sex with men and transgender women in Peru.

    PubMed

    Verre, Michael C; Peinado, Jesus; Segura, Eddy R; Clark, Jesse; Gonzales, Pedro; Benites, Carlos; Cabello, Robinson; Sanchez, Jorge; Lama, Javier R

    2014-10-01

    The association of socialization patterns with unprotected anal intercourse (UAI) and HIV/STI prevalence remains underexplored in men who have sex with men (MSM) and transgender women (TW) in developing country settings. We evaluated the correlation of UAI, HIV, and syphilis with MSM/TW venue attendance and social network size among high-risk MSM and TW in Peru according to self-reported sexual identity. Frequency of venue attendance and MSM/TW social network size were lowest among heterosexual MSM and highest among TW respondents. Attendance (frequent or occasional) at MSM/TW venues was associated with increased odds of insertive UAI among heterosexual participants. Frequent venue attendance was associated with increased odds of receptive UAI among gay/homosexual, bisexual, and TW participants. Further investigation of the differing socialization patterns and associations with HIV/STI transmission within subgroups of Peruvian MSM and TW will enable more effective prevention interventions for these populations.

  1. Elimination of mother-to-child transmission of HIV and syphilis: A dual approach in the African Region to improve quality of antenatal care and integrated disease control.

    PubMed

    Newman Owiredu, Morkor; Newman, Lori; Nzomo, Theresa; Conombo Kafando, Ghislaine; Sanni, Saliyou; Shaffer, Nathan; Bucagu, Maurice; Peeling, Rosanna; Mark, Jennifer; Diop Toure, Isseu

    2015-06-01

    The World Health Organization's (WHO) Strategic Framework for the Elimination of New HIV Infections among Children in Africa by 2015 identifies important synergies for the elimination of mother-to-child transmission of HIV and syphilis in terms of prevention interventions, implementation logistics and service delivery, monitoring and evaluation systems, and need for sustained political commitment. The WHO advocates the use of an integrated, rights-based dual approach with partnerships and collaboration to make the best use of available resources. Through a consultative approach, six countries in the African Region committed to dual elimination and developed and implemented action plans for this purpose. Where interest and commitment are high, this may also be possible and effective in other African countries.

  2. Socialization Patterns and Their Association with Unprotected Anal Intercourse, HIV, and Syphilis Among High-Risk Men Who Have Sex with Men and Transgender Women in Peru

    PubMed Central

    Verre, MC; Peinado, J; Segura, ER; Clark, JC; Gonzales, P; Benites, C; Cabello, R; Sanchez, J; Lama, JR

    2014-01-01

    The association of socialization patterns with unprotected anal intercourse (UAI) and HIV/STI prevalence remains underexplored in men who have sex with men (MSM) and transgender women (TW) in developing country settings. We evaluated the correlation of UAI, HIV, and syphilis with MSM/TW venue attendance and social network size among high-risk MSM and TW in Peru according to self-reported sexual identity. Frequency of venue attendance and MSM/TW social network size were lowest among heterosexual MSM and highest among TW respondents. Attendance (frequent or occasional) at MSM/TW venues was associated with increased odds of insertive UAI among heterosexual participants. Frequent venue attendance was associated with increased odds of receptive UAI among gay/homosexual, bisexual, and TW participants. Further investigation of the differing socialization patterns and associations with HIV/STI transmission within subgroups of Peruvian MSM and TW will enable more effective prevention interventions for these populations. PMID:24788782

  3. Syphilis (For Parents)

    MedlinePlus

    ... can check for other STDs, such as gonorrhea, chlamydia, and HIV. Anyone who is sexually active should ... For Kids For Parents MORE ON THIS TOPIC Chlamydia STDs Questions and Answers About Sex HIV and ...

  4. Syphilis (For Parents)

    MedlinePlus

    Skip Navigation KidsHealth from Nemours for Parents for Kids for Teens Parents Home General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ...

  5. Chlamydia, Gonorrhea, and Syphilis

    MedlinePlus

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  6. Risk factors and prevalence of tuberculosis, human immunodeficiency virus, syphilis, hepatitis B virus, and hepatitis C virus among prisoners in Pakistan

    PubMed Central

    Kazi, Abdul M.; Shah, Sharaf A.; Jenkins, Cathy A.; Shepherd, Bryan E.; Vermund, Sten H.

    2010-01-01

    Background We evaluated the burden of sexual- or injection drug use (IDU)-related infections in male prisoners in Karachi, Pakistan. Methods We administered a structured questionnaire in a cross-sectional survey of 365 randomly selected imprisoned men. We analyzed blood for human immunodeficiency virus (HIV) and Hepatitis B and C by ELISA, and for syphilis by rapid plasma reagin and Treponema pallidum hemagglutination assay confirmation. Subjects with possible tuberculosis (WHO criteria) provided sputum samples for an acid fast bacillus smear and culture. Results Prevalence of tuberculosis was 2.2% (95%CI: 0.71, 3.8). HIV infected 2.0% (95%CI: 0.55, 3.4) of 357 randomly selected prisoners (8 refused to give blood), with confirmed syphilis in 8.9% (95%CI: 6.0, 11.8), hepatitis B virus in 5.9% (95%CI: 3.5, 8.3), and hepatitis C virus in 15.2% (95%CI: 11.7, 18.8). By self-report, 59.0% had used any illicit drugs, among whom 11.8% (95%CI: 8.5, 15.0) had injected drugs. The median length of stay in the prison had been 3.2 (range 1-72) months. Conclusions All four infections were prevalent among the prisoners in Pakistan. Prisons are excellent venues for infectious disease screening and intervention given conditions of poverty and drug addiction. Collaboration with community-based health providers is vital for post-discharge planning. PMID:20189863

  7. Prevalence and risk factors of HIV and syphilis, and knowledge and risk behaviors related to HIV/AIDS among men who have sex with men in Chongqing, China

    PubMed Central

    Ma, Wenzhe; Wu, Gohui; Zheng, Hui; Zhang, Wenjuan; Peng, Zhihang; Yu, Rongbin; Wang, Ning

    2016-01-01

    Abstract High HIV prevalence and incidence burdens have been reported in men who have sex with men (MSM) in Chongqing, China. We aimed to estimate the prevalence of HIV and other sexually transmitted infections (STIs), to appraise the knowledge and risk behaviors related to HIV/AIDS among MSM, and to analyze the possible causes of deviation between behavior and knowledge to make better strategies. We recruited 617 MSM from February to July in 2008 by using a respondent-driven sampling (RDS) method in Chongqing, China. Through the collection of questionnaire-based data and biological testing results from all objects, we launched a cross-sectional survey. STATA/SE was used for data analysis by frequency, ANOVA, rank sum test and logistic regression models. MSM with syphilis (OR=4.16, 95%CI: 2.35-7.33, P<0.0001) were more likely to be HIV infected. Being a company employee (OR=3.64, 95%CI: 1.22-10.08, P<0.0001) and having bought male for sex (OR=3.52, 95%CI: 1.10-11.32, P < 0.034) were associated with a higher probability of syphilis. MSM with younger age, higher education and greater monthly income had a higher mean knowledge score. MSM who had HIV testing had a higher mean knowledge score than those who never had. Students, venues for finding sex partners by Internet and homosexuals in MSM had a higher mean knowledge score compared to other occupations, venues for finding sex partners and sexual orientation. There is an urgent need for delivery of barrier and biomedical interventions with coordinated behavioral and structural strategies to improve the effect of HIV interventions among MSM. PMID:28276665

  8. A possible case of acquired syphilis at the former Royal Hospital of All-Saints (RHAS) in Lisbon, Portugal (18th century): a comparative methodological approach to differential diagnosis.

    PubMed

    Assis, Sandra; Casimiro, Sílvia; Alves Cardoso, Francisca

    2015-01-01

    Between the years of 1999 and 2001, during the excavation of the Praça da Figueira (Lisbon, Portugal), several human osteological remains from various chronological periods were discovered. Amongst them several skeletons are known to be related with the Hospital Real de Todos-os-Santos (Royal Hospital of All Saints - RHAS), which had an important role. The hospital history begun in 1492 and ended in 1755 largely as a consequence of the Lisbon earthquake. Of the skeletons exhumed, one in particular, the adult female Sk. 1310 showed significant pathological changes. The bone lesions characterized by new bone deposition, with a symmetric and disseminate pattern, were found in the upper limbs, distal end of femurs and in tibia and fibula diaphyses. A bowing deformity with "sabre shape" morphology was also observed in the tibiae. The most striking lesions, characterized by healed nodular cavitations and similar to those of caries sicca, were recorded on the frontal bone. Considering the value of a complete description, as well as the application of multiple lines of enquiry for a reliable differential diagnosis, three distinct techniques were applied and compared: visual examination, imagiology and histology. The results showed that the macroscopic analysis coupled with conventional X-ray analysis were fundamental to obtain a possible diagnosis of acquired syphilis. In contrast, the CT-scan and the histological analyses were less informative. The application of a new scoring system also supports a diagnosis of acquired syphilis. This case-study constitutes the first evidence of syphilis associated with the RHAS, supporting historical data on the pivotal role that this hospital had on the treatment of several conditions, namely, syphilis.

  9. [Frequency of HIV-1, rubella, syphilis, toxoplasmosis, cytomegalovirus, simple herpes virus, hepatitis B, hepatitis C, Chagas disease and HTLV I/II infection in pregnant women of State of Mato Grosso do Sul].

    PubMed

    Figueiró-Filho, Ernesto Antonio; Senefonte, Flávio Renato de Almeida; Lopes, Alessandro Henrique Antunes; de Morais, Orlando Oliveira; Souza Júnior, Virgílio Gonçalves; Maia, Tamara Lemos; Duarte, Geraldo

    2007-01-01

    It was aimed to estimate the frequency of syphilis, rubella, hepatitis B, hepatitis C, toxoplasmosis, Chagas disease, HTLV I/II, simple herpes virus, HIV-1 and cytomegalovirus in pregnant women and to evaluate the relationship between age and the frequency of the infections studied. A transversal study of 32,512 pregnant women submitted to pre-natal screening in the period of November 2002 to October 2003. The frequency of the tried infections among the pregnant women were 0.2% of HIV-1, 0.03% of rubella, 0.8% of syphilis, 0.4% of toxoplasmosis, 0.05% of cytomegalovirus, 0.02% of simple herpes virus, 0.3% of HBsAg, 0.1% of hepatitis C, 0.1% of HTLV and 0.1% of Chagas disease. There was significative statistical association between age and prenatal infection of rubella, cytomegalovirus, Chagas disease and herpes virus. The rates of frequency of rubella, syphilis, toxoplasmosis, Chagas disease and cytomegalovirus in pregnant women studied were lower than the compared rates.

  10. [The dynamics of antibodies with IgD-class cardiolipin and treponemal group specificity in syphilis assessed quantitatively by radial immunodiffusion].

    PubMed

    Ionescu, D A; Petrovici, M; Ionescu-Dorohoi, T

    1989-01-01

    150 sera (positive at the VDRL, ELISA-Reiter, FTA-ABS tests) were tested by IDRS for the IgD quantification in syphilis. They were collected from men, 25-45 years old, in different stages of the disease, treated or not. The reference normal values for the seric IgD were established on 154 sera taken from men, 25-45 years old, apparently healthy: 0-131.2 UI/ml, with an average of 29.92 +/- 29.61 UI/ml. The IgD values with cardiolipin or group treponemal specificity were obtained from the difference between the values of the immunodiffusion diameters produced by sera, before and after the complete absorbtion with VDRL antigen or delipidated treponemal suspension. The individual values for each serum, mean +/- SD, and the percent values against the total IgD, for each stage of the disease were calculated. The medium levels of the total IgD range within normal limits, except for epsilon 2, where they are considerably higher than normal (52.53 +/- 26.66 UI/ml). All the individual minimal values, between 7.09 and 14.89 UI/ml, are higher than the normal minimal values, under 3.54 UI/ml. Treponemal IgD are present in all the sera in all stages of the disease and the cardiolipin IgD are completely absent. The mean values of the treponemal IgD are about 7-9 UI/ml, with a maximum of 19.3 UI/ml in epsilon 2. A higher percent of treponemal IgD is found, around 30%, with a maximum of 36.7% in epsilon 2. The high percent of the treponemal IgD in epsilon latent and epsilon treated persistent positive shows a continuous activation of the circulating B lymphocytes by the treponemal antigens and therefore an active infectious process. The exclusive presence of the treponemal IgD in all the cases of syphilis, irrespective of the evolution stages, indicated the extremely specific diagnosis value of their detection.

  11. 'He would by no means risque his Reputation': patient and doctor shame in Daniel Turner's De Morbis Cutaneis (1714) and Syphilis (1717).

    PubMed

    Cock, Emily

    2017-01-17

    This article offers a historical corollary to the examination of shame in medical practice by considering the negotiation of shame in the treatment of a stigmatised disease at a time in which surgeons themselves occupied a highly ambivalent social position. It will focus on case studies provided by Daniel Turner (1667-1741), prominent surgeon and later member of the College of Physicians, in his textbooks De Morbis Cutaneis. A Treatise of Diseases Incident to the Skin (1714) and Syphilis. A Practical Dissertation on the Venereal Disease (1717). Turner demonstrates an awareness of the precarious position of both the surgeon and the syphilitic, and devotes significant portions of his text to advising the trainee surgeon on how to manage patients' reticence over disclosure of symptoms, expectations for cure and impudence towards medical authority. In turn, the trainee must manage his own reputation as a moral and medical authority who can treat all distempers, yet without condoning or facilitating the shameful behaviours associated with a sexual disease. Furthermore, shaming plays a key role in enabling Turner to fashion an ideal patient whose successful cure will both respond to and build the surgeon's medical authority and that of the medical field in general.

  12. Test uptake and case detection of syphilis, HIV, and hepatitis C among women undergoing prenatal screening in British Columbia, 2007 to 2011.

    PubMed

    Kuo, Margot; Money, Deborah M; Alvarez, Maria; Buxton, Jane A; Krajden, Mel; Lester, Richard T; Ogilvie, Gina; Gilbert, Mark

    2014-06-01

    Objectif : La mesure dans laquelle les tests de dépistage de la rubéole, de la syphilis, du VIH et de l’hépatite C (VHC) ont été utilisés et les tendances en ce qui concerne la détection de cas de ces maladies ont été comparées, entre 2007 et 2011, chez les cohortes de femmes faisant l’objet d’un dépistage prénatal en Colombie-Britannique. L’analyse a mis en jeu le croisement de données de surveillance et de laboratoire centralisées à l’échelle provinciale, afin de déterminer la mesure dans laquelle les tests de dépistage prénatal ont été utilisés et de comparer le taux d’infections nouvellement diagnostiquées au taux d’infections prévalentes. Méthodes : Nous avons inclus les prélèvements prénataux, issus de Britanno-colombiennes âgées de 16 à 45 ans, qui ont été soumis au cours de la période allant de 2007 à 2011. Les dossiers de laboratoire ont été liés aux systèmes de surveillance provinciaux en vue d’identifier les cas maternels confirmés de syphilis et de VIH. La présence d’un statut de séropositivité préalable a été établie, pour ce qui est du VIH et du VHC, en ce qui concerne les cas préalablement confirmés ayant été identifiés à partir des dossiers de laboratoire. Nous avons déterminé les taux d’infections au VIH et au VHC nouvellement identifiées au moment du dépistage prénatal (nouveaux diagnostics par 100 000 par année). La prévalence du VIH et du VHC équivalait à la somme de tous les diagnostics, tant nouveaux que préalables (prévalence par 100 000 par année). Résultats : Chez 233 203 femmes, 96,9 % ont fait l’objet d’un dépistage visant la rubéole, 93,3 % ont fait l’objet d’un dépistage visant la syphilis, 93,8 % ont fait l’objet d’un dépistage visant le VIH et 21,5 % ont fait l’objet d’un dépistage visant le VHC. Entre 2007 et 2011, les taux globaux de nouveaux diagnostics ont été de 15,4, de 5,1 et de 82,8 cas par 100 000

  13. MyD88 deficiency markedly worsens tissue inflammation and bacterial clearance in mice infected with Treponema pallidum, the agent of syphilis.

    PubMed

    Silver, Adam C; Dunne, Dana W; Zeiss, Caroline J; Bockenstedt, Linda K; Radolf, Justin D; Salazar, Juan C; Fikrig, Erol

    2013-01-01

    Research on syphilis, a sexually transmitted infection caused by the non-cultivatable spirochete Treponema pallidum, has been hampered by the lack of an inbred animal model. We hypothesized that Toll-like receptor (TLR)-dependent responses are essential for clearance of T. pallidum and, consequently, compared infection in wild-type (WT) mice and animals lacking MyD88, the adaptor molecule required for signaling by most TLRs. MyD88-deficient mice had significantly higher pathogen burdens and more extensive inflammation than control animals. Whereas tissue infiltrates in WT mice consisted of mixed mononuclear and plasma cells, infiltrates in MyD88-deficient animals were predominantly neutrophilic. Although both WT and MyD88-deficient mice produced antibodies that promoted uptake of treponemes by WT macrophages, MyD88-deficient macrophages were deficient in opsonophagocytosis of treponemes. Our results demonstrate that TLR-mediated responses are major contributors to the resistance of mice to syphilitic disease and that MyD88 signaling and FcR-mediated opsonophagocytosis are linked to the macrophage-mediated clearance of treponemes.

  14. A Population-based survey of the prevalence of HIV, syphilis, hepatitis B and hepatitis C infections and associated risk factors among young women in Vitória, Brazil

    PubMed Central

    Miranda, Angelica Espinosa; Figueiredo, Nínive Camilo; Schmidt, Renylena; Page-Shafer, Kimberly

    2017-01-01

    Objective To estimate the prevalence of HIV, hepatitis B (HBV) and C (HCV) and syphilis infections and associated risk exposures in a population-based sample of young women in Vitória, Brazil. Methods From March to December 2006, a cross-sectional sample of women aged 18 to 29 years was recruited into a single stage, population-based study. Serological markers of HIV, HBV, HCV, and syphilis infections and associated risk exposures were assessed. Results Of 1,200 eligible women, 1,029 (85.8%) enrolled. Median age was 23 (interquartile range [IQR] 20, 26) years; 32.2% had ≤ 8 years of education. The survey weighted prevalence estimates were: HIV, 0.6% (95% CI), 0.1%, 1.1%); anti-HBc, 4.2% (3.0%, 5.4%); HBsAg, 0.9% (0.4%, 1.6%); anti-HCV, 0.6% (0.1%, 1.1%) and syphilis 1.2% (0.5%, 1.9%). Overall, 6.1% had at least one positive serological marker for any of the tested infection. A majority (87.9%) was sexually active, of whom 12.1% reported a previously diagnosed sexually transmitted infection (STI) and 1.4% a history of commercial sex work. Variables independently associated with any positive serological test included: older age (≥25 vs. <25 years), low monthly income (≤ 4× vs. >4× minimum wage), previously diagnosed STI, ≥ 1 sexual partner, and any illicit drug use. Conclusions These are the first population-based estimates of the prevalence of exposure to these infectious diseases and related risks in young women, a population for whom there is a scarcity of data in Brazil. PMID:18401700

  15. Challenges of respondent driven sampling to assess sexual behaviour and estimate the prevalence of human immunodeficiency virus (HIV) and syphilis in men who have sex with men (MSM) in Singapore.

    PubMed

    Chua, Arlene C; Chen, Mark Ic; Cavailler, Philippe; Jiang, Lili; Abdullah, Mohammed Ridzwan; Ng, Oon Tek; Chio, Martin; Koe, Stuart; Tay, Joanne; Wong, Mee Lian; Chan, Roy

    2013-07-01

    There is a lack of representative samples to provide reliable and accurate seroprevalence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) as well as behavioural information among men who have sex with men (MSM) in Singapore. We used respondent driven sampling (RDS) to recruit MSM. Participants completed a survey used by Asian Internet MSM Sex Survey (AIMSS) and were tested for HIV and syphilis. We compared the characteristics of the RDS participants with STI diagnosis against those who did not have any STI diagnosis in the past 6 months. We compared RDS participants with AIMSS participants. Of 72 MSM recruited, 1 was positive for HIV (1.3%) and 4 (5.5%) tested positive for syphilis. Median age was 30 years and majority was Chinese (69.4%). RDS participants who had any STI diagnosis reported to have more use of recreational drugs (P = 0.006), and lower condom use (P = 0.054). Comparing RDS participants (n = 72) with the AIMSS participants (n = 2075), RDS respondents had ≥1 male partner in the past 6 months (P = 0.003), more casual sex partners (P = 0.012) and more STI symptoms (P = 0.019). There was no difference in terms of HIV testing and recreational drug use. The HIV and syphilis seroprevalence rates from our study are similar to previous reports conducted in high-risk MSM. In contrast to other settings, RDS did not work well among MSM in Singapore. The public health implications of our study highlight the challenges in obtaining data for HIV surveillance in assessing prevalence and risk behaviours among MSM.

  16. Increasing HIV and Decreasing Syphilis Prevalence in a Context of Persistently High Unprotected Anal Intercourse, Six Consecutive Annual Surveys among Men Who Have Sex with Men in Guangzhou, China, 2008 to 2013

    PubMed Central

    Zhong, Fei; Liang, Boheng; Xu, Huifang; Cheng, Weibin; Fan, Lirui; Han, Zhigang; Liang, Caiyun; Gao, Kai; Mai, Huixia; Qin, Faju; Zhao, Jinkou; Ling, Li

    2014-01-01

    Introduction Previous studies have reported a possibly increasing HIV prevalence among men who have sex with men (MSM) in China. However there have been limited systematic analyses of existing surveillance data to learn the trend of HIV prevalence and factors driving the trend. The aims of this study were to examine the trend of HIV prevalence among MSM in Guangzhou and to explore the role of unprotected anal intercourse (UAI) in the trend. Methods Snow-ball sampling was applied in the subject recruitment for the annual serological and behavioral surveys among MSM from 2008 to 2013. Data collected in the behavioral survey include demographic information, HIV related sexual behavior with men and women, access to HIV prevention services, and symptoms of sexually transmitted infections. Chi-square test was used to analyze the trend of HIV prevalence. Multivariate logistic regression was conducted to test the factors associated with HIV infection. Results HIV prevalence increased significantly from 5.0% in 2008 to 11.4% in 2013 while syphilis prevalence decreased from 17.4% to 3.3% in the same period. UAI rates were high and stable in every single year, ranging from 54.5% to 62.0%. Those who were having UAI (OR = 1.80, 95% confidence interval (CI): 1.26–2.58), being migrants, having more than 10 partners, and infected with syphilis had higher risk for HIV infection. Conclusions HIV epidemic is expanding in Guangzhou. The persistently high UAI may have played a major role in the increasing trend of HIV prevalence. Targeted prevention program should be conducted among MSM who are migrants, low educational level, syphilis infected, or having multiple partners to encourage HIV test and change UAI behavior. The general high UAI calls for tailored intervention program to promote healthy culture and form a safe sex social norm in the MSM community. PMID:25061936

  17. Evidence for Posttranslational Protein Flavinylation in the Syphilis Spirochete Treponema pallidum: Structural and Biochemical Insights from the Catalytic Core of a Periplasmic Flavin-Trafficking Protein

    PubMed Central

    Deka, Ranjit K.; Brautigam, Chad A.; Liu, Wei Z.

    2015-01-01

    ABSTRACT The syphilis spirochete Treponema pallidum is an important human pathogen but a highly enigmatic bacterium that cannot be cultivated in vitro. T. pallidum lacks many biosynthetic pathways and therefore has evolved the capability to exploit host-derived metabolites via its periplasmic lipoprotein repertoire. We recently reported a flavin-trafficking protein in T. pallidum (Ftp_Tp; TP0796) as the first bacterial metal-dependent flavin adenine dinucleotide (FAD) pyrophosphatase that hydrolyzes FAD into AMP and flavin mononucleotide (FMN) in the spirochete’s periplasm. However, orthologs of Ftp_Tp from other bacteria appear to lack this hydrolytic activity; rather, they bind and flavinylate subunits of a cytoplasmic membrane redox system (Nqr/Rnf). To further explore this dichotomy, biochemical analyses, protein crystallography, and structure-based mutagenesis were used to show that a single amino acid change (N55Y) in Ftp_Tp converts it from an Mg2+-dependent FAD pyrophosphatase to an FAD-binding protein. We also demonstrated that Ftp_Tp has a second enzymatic activity (Mg2+-FMN transferase); it flavinylates protein(s) covalently with FMN on a threonine side chain of an appropriate sequence motif using FAD as the substrate. Moreover, mutation of a metal-binding residue (D284A) eliminates Ftp_Tp’s dual activities, thereby underscoring the role of Mg2+ in the enzyme-catalyzed reactions. The posttranslational flavinylation activity that can target a periplasmic lipoprotein (TP0171) has not previously been described. The observed activities reveal the catalytic flexibility of a treponemal protein to perform multiple functions. Together, these findings imply mechanisms by which a dynamic pool of flavin cofactor is maintained and how flavoproteins are generated by Ftp_Tp locally in the T. pallidum periplasm. PMID:25944861

  18. Evidence for posttranslational protein flavinylation in the syphilis spirochete Treponema pallidum: Structural and biochemical insights from the catalytic core of a periplasmic flavin-trafficking protein

    DOE PAGES

    Deka, Ranjit K.; Brautigam, Chad A.; Liu, Wei Z.; ...

    2015-05-05

    The syphilis spirochete Treponema pallidum is an important human pathogen but a highly enigmatic bacterium that cannot be cultivated in vitro. T. pallidum lacks many biosynthetic pathways and therefore has evolved the capability to exploit host-derived metabolites via its periplasmic lipoprotein repertoire. We recently reported a flavin-trafficking protein in T. pallidum (Ftp_Tp; TP0796) as the first bacterial metal-dependent flavin adenine dinucleotide (FAD) pyrophosphatase that hydrolyzes FAD into AMP and flavin mononucleotide (FMN) in the spirochete’s periplasm. However, orthologs of Ftp_Tp from other bacteria appear to lack this hydrolytic activity; rather, they bind and flavinylate subunits of a cytoplasmic membrane redoxmore » system (Nqr/Rnf). To further explore this dichotomy, biochemical analyses, protein crystallography, and structure-based mutagenesis were used to show that a single amino acid change (N55Y) in Ftp_Tp converts it from an Mg²⁺-dependent FAD pyrophosphatase to an FAD-binding protein. We also demonstrated that Ftp_Tp has a second enzymatic activity (Mg²⁺-FMN transferase); it flavinylates protein(s) covalently with FMN on a threonine side chain of an appropriate sequence motif using FAD as the substrate. Moreover, mutation of a metal-binding residue (D284A) eliminates Ftp_Tp’s dual activities, thereby underscoring the role of Mg²⁺ in the enzyme-catalyzed reactions. The posttranslational flavinylation activity that can target a periplasmic lipoprotein (TP0171) has not previously been described. The observed activities reveal the catalytic flexibility of a treponemal protein to perform multiple functions. Together, these findings imply mechanisms by which a dynamic pool of flavin cofactor is maintained and how flavoproteins are generated by Ftp_Tp locally in the T. pallidum periplasm.« less

  19. Text Messaging for Enhancement of Testing and Treatment for Tuberculosis, Human Immunodeficiency Virus, and Syphilis: A Survey of Attitudes Toward Cellular Phones and Healthcare

    PubMed Central

    Person, Anna K.; Blain, Michela L.M.; Jiang, Helen; Rasmussen, Petra W.

    2011-01-01

    Abstract Objectives: The objective of this study was to assess knowledge, attitudes, and behaviors surrounding healthcare-related mobile phone use and text messaging among persons at risk for or infected with tuberculosis (TB) or the human immunodeficiency virus (HIV). Methods: An anonymous survey was conducted in three groups of subjects: (1) HIV-infected persons attending an HIV clinic; (2) persons with latent TB infection at a public health clinic; and (3) persons presenting for TB, HIV, and syphilis screening at a community screening site. Results: Three hundred fifteen (n  = 315) persons responded to the survey, of whom 241 (76.5%) owned a cell phone. Cell phone owners were younger and more educated than nonowners. Transportation difficulty and forgetting appointments were cited as significant barriers by 34.2% and 39.5% of respondents, respectively. Fifty-six percent of subjects felt it would be acceptable to receive text message appointment reminders, and 33% felt that text message reminders to take medications would be acceptable. Younger age and cell phone ownership were significantly associated with acceptance of text message reminders. Black and Hispanic subjects were more likely to feel that text message reminders for appointments or medications were helpful than White subjects. Further, Black and Hispanic subjects, as well as subjects with lower educational attainment, were more receptive to healthcare-related educational text messages. Conclusions: Cell phones and text messaging were prevalent among our subjects attending HIV and TB clinics, and subjects were generally receptive to text messaging for healthcare-related communication. Interventions that explore the potential for text messaging to improve clinic attendance, medication adherence, and health knowledge should be explored. PMID:21457085

  20. Etude séro-epidémiologique de trois infections sexuellement transmissibles (Chlamydia Trachomatis, Hépatite B, Syphilis): cas de l’Hôpital de District de Nkoldongo à Yaoundé

    PubMed Central

    Essome, Marie Chantal Ngonde; Nsawir, Bonglaisin Julius; Nana, Rodrigue Dongang; Molu, Patrick; Mohamadou, Mansour

    2016-01-01

    Introduction Les infections sexuellement transmissibles sévissent toujours dans les pays en voie de développement et particulièrement au Cameroun. Le but de notre étude est de déterminer la distribution des infections sexuellement transmissibles suivantes: l’hépatite virale B, le Chlamydia trachomatis et de la syphilis dans une population de femmes venant consulter spontanément à l’Hôpital de District de Nkoldongo à Yaoundé, d’évaluer d’éventuelles coïnfections entre ces trois affections et de ressortir les connaissances de ces femmes sur leur mode de transmission sexuelle. Méthodes Notre étude prospective et descriptive a porté sur 182 femmes dont l’âge variait entre 18 et 48 ans. Les femmes ont été testées sérologiquement pour le Chlamydia trachomatis par une méthode ELISA (kit des laboratoires General Biological Corp). L’hépatite virale B a été dépistée par une méthode immunochromatographique (kit des laboratoires Human) et la syphilis par une méthode d’agglutination en ce qui concerne le RPR (Kit des laboratoires Biocentric) et le TPHA (kit des laboratoires Human). Résultats Nos résultats ont montré que: la distribution du Chlamydia trachomatis, de l’hépatite virale B et la syphilis a été respectivement de 22,52%, 4,39%, 0,54%.De plus, nous avons observé une coinfection Chlamydia trachomatis hépatite virale B avec un taux de 2,74%. Par ailleurs la réinfection au Chlamydia trachomatis a été rencontrée dans 4,94% de cas. S’agissant du mode de transmission de ces affections 67,57% et 70,87% de femmes ne connaissaient pas la voie de transmission sexuelle pour le Chlamydia trachomatis et pour l’hépatite virale B respectivement, tandis que 91,2 % des femmes connaissaient la voie de transmission sexuelle pour la syphilis. Conclusion Le diagnostic d’une infection à Chlamydia trachomatis chez une patiente doit susciter le dépistage de l’hépatite virale B. Introduction Sexually transmitted infections

  1. High Prevalence and High Incidence of Coinfection with Hepatitis B, Hepatitis C, and Syphilis and Low Rate of Effective Vaccination against Hepatitis B in HIV-Positive Men Who Have Sex with Men with Known Date of HIV Seroconversion in Germany

    PubMed Central

    Jansen, Klaus; Thamm, Michael; Bock, Claus-Thomas; Scheufele, Ramona; Kücherer, Claudia; Muenstermann, Dieter; Hagedorn, Hans-Jochen; Jessen, Heiko; Dupke, Stephan; Hamouda, Osamah; Gunsenheimer-Bartmeyer, Barbara; Meixenberger, Karolin

    2015-01-01

    Objectives Men who have sex with men (MSM) are at higher risk for coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis than the general population. HIV infection and these coinfections accelerate disease progression reciprocally. This study evaluated the prevalence and incidence of these coinfections in HIV1-positive MSM in Germany. Materials and Methods As part of a nationwide, multicenter, prospective cohort study of HIV-infected MSM, plasma samples collected yearly were screened for HBsAg and antibodies to HBc, HBs, HCV, and syphilis. Samples with indications of active HBV or HCV infection were confirmed by polymerase chain reaction. Prevalence and incidence of each infection and incidence rates per study participant were calculated, and incidences over 4-year time intervals compared. Results This study screened 5,445 samples from 1,843 MSM. Median age at HIV seroconversion was 33 years. Prevalences of active, cleared, and occult HBV, and of active/cleared HCV were 1.7%, 27.1%, 0.2%, and 8.2%, respectively, and 47.5% had been effectively vaccinated against HBV. Prevalence of antibodies to Treponema pallidum and of triple or quadruple sexually transmitted infections (STIs) were 39.6% and 18.9%, respectively. Prevalence of STI, cleared HBV, HBV vaccination, and history of syphilis differed significantly among age groups. Incidences of HBV, HCV, and syphilis were 2.51, 1.54, and 4.06 per 100 person-years, respectively. Incidences of HCV and syphilis increased over time. HCV incidence was significantly higher in MSM coinfected with syphilis and living in Berlin, and syphilis incidence was significantly higher for MSM living in Berlin. Discussion Despite extensive HBV vaccination campaigns, fewer than 50% of screened MSM were effectively vaccinated, with a high proportion of HIV-positive MSM coinfected with HBV. High rates of STI coinfections in HIV-positive MSM and increasing incidences emphasize the need for better tailored campaigns for

  2. Prevalence and Trends of HIV, Syphilis, and HCV in Migrant and Resident Men Who Have Sex with Men in Shandong, China: Results from a Serial Cross-Sectional Study

    PubMed Central

    Hu, Jun; Gu, Xu; Tao, Xiaorun; Qian, Yaosheng; Babu, Giridhara R.; Wang, Guoyong; Liao, Meizhen; Han, Larry; Kang, Dianmin; Tang, Weiming

    2017-01-01

    Background Migrant men who have sex with men (MSM) have a higher predisposition for HIV transmission. We aimed to determine and compare the prevalence and trends of HIV, Syphilis, and HCV between migrant and resident MSM in Shandong, China. Methods A serial cross-sectional study was conducted in eight cities in Shandong, China from 2010 to 2014. The surveys collected information on demographics, HIV-related knowledge, and HIV-related behaviors including the serologic status of HIV, syphilis, and HCV. Bivariate and multivariable logistic regressions were used to determine differences between migrant and resident MSM. Results The overall prevalence of HIV among the 15,705 MSM (14120 were resident, 1580 were migrant and 5 were missing) was 2.6%, with an increase of 1.0% in 2010 to 4.4% in 2014. Prevalence of HIV was higher among migrant MSMs (5.5%) compared to resident MSMs (2.3%). Compared to residents, migrants also had higher prevalence of syphilis (7.5% vs 4.9%) and HCV (1.1% vs 0.6%). We found that there was an increase in the proportion of migrant MSM engaging in anal sex [adjusted OR (AOR) = 1.41 in migrants vs 1.12 in residents], condom use during last anal sex (AOR = 1.14 in residents, P for trend = 0.32), consistent condom use (AOR = 1.04 residents, P for trend = 0.11) and drug use (AOR = 1.51 in migrants and 1.29 among residents). Except in the year 2011, receiving some health services in last year was significant for people who were HIV-positive compared to negative. (P for trend <0.05). Conclusions Prevalence of HIV increased in resident as well as migrant MSMs. The migrant MSMs had higher STIs compared to resident MSMs and therefore, should be targeted for effective interventions aimed at reducing their risk behaviors. Deeper understanding of the role of migration in health issues is required for combating the persistently high and gradually increasing HIV burden in MSM in China. PMID:28103295

  3. The Prevalence of Syphilis in England and Wales on the Eve of the Great War: Re-visiting the Estimates of the Royal Commission on Venereal Diseases 1913–1916

    PubMed Central

    Szreter, Simon

    2014-01-01

    Public fears of widespread venereal disease led in 1913 to the appointment of The Royal Commission on Venereal Diseases (RCVD). In 1916 its Final Report offered only a single cautious and somewhat imprecise summary statement about the likely prevalence of venereal diseases in England and Wales. Although the significance of contemporary attitudes to venereal disease has attracted a good deal of historiographic attention, no historian or demographer has since investigated this aspect of the Royal Commission's work. This article critically re-examines the most important quantitative evidence presented to the Royal Commission relating to the years immediately prior to the First World War. It utilises this evidence to produce new estimates of the probable prevalence of syphilis among adult males, both nationally and among certain geographical divisions and social groups in the national population; and also to offer a comment on the likely prevalence of gonorrhoea. PMID:25067890

  4. The Prevalence of Syphilis in England and Wales on the Eve of the Great War: Re-visiting the Estimates of the Royal Commission on Venereal Diseases 1913-1916.

    PubMed

    Szreter, Simon

    2014-08-01

    Public fears of widespread venereal disease led in 1913 to the appointment of The Royal Commission on Venereal Diseases (RCVD). In 1916 its Final Report offered only a single cautious and somewhat imprecise summary statement about the likely prevalence of venereal diseases in England and Wales. Although the significance of contemporary attitudes to venereal disease has attracted a good deal of historiographic attention, no historian or demographer has since investigated this aspect of the Royal Commission's work. This article critically re-examines the most important quantitative evidence presented to the Royal Commission relating to the years immediately prior to the First World War. It utilises this evidence to produce new estimates of the probable prevalence of syphilis among adult males, both nationally and among certain geographical divisions and social groups in the national population; and also to offer a comment on the likely prevalence of gonorrhoea.

  5. The Legacy of the U. S. Public Health Services Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years After President Clinton’s Apology

    PubMed Central

    Mays, Vickie M.

    2013-01-01

    This special issue addresses the legacy of the United States Public Health Service Syphilis Study on health reform, particularly the Affordable Care Act (ACA). The 12 manuscripts cover the history and current practices of ethical abuses affecting American Indians, Latinos, Asian Americans and African Americans in the United States and in one case, internationally. Commentaries and essays include the voice of a daughter of one of the study participants in which we learn of the stigma and maltreatment some of the families experienced and how the study has impacted generations within the families. Consideration is given in one essay to utilizing narrative storytelling with the families to help promote healing. This article provides the reader a roadmap to the themes that emerged from the collection of articles. These themes include population versus individual consent issues, need for better government oversight in research and health care, the need for overhauling our bioethics training to develop a population level, culturally driven approach to research bioethics. The articles challenge and inform us that some of our assumptions about how the consent process best works to protect racial/ethnic minorities may be merely assumptions and not proven facts. Articles challenge the belief that low participation rates seen in biomedical studies have resulted from the legacy of the USPHS Syphilis Study rather than a confluence of factors rooted in racism, bias and negative treatment. Articles in this special issue challenge the “cultural paranoia” of mistrust and provide insights into how the distrust may serve to lengthen rather than shorten the lives of racial/ethnic minorities who have been used as guinea pigs on more than one occasion. We hope that the guidance offered on the importance of developing a new framework to bioethics can be integrated into the foundation of health care reform. PMID:23630410

  6. [How to handle unexpected biological abnormalities observed in the pre-donation workup for hematopoietic stem cell transplantation: an SFGM-TC report on pre-transplant cytomegalovirus, Epstein-Barr virus, Toxoplasma gondii, or syphilis IgM positive serology test].

    PubMed

    Duléry, R; Giraud, C; Beaumont, J-L; Bilger, K; Borel, C; Dhedin, N; Thiebaut, A; Willems, E; Alain, S; Alfandari, S; Dewilde, A; Jouet, J-P; Milpied, N; Yakoub-Agha, I

    2013-08-01

    In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the third annual series of workshops which brought together practitioners from all member centers and took place in October 2012 in Lille. Here we report our results and recommendations regarding the management of pre-transplant donor's cytomegalovirus, Epstein-Barr virus, Toxoplasma gondii, or syphilis IgM positive serology test.

  7. Comparison of the cerebrospinal fluid (CSF) toluidine red unheated serum test and the CSF rapid plasma reagin test with the CSF venereal disease research laboratory test for diagnosis of neurosyphilis among HIV-negative syphilis patients in China.

    PubMed

    Zhu, Lin; Gu, Xin; Peng, Rui-Rui; Wang, Cuini; Gao, Zixiao; Zhou, Pingyu; Gao, Ying; Shi, Mei; Guan, Zhifang; Seña, Arlene C

    2014-03-01

    In this study, we aimed to investigate the performance of nontreponemal antibody tests in cerebrospinal fluid (CSF) specimens from syphilis patients. From September 2009 to September 2012, CSF specimens were collected at the Shanghai Skin Disease Hospital in Shanghai, China, from 1,132 syphilis patients without HIV infection, including 154 with symptomatic and 56 with asymptomatic neurosyphilis. All of the CSF specimens underwent testing with a rapid plasma reagin (RPR) test, an RPR-V (commercial RPR antigen diluted 1:2 in 10% saline) test, the toluidine red unheated serum test (TRUST), and the Venereal Disease Research Laboratory (VDRL) test. Specificities, sensitivities, positive predictive values (PPVs), negative predictive values (NPVs), and kappa values were calculated to determine the performances of the tests. We compared results of the CSF-VDRL, CSF-RPR, CSF-RPR-V, and CSF-TRUST among patients with symptomatic and asymptomatic neurosyphilis who had reactive CSF-Treponema pallidum particle agglutination (TPPA) test results. Overall, the CSF-VDRL test was reactive in 261 patients (23.1%). There were no cases in which the CSF-VDRL was nonreactive and CSF-RPR, CSF-RPR-V, or CSF-TRUST was reactive. Agreement between the results of CSF-TRUST and CSF-RPR was almost perfect (κ=0.861), with substantial agreement between the results of CSF-RPR and CSF-RPR-V (κ=0.740). The sensitivities of CSF-VDRL, CSF-RPR, CSF-RPR-V, and CSF-TRUST were 81.4%, 76.2%, 79.5%, and 76.2%, respectively. Compared to CSF-VDRL, CSF-RPR, CSF-RPR-V, and CSF-TRUST had comparable PPVs and NPVs. However, the specificity of CSF-VDRL (90.3%) was significantly lower than those of the other tests (92.7 to 93.4%). Therefore, CSF-RPR, CSF-RPR-V, and CSF-TRUST can be considered alternative tests for neurosyphilis diagnosis in HIV-negative populations, particularly when the CSF-VDRL is not available.

  8. Evidence for posttranslational protein flavinylation in the syphilis spirochete Treponema pallidum: Structural and biochemical insights from the catalytic core of a periplasmic flavin-trafficking protein

    SciTech Connect

    Deka, Ranjit K.; Brautigam, Chad A.; Liu, Wei Z.; Tomchick, Diana R.; Norgard, Michael V.

    2015-05-05

    The syphilis spirochete Treponema pallidum is an important human pathogen but a highly enigmatic bacterium that cannot be cultivated in vitro. T. pallidum lacks many biosynthetic pathways and therefore has evolved the capability to exploit host-derived metabolites via its periplasmic lipoprotein repertoire. We recently reported a flavin-trafficking protein in T. pallidum (Ftp_Tp; TP0796) as the first bacterial metal-dependent flavin adenine dinucleotide (FAD) pyrophosphatase that hydrolyzes FAD into AMP and flavin mononucleotide (FMN) in the spirochete’s periplasm. However, orthologs of Ftp_Tp from other bacteria appear to lack this hydrolytic activity; rather, they bind and flavinylate subunits of a cytoplasmic membrane redox system (Nqr/Rnf). To further explore this dichotomy, biochemical analyses, protein crystallography, and structure-based mutagenesis were used to show that a single amino acid change (N55Y) in Ftp_Tp converts it from an Mg²⁺-dependent FAD pyrophosphatase to an FAD-binding protein. We also demonstrated that Ftp_Tp has a second enzymatic activity (Mg²⁺-FMN transferase); it flavinylates protein(s) covalently with FMN on a threonine side chain of an appropriate sequence motif using FAD as the substrate. Moreover, mutation of a metal-binding residue (D284A) eliminates Ftp_Tp’s dual activities, thereby underscoring the role of Mg²⁺ in the enzyme-catalyzed reactions. The posttranslational flavinylation activity that can target a periplasmic lipoprotein (TP0171) has not previously been described. The observed activities reveal the catalytic flexibility of a treponemal protein to perform multiple functions. Together, these findings imply mechanisms by which a dynamic pool of flavin cofactor is maintained and how flavoproteins are generated by Ftp_Tp locally in the T. pallidum periplasm.

  9. [Syphilis: Prevalence in a Hospital in Lisbon].

    PubMed

    Lopes, Leonor; Ferro-Rodrigues, Rita; Llobet, Samuel; Lito, Luís; Borges-Costa, João

    2016-01-01

    Introdução: A sífilis é uma doença de transmissão sexual e vertical. A sua incidência está a aumentar na Europa, particularmente em Portugal. Material e Métodos: Estudo retrospetivo baseado na análise laboratorial de testes treponémicos positivos, entre janeiro e dezembro de 2013, no Hospital de Santa Maria. Foram incluídos doentes internados, da consulta externa, do hospital dia e da urgência. Procedeu-se a caraterização epidemiológica, classificação da doença e de fatores de risco associados. Resultados: Obteve-se uma amostra de 484 doentes, após exclusão de 51 por ausência de dados clínicos nos processos e de 45 por valores falsos positivos. Verificou-se predomínio do sexo masculino (75%) e idade média de 47 anos. A maioria (59%) tinha testes serológicos compatíveis com sífilis no passado e 3,7% encontrava-se em vigilância clínica. Diagnosticou-se sífilis primária em 13doentes, secundária em 71, latente precoce em 40, latente indeterminada em 49 e latente tardia em cinco. No grupo sífilis recente, 42% (n = 124) eram seropositivos para o VIH e 8% tiveram, em simultâneo, este diagnóstico. Discussão: Salienta-se a elevada prevalência da coinfeção pelo VIH nos doentes com sífilis recente, reforçando a importância de promover a utilização de medidas preventivas. Registaram-se 11% de formas clínicas tardias, que são de notificação obrigatória desde junho de 2014. Todos os testes serológicos para o diagnóstico de sífilis apresentam limitações, o que enfatiza a importância da correlação clínico-laboratorial. Conclusão: A sífilis continua a ser um problema de saúde pública pelo que é necessário estabelecer programas de educação, rastreio e follow-up para reduzir a sua prevalência e tornar mais eficiente o rastreio dos parceiros.

  10. A case of secondary syphilis presenting as optic neuritis.

    PubMed

    Bandettini di Poggio, Monica; Primavera, Alberto; Capello, Elisabetta; Bandini, Fabio; Mazzarello, Giovanni; Viscoli, Claudio; Schenone, Angelo

    2010-06-01

    Neurosyphilis is still a significant medical problem in developing countries and syphilitic ocular manifestations are often not diagnosed due to the lack of typical characteristics. We describe the case of a 59-year-old homosexual man with a 1-month history of decreased vision acuity in his left eye who was diagnosed with neurosyphilis and received treatment with intravenous penicillin G (16 million units in divided daily doses), with great improvement of visual acuity and CSF examination findings. The interest of this case is not only represented by the unusually early ocular involvement, but also by the rapid evolution of the disease into the secondary stage in a man who had had one at-risk homosexual relationship only 3 months before the onset symptoms. We also support the view that the presence of ocular involvement in syphilitic patients is suggestive of involvement of the CNS and should be considered synonymous with neurosyphilis.

  11. STUDIES IN EXPERIMENTAL SYPHILIS : III. FURTHER OBSERVATIONS ON THE POSSIBILITY OF CURE OF SYPHILIS IN THE RABBIT WITH ARSPHENAMINE.

    PubMed

    Chesney, A M; Kemp, J E

    1925-06-30

    Syphilitic rabbits can be treated with arsphenamine in such a manner as to render the lymph nodes incapable of transmitting the infection to normal rabbits. This can be accomplished if treatment is begun either early or comparatively late in the course of the disease. If treatment is begun early, the animals are almost uniformly susceptible to a second infection, whereas, if it is begun late, they are almost uniformly refractory to a second infection. It is suggested that this refractory state in rabbits may be explained by the existence of an acquired immunity which persists after the abolition of the disease, rather than to the persistence of the first infection. It would appear that it is possible under certain conditions to reinoculate rabbits and produce generalized infection without producing any lesion at the portal of entry.

  12. Is there a difference between hare syphilis and rabbit syphilis? Cross infection experiments between rabbits and hares.

    PubMed

    Lumeij, Johannes T; Mikalová, Lenka; Smajs, David

    2013-05-31

    Cross infection of rabbits and hares with Treponema paraluiscuniculi from rabbits and the related microorganism from hares, which was provisionally named "Treponema paraluisleporis", revealed that T. paraluiscuniculi affects rabbits clinically, but only causes seroconversion in hares without causing clinical disease, while "T. paraluisleporis" induces disease in both rabbits and hares. The 16S rRNA gene of "T. paraluisleporis" was sequenced (GenBank acc. no. JX899416) and compared to the sequence of T. paraluiscuniculi strain Cuniculi A. A phylogenetic tree based on the sequence alignment of 2002 bp taken from several treponemal strains was constructed. Both "T. paraluisleporis" and T. paraluiscuniculi are clustered together indicating their common origin. The close phylogenetic relatedness of both representatives supports the conclusion that subspecies or ecovar status should be given to these strains rather than species status. A more appropriate species name might be Treponema paraluisleporidarum. The genitive refers to the nominative Leporidae (family of rabbits and hares). The naturally occurring strain in rabbits would than be T. paraluisleporidarum ecovar Cuniculus and the strain from hares T. paraluisleporidarum ecovar Lepus. Since the former seems to have fewer physiological hosts, ecovar Lepus may represent an evolutionary ancestor of ecovar Cuniculus.

  13. STD Symptoms: Common STDs and Their Symptoms

    MedlinePlus

    ... pregnant woman with syphilis to be treated. Primary syphilis The first sign of syphilis, which may occur ... the second (secondary) or third (tertiary) stage. Secondary syphilis Signs and symptoms of secondary syphilis may begin ...

  14. Paroxysmal cold hemoglobinuria (PCH)

    MedlinePlus

    ... the urine. PCH has been linked to secondary syphilis, tertiary syphilis, and other viral or bacterial infections. Sometimes the ... help. For example, if PCH is caused by syphilis, symptoms may get better when the syphilis is ...

  15. Syphilis Rates Spike Among U.S. Gay, Bisexual Men: CDC

    MedlinePlus

    ... West. "People in the South often experience poorer health outcomes than the rest of the nation, due to multiple factors including income inequality, poverty, and high numbers of people without health ...

  16. Effects of cefetamet (Ro 15-8074) on Treponema pallidum and experimental syphilis.

    PubMed Central

    Fitzgerald, T J

    1992-01-01

    Cefetamet pivoxil (Ro 15-8075) is a newly developed, expanded-spectrum cephalosporin that is orally active. In vitro, the active form, cefetamet (Ro 15-8074), at a concentration of 0.05 micrograms/ml killed and lysed Treponema pallidum. Rabbit serum did not diminish its effectiveness. The antibiotic rapidly entered the circulation following intramuscular injection into rabbits, attaining its highest levels of 24 to 37 micrograms/ml within 10 to 30 min. Animals were infected intradermally with T. pallidum and then treated with different doses of cefetamet. Accelerated healing was detected following treatment with 15 and 30 mg/kg of body weight. The antibiotic was also effective in killing organisms that had disseminated to distant tissues. In three separate sets of experiments, rabbits were infected with treponemes and then treated with cefetamet intramuscularly at 1, 15, or 30 mg/kg as follows: (i) after lesions had just become clinically apparent, (ii) after lesions were enlarged and well developed, or (iii) prior to the appearance of clinical lesions. Antibiotic effectiveness was determined by sacrificing the animals 1 week after antibiotic treatment and examining splenic tissue for residual, disseminated treponemes. Cefetamet was treponemicidal in all three situations. Maximum effects occurred when the antibiotic was injected before lesions had become clinically apparent (incubation period). These results suggest that cefetamet pivoxil might be useful for treating syphilitic infections. PMID:1622168

  17. Bad Blood: The Tuskegee Syphilis Study and Legacy Recruitment for Experimental AIDS Vaccines

    ERIC Educational Resources Information Center

    Hagen, Kimberly Sessions

    2005-01-01

    For African Americans, medical research often connotes exploitation and cruelty, making recruiting African Americans to participate in HIV vaccine trials particularly daunting. But infusing adult education principles into such efforts is both increasing African American participation and helping heal the legacy of the Tuskegee experiment.

  18. UNICEF, syphilis and the state: negotiating female citizenship in the post-Second World War world.

    PubMed

    Morris, Jennifer

    2010-01-01

    Few charitable organizations have achieved the status of global recognition enjoyed by UNICEF, the United Nations Children's Fund, which embodies the international effort to provide for needy children the world over. Created because of its synchronicity with the United Nations' stated purpose—to maintain peace in the world—UNICEF launched its operations in 1946. Its founding, early operations and eventual restructuring reveal a great deal about concurrent political and economic events, but also provide keen insight into international ideas about who qualified for full citizenship in the post-war world. The consequences of UNICEF's policies, procedures and practices posed challenges to notions of citizenship for both women and children. It challenged citizenship not by questioning sex-specific gender roles, but by judiciously adhering to the United Nations' promise to create equality for men and women alike. UNICEF found itself in the unique position to be able to globalize definitions of what constituted full citizenship in any nation, due to its rapid expansion throughout the world. Through its programs, especially those related to health care, it not only challenged these roles in the West, but began over several decades to complicate the definition of citizenship as it became a forceful presence in Asia and Africa throughout the 1970s.

  19. Use of Tunable, Pulsed Dye Laser for Quantitative Fluorescence in Syphilis Serology (FTA-ABS Test)

    PubMed Central

    Kasatiya, S. S.; Lambert, N. G.; Laurence, R. A.

    1974-01-01

    A pulsed dye laser was used as an excitation source in a fluorescent treponemal antibody absorption (FTA-ABS) test. A high precision in quantitative fluorescence was obtained with this high-power excitation source coupled to an electronic detection system and a storage oscilloscope by standardization of fluorescence evaluation and through elimination of human error. One 0.4-μs pulse exposure was sufficient to record fluorescence intensity data on the oscilloscope. Absence of fading of fluorescence after repeated excitation permitted multiple readings of the same microscope field. Almost 100% reproducible results were obtained for the FTA-ABS test with 40 samples. Electronic detection of fluorescence and the high sensitivity obtained with laser excitation raise doubts about the relative value of quantitative immunofluorescence in the FTA-ABS test. PMID:4598221

  20. SUPERINFECTION IN EXPERIMENTAL SYPHILIS FOLLOWING THE ADMINISTRATION OF SUBCURATIVE DOSES OF ARSPHENAMINE OR NEOARSPHENAMINE.

    PubMed

    Brown, W H; Pearce, L

    1921-04-30

    Experiments were carried out on rabbits for the purpose of determining the effects of subcurative doses of arsphenamine and of neo-arsphenamine upon the resistance of infected animals to reinoculation with Treponema pallidum and hence the possibilities of the occurrence of a second infection in treated but uncured cases of infection. All the animals used were inoculated with the same virus, and the experimental tests were carried out when the first cycle of testicular reaction was nearing its height. The animals with the most marked testicular lesions were used for the basic experiment of treatment and reinoculation. The results of this experiment were controlled from four different standpoints: (1) the effect of the treatment employed upon the existing infection; (2) the immunity present at the time of treatment; (3) the virulence of the organisms used for reinoculation as compared with those causing the existing infection; (4) the comparative susceptibility of normal animals to the virus used for reinoculation. The results obtained showed (1) that the treatment employed was insufficient to cure any of the therapeutic controls; (2) that the infected controls were highly refractory to a second inoculation; (3) that the treated animals were highly susceptible to a second inoculation and although not cured of their original infection, reacted to the second inoculation with the formation of lesions indistinguishable from those of a first infection; (4) that in certain instances the treatment given had rendered infected animals more susceptible to infection than the normal controls.

  1. Textiles as social texts: syphilis, material culture and gender in golden age Spain.

    PubMed

    Berco, Cristian

    2011-01-01

    Whereas traditional social and health histories have viewed the garments of early modern patients accessing hospital care as evidence of their poverty, this article reinterprets the meaning of patient clothing in the context of a venereal disease hospital in Toledo, Spain, in the seventeenth century. Patients carefully selected what they wore as they entered the hospital to produce certain effects on local audiences. Thus, these choices can be understood as body scripts meant to be read in certain ways rather than mere reflections of actual social status. In a context of gendered and social pressures associated with women's sexuality, female syphilitic patients wore garments meant to emphasize respectability and thereby avoid a loss of reputation.

  2. [Position hopeless lost--Heinrich Dreuw's lonely struggle against syphilis and Salvarsan].

    PubMed

    Mildenberger, Florian

    2011-01-01

    The invention of Salvarsan (Triaminotrihydroxy-arsenobenzol) in 1910 meant a revolution in the medical treatment. Chemotherapy was born and its founder Paul Ehrlich is still famous for his experimental work. In medical history mostly successes, not widespread discussions about misuse or failing of the new drug were. The Berlin doctor Heinrich Dreuw was a key figure in these debates. He and his colleagues presented evidence that Salvarsan was not an effective drug and just an expensive placebo, which helped pharmaceutical trusts earning more money. Dreuw even attacked state medical branches for infringement against patients. At last doubts about Salvarsan never disappeared.

  3. [Acute non cholestatic hepatitis as the first manifestation of secondary syphilis].

    PubMed

    Rinascente, Chiara; Candela, Giancarlo; Cervero, Miguel; Lobato, Alejandro; Carbonell, Alejandro

    2015-01-01

    We present a 34 year old male who enter the Digestive Department of the University Hospital Severo Ochoa in Madrid, Spain with jaundice with a great elevation of transaminases in relationship with an infectious syndrome that was correctly diagnosed and treated with a very good outcome.

  4. 75 FR 48698 - Medicare, Medicaid and CLIA Programs; COLA (Formerly the Commission on Office Laboratory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... Bacteriology, Mycobacteriology, Mycology, Parasitology, Virology. Diagnostic Immunology, including Syphilis..., Virology. Diagnostic Immunology, including Syphilis Serology, General Immunology. Chemistry,...

  5. 78 FR 12323 - Announcement of the Re-Approval of the Commission on Office Laboratory Accreditation (COLA) as an...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ..., Mycobacteriology, Mycology, Parasitology, Virology. Diagnostic Immunology, including Syphilis Serology, General..., Mycobacteriology, Mycology, Parasitology, Virology. Diagnostic Immunology, including Syphilis Serology,...

  6. Superoxide reductase from the syphilis spirochete Treponema pallidum: crystallization and structure determination using soft X-rays

    SciTech Connect

    Santos-Silva, Teresa; Trincão, José; Carvalho, Ana L.; Bonifácio, Cecília; Auchère, Françoise; Moura, Isabel; Moura, José J. G.; Romão, Maria J.

    2005-11-01

    Superoxide reductase is a non-haem iron-containing protein involved in resistance to oxidative stress. The oxidized form of the protein has been crystallized and its three-dimensional structure solved. A highly redundant X-ray diffraction data set was collected on a rotating-anode generator using Cu Kα X-ray radiation. Four Fe atoms were located in the asymmetric unit corresponding to four protein molecules arranged as a dimer of homodimers. Superoxide reductase is a 14 kDa metalloprotein containing a catalytic non-haem iron centre [Fe(His){sub 4}Cys]. It is involved in defence mechanisms against oxygen toxicity, scavenging superoxide radicals from the cell. The oxidized form of Treponema pallidum superoxide reductase was crystallized in the presence of polyethylene glycol and magnesium chloride. Two crystal forms were obtained depending on the oxidizing agents used after purification: crystals grown in the presence of K{sub 3}Fe(CN){sub 6} belonged to space group P2{sub 1} (unit-cell parameters a = 60.3, b = 59.9, c = 64.8 Å, β = 106.9°) and diffracted beyond 1.60 Å resolution, while crystals grown in the presence of Na{sub 2}IrCl{sub 6} belonged to space group C2 (a = 119.4, b = 60.1, c = 65.6 Å, β = 104.9°) and diffracted beyond 1.55 Å. A highly redundant X-ray diffraction data set from the C2 crystal form collected on a copper rotating-anode generator (λ = 1.542 Å) clearly defined the positions of the four Fe atoms present in the asymmetric unit by SAD methods. A MAD experiment at the iron absorption edge confirmed the positions of the previously determined iron sites and provided better phases for model building and refinement. Molecular replacement using the P2{sub 1} data set was successful using a preliminary trace as a search model. A similar arrangement of the four protein molecules could be observed.

  7. Canadian Public Health Laboratory Network laboratory guidelines for the use of direct tests to detect syphilis in Canada

    PubMed Central

    Tsang, Raymond SW; Morshed, Muhammad; Chernesky, Max A; Jayaraman, Gayatri C; Kadkhoda, Kamran

    2015-01-01

    Treponema pallidum subsp. pallidum and/or its nucleic acid can be detected by various methods such as microscopy, rabbit infectivity test or polymerase chain reaction (PCR) tests. The rabbit infectivity test for T. pallidum, although very sensitive, has been discontinued from most laboratories due to ethical issues related to the need for animal inoculation with live T. pallidum, the technically demanding procedure and long turnaround time for results, thus making it impractical for routine diagnostic use. Dark-field and phase-contrast microscopy are still useful at clinic- or hospital-based laboratories for near-bedside detection of T. pallidum in genital, skin or mucous lesions although their availability is decreasing. The lack of reliable and specific anti-T. pallidum antibodies and its inferior sensitivity to PCR may explain why the direct fluorescent antibody test for T. pallidum is not widely available for clinical use. Immunohistochemical staining for T. pallidum also depends on the availability of specific antibodies, and the method is only applicable for histopathological examination of biopsy and autopsy specimens necessitating an invasive specimen collection approach. With recent advances in molecular diagnostics, PCR is considered to be the most reliable, versatile and practical for laboratories to implement. In addition to being an objective and sensitive test for direct detection of Treponema pallidum subsp. pallidum DNA in skin and mucous membrane lesions, the resulting PCR amplicons from selected gene targets can be further characterized for antimicrobial (macrolide) susceptibility testing, strain typing and identification of T. pallidum subspecies. PMID:25798160

  8. Syphilitic aseptic meningitis

    MedlinePlus

    ... or syphilitic meningitis, is a complication of untreated syphilis . It involves inflammation of the tissues covering the ... This condition is a life-threatening complication of syphilis infection. Syphilis is a sexually transmitted infection. Syphilitic ...

  9. General paresis

    MedlinePlus

    ... due to damage to the brain from untreated syphilis. Causes General paresis is one form of neurosyphilis . ... usually occurs in people who have had untreated syphilis for many years. Syphilis is bacterial infection that ...

  10. 77 FR 47072 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ... Syphilis (CS) Case investigation and Report Form (CDC73.126), (OMB) No.0920-0128, Expiration (03/31/2013... Congenital syphilis (CS) is an important sentinel health event that marks potential problems in both prenatal care and syphilis prevention programs. Congenital syphilis (CS) is nearly 100% preventable by...

  11. 77 FR 73470 - Agency Forms Undergoing Paperwork Reduction Act Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... this notice. Proposed Project Congenital Syphilis Case Investigation and Reporting Form (CDC73.126... Congenital syphilis (CS) is an important sentinel health event that marks potential problems in both prenatal care and syphilis prevention programs. Congenital syphilis (CS) is nearly 100% preventable by...

  12. 75 FR 6671 - Agency Forms Undergoing Paperwork Reduction Act Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-10

    ... should be received within 30 days of this notice. Proposed Project Congenital Syphilis (CS) Case... collection for congenital syphilis case investigations with a revised ``Congenital Syphilis (CS) Case... ``resident city'' information blocks from the CS Form. Reducing congenital syphilis is a national...

  13. Seropositivity rates for toxoplasmosis, rubella, syphilis, cytomegalovirus, hepatitis and HIV among pregnant women receiving care at a public health service, São Paulo state, Brazil.

    PubMed

    Gonçalves, Márcia Aparecida dos Santos; Matos, Cinara de Cássia Brandão de; Spegiorin, Lígia Cosentino Junqueira Franco; Oliani, Denise Cristina Mós Vaz; Oliani, Antonio Hélio; Mattos, Luiz Carlos de

    2010-01-01

    Infectious and parasitic diseases affecting women during their reproductive age may result in vertical transmission. The aim of this study was to determine the seroprevalence for TORSCH among pregnant women receiving care at a university hospital. Records of 574 pregnant women who received medical attention from January 2006 to December 2007 were assessed. The mean age was 27.2 ± 6.5 years ranging from 13 to 44. The results of the immunodiagnostic tests were: 62.0% (345/556) for IgG and 3.4% (19/556) for IgM anti-T. gondii; 93.1% (433/465) for IgG and 0.6% (3/465) for IgM anti-rubella; 0.9% (5/561) for VDRL; 1.8% (10/554) for HBsAg; 0.7% (4/545) for anti-HCV and 2.1% (11/531) for HIV. In conclusion, the results of immunodiagnostic tests for the TORSCH panel among pregnant women attending a perinatal service of a university hospital are in agreement with those reported by previous studies and by governmental sources.

  14. Acroangiodermatitis (pseudo-Kaposi's sarcoma) in an HIV sero-positive patient with syphilis and hepatitis C virus coinfection: clinical and dermatopathological features*

    PubMed Central

    Bernardes Filho, Fred; Martins, Gustavo; Nery, José Augusto da Costa; de Andrade, Cecília Vianna; Kac, Bernard Kawa

    2014-01-01

    Acroangiodermatitis is an angioproliferative disease usually related to chronic venous insufficiency, and it is considered a clinical and histological simulator of Kaposi's sarcoma (KS). Immunohistochemistry is the suitable method to differentiate between these two entities. It reveals the following immunostaining profile: immunopositivity with anti-CD34 antibody is restricted to the vascular endothelium in acroangiodermatitis, and diffuse in the KS (endothelial cells and perivascular spindle cells); immunopositivity with anti-HHV-8 only in KS cases. We report the case of an HIV seropositive patient without apparent vascular disease, who presented violaceous and brownish erythematous lesions on the feet, and whose histopathology and immunohistochemistry indicated the diagnosis of acroangiodermatitis. PMID:25184919

  15. Bad habits and bad genes: early 20th-century eugenic attempts to eliminate syphilis and associated "defects" from the United States.

    PubMed

    Wilson, Philip K

    2003-01-01

    American eugenists in the early 20th century distinguished "degenerates," including syphilitics, prostitutes, alcoholics and criminals, from the "normal" population by their particular bad habits. From eugenists' viewpoint, these bad habits were derived from bad character, a flaw that stemmed from an individual's bad genes. This essay explores how eugenists during this period characterized syphilitics and those with associated character "defects" in terms of heredity. Additionally, it examines the methods eugenists most frequently advocated to rectify these bad habits. These methods included marriage restriction, immigration control and reproductive sterilization. Overall, eugenists directed their efforts not so much at the "degenerate" as at his or her germ line.

  16. Use of sentinel surveillance and geographic information systems to monitor trends in HIV prevalence, incidence, and related risk behavior among women undergoing syphilis screening in a jail setting.

    PubMed

    Kim, Andrea A; Martinez, Alexis N; Klausner, Jeffrey D; Goldenson, Joe; Kent, Charlotte; Liska, Sally; McFarland, Willi

    2009-01-01

    Innovative methods are needed to systematically track the HIV epidemic and appropriately target prevention and care programs in vulnerable populations of women. We conducted sentinel surveillance among women entering the jail system of San Francisco from 1999 to 2001 to track trends in HIV incidence, HIV prevalence, and related risk behavior. Using geographic information software (GIS), we triangulated findings to examine the spatial distribution of risk and disease. A total of 1,577 female arrestees voluntarily screened for sexually transmitted diseases at intake were included. HIV incidence, estimated using the serologic testing algorithm for recent HIV seroconversion (STARHS), was 0.4% per year (95% confidence interval [95%CI]=0.1-2.1). HIV prevalence was 1.8% (95%CI=1.1-2.4). HIV infection was independently associated with age 30 to 39 years compared to all other ages, African-American race/ethnicity vs. non-African-American, and recent injection drug use. Maps showed that the communities in which arrested women reside are also those with the highest concentrations of newly detected female HIV cases, AIDS cases, and clients of substance use programs. The combined strategy of using sentinel surveillance in the jail setting and GIS to map the spatial distribution of disease provides a useful tool to identify patterns of risk in hard-to-reach, vulnerable populations of women.

  17. Top Health Issues for LGBT Populations

    MedlinePlus

    ... syphilis among MSM has been reported in various cities and areas— including outbreaks in Chicago, Seattle, San Francisco, Southern California, Miami, and New York City. These areas have experienced high rates of syphilis ...

  18. Chancroid

    MedlinePlus

    ... ulcer may look like the sore of primary syphilis (chancre). About half of the people who are ... be checked for other sexually transmitted infections, including syphilis , HIV , and genital herpes . In people with HIV, ...

  19. Condom Fact Sheet in Brief

    MedlinePlus

    ... such as genital herpes, human papillomavirus [HPV] infection, syphilis, and chancroid). HIV Infection Consistent and correct use ... for genital ulcer diseases, such as genital herpes, syphilis, and chancroid, only when the infected area or ...

  20. Neurosyphilis

    MedlinePlus

    ... usually occurs in people who have had untreated syphilis for many years. Causes Neurosyphilis is caused by Treponema pallidum . This is the bacteria that causes syphilis. It usually occurs about 10 to 20 years ...

  1. 2012 Sexually Transmitted Diseases Surveillance

    MedlinePlus

    ... National Overview National Profile Chlamydia Figures Gonorrhea Figures Syphilis Figures Other STDs Figures Special Focus Profiles Women ... Case Definitions Case Definitions Part 2 Contributors Slides Syphilis Profiles GISP Profiles Related Links STD Home STD ...

  2. Interstitial keratitis

    MedlinePlus

    ... cornea. This condition is often caused by infections. Syphilis is the most common cause of interstitial keratitis, ... Tuberculosis In the United States, most cases of syphilis are recognized and treated before this eye condition ...

  3. Yaws

    MedlinePlus

    ... is closely related to the bacterium that causes syphilis, but this form of the bacterium is not ... test for yaws. However, the blood test for syphilis is often positive in people with yaws because ...

  4. Human Papillomavirus - Prevalence of High-Risk and Low-Risk Types among Females Aged 14-59 Years, National Health and ...

    MedlinePlus

    ... National Overview National Profile Chlamydia Figures Gonorrhea Figures Syphilis Figures Other STDs Figures Special Focus Profiles Women ... Case Definitions Case Definitions Part 2 Contributors Slides Syphilis Profiles GISP Profiles File Formats Help: How do ...

  5. Pelvic Inflammatory Disease (PID) Treatment and Care

    MedlinePlus

    ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ...

  6. VDRL test

    MedlinePlus

    ... The VDRL test is a screening test for syphilis. It measures substances (proteins), called antibodies, that your ... come in contact with the bacteria that cause syphilis. How the Test is Performed The test is ...

  7. Pelvic Inflammatory Disease (PID) Fact Sheet

    MedlinePlus

    ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ...

  8. Trichomoniasis Statistics

    MedlinePlus

    ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy HIV / AIDS ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy HIV / AIDS ...

  9. Bacterial Vaginosis

    MedlinePlus

    ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ...

  10. Medical Surveillance Monthly Report (MSMR). Volume 17, Number 06, June 2010

    DTIC Science & Technology

    2010-06-01

    location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever...Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis...Reporting location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc

  11. Medical Surveillance Monthly Report (MSMR). Volume 17, Number 12, December 2010

    DTIC Science & Technology

    2010-12-01

    Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010...Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 NATIONAL...Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold d Heatd Q Fever Tuberculosis

  12. Institutional Review Boards and Your Research: A Proposal for Improving the Review Procedures for Research Projects that Involve Human Subjects and Their Associated Identifiable Private Information

    DTIC Science & Technology

    2010-06-01

    Failure to address this issue now may cause significant problems for computer science in the near future. Prisons and syphilis At issue are the...objectionable cases involved human medical experimen- tation—specifically the Tuskegee Syphilis Experiment, a 40-year long U.S. government project...that delib- erately withheld syphilis treatment from poor rural black men. Another was the 1971 Stanford Prison Experi- ment, funded by the U.S

  13. Medical Surveillance Monthly Report (MSMR). Volume 17, Number 10, October 2010

    DTIC Science & Technology

    2010-10-01

    Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009...Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009...Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold d Heatd Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010

  14. Medical Surveillance Monthly Report. Volume 17, Number 5, May 2010

    DTIC Science & Technology

    2010-05-01

    associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010...Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009... Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 Air Combat Cmd 3 1

  15. Medical Surveillance Monthly Report (MSMR). Volume 17, Number 07, July 2010

    DTIC Science & Technology

    2010-07-01

    associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010...Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009...Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009

  16. Medical Surveillance Monthly Report (MSMR). Volume 16, Number 12, December 2009

    DTIC Science & Technology

    2009-12-01

    disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008...Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009...6 6 Reporting location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold

  17. Medical Surveillance Monthly Report (MSMR). Volume 16, Number 11, November 2009

    DTIC Science & Technology

    2009-11-01

    associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009... Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 NORTH ATLANTIC...Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009

  18. The Grog. A Journal of Navy Medical History and Culture. Issue 43

    DTIC Science & Technology

    2015-01-01

    infected by syphilis and tuberculosis . Despite the intense cold weather which caused the ship to be covered with a heavy coating of ice, there... tuberculosis , and, as one would expect of any fron- tier town of the time, syphilis. Several decades before the discovery of penicil- lin, and even...syphilis, tuberculosis , and alcoholism as problems among the military population. In 1909, a Navy physician with the unfortunate sur- name "Grieve

  19. Morbidity and Mortality Weekly Report. Volume 47. Number RR-1. 1998 Guidelines for Treatment of Sexually Transmitted Diseases.

    DTIC Science & Technology

    1997-01-23

    in choosing specific regimens. There is minimal evidence to support the use of non - penicillin regimens. Recommended Regimens for Adults The...for non - allergic children who have acquired syphilis and whose results of the CSF examina- tion were normal. Early Latent Syphilis: Benzathine... non - treponemal serologic tests for syphilis can be interpreted in the usual manner for most patients who are coinfected with T. pallidum and HIV

  20. Syphilitic gumma arising in association with foreign material.

    PubMed

    Boyd, Alan S

    2016-11-01

    Until recently the number of patients with syphilis has been diminishing. Although that trend has reversed cases of tertiary syphilis are rare and often difficult to diagnose as a substantial number of patients will have a negative rapid plasma reagin. Histologically, cutaneous lesions in late stage syphilis exist in two forms, noduloulcerative and gummatous. Silver stains for spirochetes are almost invariably negative and, surprisingly, immunohistochemical stains are problematic as most lesions contain few, if any organisms. Presented here is a case of gummatous tertiary syphilis arising in association with foreign material deposited after a motor vehicle accident.

  1. 21 CFR 866.3830 - Treponema pallidum tre-ponemal test reagents.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... from infecting treponemal organisms in serum. The identification aids in the diagnosis of syphilis caused by bacteria belonging to the genus Treponema and provides epidemiological information on...

  2. 21 CFR 866.3830 - Treponema pallidum tre-ponemal test reagents.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... from infecting treponemal organisms in serum. The identification aids in the diagnosis of syphilis caused by bacteria belonging to the genus Treponema and provides epidemiological information on...

  3. 21 CFR 866.3830 - Treponema pallidum tre-ponemal test reagents.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... from infecting treponemal organisms in serum. The identification aids in the diagnosis of syphilis caused by bacteria belonging to the genus Treponema and provides epidemiological information on...

  4. 21 CFR 866.3830 - Treponema pallidum tre-ponemal test reagents.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... from infecting treponemal organisms in serum. The identification aids in the diagnosis of syphilis caused by bacteria belonging to the genus Treponema and provides epidemiological information on...

  5. 21 CFR 866.3830 - Treponema pallidum tre-ponemal test reagents.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... from infecting treponemal organisms in serum. The identification aids in the diagnosis of syphilis caused by bacteria belonging to the genus Treponema and provides epidemiological information on...

  6. 75 FR 65356 - Proposed Agency Information Collection Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-22

    ... prevention and control of HIV infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB), as well as for community-based HIV prevention activities, syphilis, and TB...

  7. In Remembrance There Is Prevention: A Brief Review of Four Historical Failures to Protect Human Subjects

    ERIC Educational Resources Information Center

    Nelson, Cameron R.

    2012-01-01

    This year the world commemorates the beginning of the tragic USPHS syphilis experiments that occurred in Tuskegee, Alabama from 1932 to 1972. In light of this sobering anniversary, this article will briefly examine four studies: the already mentioned USPHS syphilis studies in Tuskegee, the Nazi Holocaust Experiments and the resulting Doctors'…

  8. VD--Epidemic Among Teenagers. Public Affairs Pamphlet No. 517.

    ERIC Educational Resources Information Center

    Saltman, Jules

    This booklet discusses the venereal disease (VD) epidemic among teenagers. After presenting some basic facts about VD, the effect, treatment, and prevention of both gonorrhea and syphilis is discussed. The booklet then examines statistics concerning gonorrhea and syphilis. It also looks at why the VD epidemic exists and includes discussions on (1)…

  9. Medical Surveillance Monthly Report (MSMR). Volume 16, Number 5, May 2009

    DTIC Science & Technology

    2009-05-01

    location Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis ‡ Urethritis§ Cold Heat 2008 2009 2008...borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis ‡ Urethritis§ Cold Heat 2008 2009 2008 2009 2008 2009 2008

  10. Medical Surveillance Monthly Report (MSMR). Volume 16, Number 9, September 2009

    DTIC Science & Technology

    2009-09-01

    disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008...Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008

  11. RPR test

    MedlinePlus

    ... more specific test for syphilis, such as FTA-ABS . The FTA-ABS test will help distinguish between syphilis and other ... Elsevier Saunders; 2015:chap 239. Read More FTA-ABS test VDRL test Review Date 9/10/2015 ...

  12. The "Other" Venereal Diseases: Herpes Simplex, Trichomoniasis and Candidiasis.

    ERIC Educational Resources Information Center

    McNab, Warren L.

    1979-01-01

    Although the term venereal disease has been synonymous with gonorrhea and syphilis, the Center for Disease Control now states that the number of new cases of herpes simplex, trichomoniasis, and candidiasis is rapidly approaching the number of cases of syphilis and gonorrhea. (MM)

  13. Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility.

    PubMed Central

    Bachmann, L H; Lewis, I; Allen, R; Schwebke, J R; Leviton, L C; Siegal, H A; Hook, E W

    2000-01-01

    OBJECTIVES: We evaluated the prevalence of gonorrhea, chlamydia, trichomoniasis, and syphilis in patients entering residential drug treatment. METHODS: Data on sexual and substance abuse histories were collected. Participants provided specimens for chlamydia and gonorrhea ligase chain reaction testing. Trichomonas vaginalis culture, and syphilis serologic testing. RESULTS: Of 311 patients, crack cocaine use was reported by 67% and multisubstance use was reported by 71%. Sexually transmitted disease (STD) risk behaviors were common. The prevalence of infection was as follows: Chlamydia trachomatis, 2.3%; Neisseria gonorrhoeae, 1.6%; trichomoniasis, 43%; and syphilis, 6%. CONCLUSIONS: STD counseling and screening may be a useful adjunct to inpatient drug treatment. PMID:11029998

  14. Under the shadow of Tuskegee: African Americans and health care.

    PubMed Central

    Gamble, V N

    1997-01-01

    The Tuskegee Syphilis Study continues to cast its long shadow on the contemporary relationship between African Americans and the biomedical community. Numerous reports have argued that the Tuskegee Syphilis Study is the most important reason why many African Americans distrust the institutions of medicine and public health. Such an interpretation neglects a critical historical point: the mistrust predated public revelations about the Tuskegee study. This paper places the syphilis study within a broader historical and social context to demonstrate that several factors have influenced--and continue to influence--African American's attitudes toward the biomedical community. PMID:9366634

  15. Immigration Policies and Issues on Health-Related Grounds for Exclusion

    DTIC Science & Technology

    2010-01-29

    diseases as a “communicable disease of public health significance”: HIV infection; chancroid; gonorrhea; granuloma inguinale; infectious leprosy...HIV infection, syphilis, chancroid, gonorrhea, granuloma inguinale, lymphogranuloma venereum, and Hansen’s disease) should also be sought. • a

  16. Genital sores - female

    MedlinePlus

    ... painless sores. Less common infections such as chancroid , granuloma inguinale , molluscum contagiosum , and syphilis may also cause ... Elsevier; 2016:chap 16. Read More Chancroid Donovanosis (granuloma inguinale) Genital herpes Genital warts Melanoma Molluscum contagiosum ...

  17. Neurosyphilis

    MedlinePlus

    ... risk of having neurosyphilis. View Full Definition Treatment Penicillin, an antibiotic, is used to treat syphilis. Individuals with neurosyphilis can be treated with penicillin given by vein, or by daily intramuscular injections ...

  18. Foreign body granuloma of the penis caused by occupational glass fibre exposure.

    PubMed Central

    Hinnen, U; Elsner, P; Barraud, M; Burg, G

    1997-01-01

    We report a patient who presented with the suspected diagnosis of syphilis. Clinical findings included a penile ulcer, positive history of syphilis more than 20 years ago, and positive syphilis serology (TPHA, FTA-Abs). A biopsy showed a plasma-cell rich inflammation with granuloma formation. Since a birefractory structure was observed in the biopsy possibly corresponding to a foreign body, the patient's occupational exposure was investigated. Working in the fiber reinforced plastics industry, he was heavily exposed to glass fibre that was even detected on the inside of his underwear. Taking the serological pattern into account that was not consistent with active syphilis, a penile ulcer following a foreign body reaction was diagnosed. This case report demonstrates the difficulties of differentiating foreign body granuloma of the genital region from venereal diseases with granuloma formation. Images PMID:9582491

  19. Stop the sores: the making and evaluation of a successful social marketing campaign.

    PubMed

    Plant, Aaron; Montoya, Jorge A; Rotblatt, Harlan; Kerndt, Peter R; Mall, Karen L; Pappas, Les G; Kent, Charlotte K; Klausner, Jeffrey D

    2010-01-01

    Los Angeles County has experienced a rapid increase in early syphilis among men who have sex with men (MSM) in recent years, with the number of cases rising from 126 in 2000 to 809 in 2005. As part of the public health response to this outbreak, a sustained social marketing campaign was launched in 2002, with the objectives of increasing syphilis testing, knowledge, and awareness among MSM in Los Angeles. This campaign, as implemented, exemplified key principles of social marketing, including market research, audience segmentation, and branding. A cross-sectional study conducted in 2004 to evaluate the campaign found that those MSM who were aware of the campaign were nearly twice as likely to have tested for syphilis in the past 6 months as those MSM who were not aware of the campaign. Those MSM who were aware of the campaign also had more syphilis awareness and knowledge in key areas.

  20. Eighteen ninety five and all that

    NASA Astrophysics Data System (ADS)

    Heilbron, J. L.; Bynum, W. F.

    1995-01-01

    Anniversarial commemorations this year include the discovery of X-rays, the calculation of the position of the undiscovered planet Neptune, the emergence of syphilis and the mandatory serving of lime juice to British sailors.

  1. Bad Science and Its Social Implications.

    ERIC Educational Resources Information Center

    Zeidler, Dana L.; Sadler, Troy D.; Berson, Michael J.; Fogelman, Aimee L.

    2002-01-01

    Investigates three types of bad science: (1) cultural prejudice based on scientific errors (polygenism, phrenology, reification through intelligence testing); (2) unethical science (Tuskegee syphilis experiments, tobacco companies and research); and (3) unwitting errors (pesticides, chlorofluorocarbons). (Contains 50 references.) (SK)

  2. The host-interacting proteins Tp0750 and Pallilysin; conservation among treponemes and restriction of proteolytic capacity to Treponema pallidum

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The spirochete Treponema pallidum is the causative agent of syphilis, a chronic, sexually transmitted bacterial infection characterized by multiple symptomatic and asymptomatic stages. Treponema pallidum is significantly more invasive than other treponemal species, being able to cross both the blood...

  3. Sexually transmitted infections, pregnancy, and breastfeeding

    MedlinePlus

    ... Genital herpes fact sheet Genital warts fact sheet Gonorrhea fact sheet HIV/AIDS Human papillomavirus (HPV) Pap ... sexually transmitted diseases, or STDs. STIs include chlamydia, gonorrhea, trichomoniasis, genital herpes, genital warts, HIV, and syphilis. ...

  4. 21 CFR 606.122 - Instruction circular.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... nonreactive for hepatitis B surface antigen by FDA required tests and nonreactive when tested for syphilis by... this product has the same hepatitis risk as Whole Blood; other plasma volume expanders without...

  5. Chlamydia

    MedlinePlus

    In men, chlamydia may cause symptoms similar to gonorrhea . Symptoms may include: Burning feeling during urination Discharge ... of sexually transmitted infection (STIs). Common STIs are gonorrhea, HIV, syphilis, hepatitis, and herpes . Even if you ...

  6. Chlamydia infections in women

    MedlinePlus

    ... other types of STIs. Most common STIs are: Gonorrhea HIV/AIDS Syphilis Hepatitis Herpes Even if you ... you from passing the STIs back and forth. Gonorrhea often occurs with chlamydia. Therefore, treatment for gonorrhea ...

  7. Skin Diseases and the Adolescent

    ERIC Educational Resources Information Center

    Bauer, Marjorie

    1970-01-01

    Discusses such concerns as acne, syphilis, drug abuse, and tatoos. Indicates need for physician not only to treat skin diseases but to help adolescents to accept themselves and find constructive directions. (CJ)

  8. PERSISTENT ULCER RESULTING FROM AN IXODID TICK BITE,

    DTIC Science & Technology

    ulcer) resembles acne vulgaris and impetigo, but differs from them by itching and also in that it does not heal rapidly. The nodule differs from tubercular-syphilis by absence of serpiginous development of the nodule. (Author)

  9. 38 CFR Appendix B to Part 4 - Numerical Index of Disabilities

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., subacute, or chronic. 5001 Bones and Joints, tuberculosis. 5002 Arthritis, rheumatoid (atrophic). 5003... Eye, injury of, unhealed. 6010 Eye, tuberculosis. 6011 Retina, localized scars. 6012 Glaucoma... Relapsing fever. 6309 Rheumatic fever. 6310 Syphilis. 6311 Tuberculosis, miliary. 6313 Avitaminosis....

  10. 38 CFR Appendix B to Part 4 - Numerical Index of Disabilities

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., subacute, or chronic. 5001 Bones and Joints, tuberculosis. 5002 Arthritis, rheumatoid (atrophic). 5003... Eye, injury of, unhealed. 6010 Eye, tuberculosis. 6011 Retina, localized scars. 6012 Glaucoma... Relapsing fever. 6309 Rheumatic fever. 6310 Syphilis. 6311 Tuberculosis, miliary. 6313 Avitaminosis....

  11. 38 CFR Appendix B to Part 4 - Numerical Index of Disabilities

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., subacute, or chronic. 5001 Bones and Joints, tuberculosis. 5002 Arthritis, rheumatoid (atrophic). 5003... Eye, injury of, unhealed. 6010 Eye, tuberculosis. 6011 Retina, localized scars. 6012 Glaucoma... Relapsing fever. 6309 Rheumatic fever. 6310 Syphilis. 6311 Tuberculosis, miliary. 6313 Avitaminosis....

  12. 76 FR 1433 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ... prevention and control of HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis, as well as for community-based HIV prevention activities, syphilis, and tuberculosis elimination programs... Tuberculosis Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC). Background and...

  13. 75 FR 45122 - Periodic Summaries of Proposed Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-02

    ... Service for the prevention and control of HIV infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB), as well as for community-based HIV prevention activities, syphilis,...

  14. 38 CFR Appendix B to Part 4 - Numerical Index of Disabilities

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., subacute, or chronic. 5001 Bones and Joints, tuberculosis. 5002 Arthritis, rheumatoid (atrophic). 5003... Eye, injury of, unhealed. 6010 Eye, tuberculosis. 6011 Retina, localized scars. 6012 Glaucoma... Relapsing fever. 6309 Rheumatic fever. 6310 Syphilis. 6311 Tuberculosis, miliary. 6313 Avitaminosis....

  15. 38 CFR Appendix B to Part 4 - Numerical Index of Disabilities

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., subacute, or chronic. 5001 Bones and Joints, tuberculosis. 5002 Arthritis, rheumatoid (atrophic). 5003... Eye, injury of, unhealed. 6010 Eye, tuberculosis. 6011 Retina, localized scars. 6012 Glaucoma... Relapsing fever. 6309 Rheumatic fever. 6310 Syphilis. 6311 Tuberculosis, miliary. 6313 Avitaminosis....

  16. Frontal bossing

    MedlinePlus

    Causes include: Acromegaly Basal cell nevus syndrome Congenital syphilis Cleidocranial dysostosis Crouzon syndrome Hurler syndrome Pfeiffer syndrome Rubinstein-Taybi syndrome Russell-Silver syndrome (Russell-Silver dwarf) Use ...

  17. Slippery Elm

    MedlinePlus

    ... is applied to the skin for wounds, burns, gout, rheumatism, cold sores, boils, abscesses, ulcers, toothaches, sore ... infection. Burns and wounds. Coughs. Colic. Constipation. Diarrhea. Gout. Hemorrhoids. Herpes. Rheumatism. Stomach ulcers. Syphilis. Tapeworm. Toothache. ...

  18. Medical Surveillance Monthly Report MSMR). Volume 5, Number 3, April 1999

    DTIC Science & Technology

    1999-04-01

    sexually transmitted diseases, US Army medical treatment facilities* March, 1999 Reporting Chlamydia Urethritis non-spec. Gonorrhea Syphilis Prim/Sec...II. Reportable sexually transmitted diseases, US Army medical treatment facilities* Cases per month, Apr 97 - Mar 99 Chlamydia Gonorrhea Syphilis...n=328,898), vision, hearing, dental, and gynecological examinations (n=276,373), contraceptive and normal pregnancy management (n=112,036), and

  19. Medical Surveillance Monthly Report (MSMR). Volume 15, Number 5, June 2008

    DTIC Science & Technology

    2008-06-01

    transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2007 2008 2007 2008 2007 2008 2007 2008 2007 2008 2007...transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis ‡ Urethritis§ Cold Heat 2007 2008 2007 2008 2007 2008 2007 2008 2007 2008...by facility. Reporting location Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis ‡ Urethritis

  20. Double-conjugate enzyme-linked immunosorbent assay for immunoglobulins G and M against Treponema pallidum.

    PubMed Central

    Farshy, C E; Hunter, E F; Larsen, S A; Cerny, E H

    1984-01-01

    An enzyme-linked immunosorbent assay (ELISA) for the simultaneous measurement of immunoglobulin G (IgG) and IgM was developed to detect antibodies to Treponema pallidum. Wells of polystyrene microtiter plates were coated with T. pallidum antigen, diluted patient serum was added, and IgG and IgM which bound to the T. pallidum antigen were measured by the simultaneous addition of alkaline phosphatase-labeled anti-human IgG and horseradish peroxidase-labeled anti-human IgM. Bound IgG was detected first, followed by bound IgM. After development of the procedure, 145 categorized sera were evaluated: 60 from individuals without syphilis; 62 from patients with syphilis, including 22 with primary, 20 with secondary, and 20 with latent phases of syphilis; and 23 from patients with rheumatoid arthritis. Of the 60 sera from individuals without syphilis, 100% were nonreactive for IgG antibody and 16% were reactive for IgM. Of the 23 sera from patients with rheumatoid arthritis, 3 were reactive for IgG and 3 were nonreactive for IgM. Of the 62 sera from patients with syphilis, 61 (98%) were reactive for IgG antibody with increased titers as the stage of syphilis increased, whereas IgM reactivity decreased. This enzyme-linked immunosorbent assay appears to be a simple method for the simultaneous measurement of antibodies under equal assay conditions. PMID:6394613

  1. Serological findings in leprosy and tuberculosis with the Wassermann, Meinicke, and VDRL tests

    PubMed Central

    Ruge, H.

    1955-01-01

    In the course of a venereal disease survey in Egypt, 820 cases of leprosy and 720 cases of tuberculosis were serologically examined with the Wassermann, Meinicke (MKR II), and VDRL tests; the results are reported in this paper. On serological and anamnestic evidence, 31 cases of syphilis were discovered among the leprosy cases and 37 among the tuberculosis cases. Apparently false positive reactions were seen in 203 cases of leprosy (25%) and in 38 cases of tuberculosis (5%). The author discusses the probability that a fairly high proportion of these reactions were in fact caused by otherwise undetected syphilis or were non-specific. The Meinicke test proved the most specific of the three, followed, in that order, by the Wassermann and the VDRL tests. It was found that syphilis was more frequent among males with tuberculosis than among those with leprosy; this is attributed to the fact that leprosy patients are kept in greater isolation. Less easily explicable is the fact that more females than males with leprosy were found to have syphilis, whereas in tuberculous persons the difference in syphilis incidence between male and female patients was not very great. PMID:13284561

  2. Evaluating outcome-correlated recruitment and geographic recruitment bias in a respondent-driven sample of people who inject drugs in Tijuana, Mexico.

    PubMed

    Rudolph, Abby E; Gaines, Tommi L; Lozada, Remedios; Vera, Alicia; Brouwer, Kimberly C

    2014-12-01

    Respondent-driven sampling's (RDS) widespread use and reliance on untested assumptions suggests a need for new exploratory/diagnostic tests. We assessed geographic recruitment bias and outcome-correlated recruitment among 1,048 RDS-recruited people who inject drugs (Tijuana, Mexico). Surveys gathered demographics, drug/sex behaviors, activity locations, and recruiter-recruit pairs. Simulations assessed geographic and network clustering of active syphilis (RPR titers ≥1:8). Gender-specific predicted probabilities were estimated using logistic regression with GEE and robust standard errors. Active syphilis prevalence was 7 % (crude: men = 5.7 % and women = 16.6 %; RDS-adjusted: men = 6.7 % and women = 7.6 %). Syphilis clustered in the Zona Norte, a neighborhood known for drug and sex markets. Network simulations revealed geographic recruitment bias and non-random recruitment by syphilis status. Gender-specific prevalence estimates accounting for clustering were highest among those living/working/injecting/buying drugs in the Zona Norte and directly/indirectly connected to syphilis cases (men: 15.9 %, women: 25.6 %) and lowest among those with neither exposure (men: 3.0 %, women: 6.1 %). Future RDS analyses should assess/account for network and spatial dependencies.

  3. Evaluating outcome-correlated recruitment and geographic recruitment bias in a respondent-driven sample of people who inject drugs in Tijuana, Mexico

    PubMed Central

    Rudolph, Abby E.; Gaines, Tommi L.; Lozada, Remedios; Vera, Alicia; Brouwer, Kimberly C.

    2015-01-01

    Respondent-driven sampling’s (RDS) widespread use and reliance on untested assumptions suggests a need for new exploratory/diagnostic tests. We assessed geographic recruitment bias and outcome-correlated recruitment among 1048 RDS-recruited people who inject drugs (Tijuana, Mexico). Surveys gathered demographics, drug/sex behaviors, activity locations, and recruiter-recruit pairs. Simulations assessed geographic and network clustering of active syphilis (RPR titers≥1:8). Gender-specific predicted probabilities were estimated using logistic regression with GEE and robust standard errors. Active syphilis prevalence was 7% (crude: men=5.7% and women=16.6%; RDS-adjusted: men=6.7% and women=7.6%). Syphilis clustered in the Zona Norte, a neighborhood known for drug and sex markets. Network simulations revealed geographic recruitment bias and non-random recruitment by syphilis status. Gender-specific prevalence estimates accounting for clustering were highest among those living/working/injecting/buying drugs in the Zona Norte and directly/indirectly connected to syphilis cases (men:15.9%, women:25.6%) and lowest among those with neither exposure (men:3.0%, women:6.1%). Future RDS analyses should assess/account for network and spatial dependencies. PMID:24969586

  4. Yaws

    PubMed Central

    Lebari, Dornubari; Solomon, Anthony W; Higgins, Stephen P

    2014-01-01

    Yaws is a non-venereal endemic treponemal infection caused by Treponema pallidum sub-species pertenue, a spirochaete bacterium closely related to Treponema pallidum ssp. pallidum, the agent of venereal syphilis. Yaws is a chronic, relapsing disease predominantly affecting children living in certain tropical regions. It spreads by skin-to-skin contact and, like syphilis, occurs in distinct clinical stages. It causes lesions of the skin, mucous membranes and bones which, without treatment, can become chronic and destructive. Treponema pallidum ssp. pertenue, like its sexually-transmitted counterpart, is exquisitely sensitive to penicillin. Infection with yaws or syphilis results in reactive treponemal serology and there is no widely available test to distinguish between these infections. Thus, migration of people from yaws-endemic areas to developed countries may present clinicians with diagnostic dilemmas. We review the epidemiology, clinical presentation and treatment of yaws. PMID:25193248

  5. Brief Report: Gonorrhea and Chlamydia Testing Increasing but Still Lagging in HIV Clinics in the United States.

    PubMed

    Berry, Stephen A; Ghanem, Khalil G; Mathews, William Christopher; Korthuis, Philip Todd; Yehia, Baligh R; Agwu, Allison L; Lehmann, Christoph U; Moore, Richard D; Allen, Sara L; Gebo, Kelly A

    2015-11-01

    Screening persons living with HIV for gonorrhea and chlamydia has been recommended since 2003. We compared annual gonorrhea/chlamydia testing to syphilis and lipid testing among 19,368 adults (41% men who have sex with men, 30% heterosexual men, and 29% women) engaged in HIV care. In 2004, 22%, 62%, and 70% of all patients were tested for gonorrhea/chlamydia, syphilis, and lipid levels, respectively. Despite increasing steadily [odds ratio per year (95% confidence interval): 1.14 (1.13 to 1.15)], gonorrhea/chlamydia testing in 2010 remained lower than syphilis and lipid testing (39%, 77%, 76%, respectively). Interventions to improve gonorrhea/chlamydia screening are needed. A more targeted screening approach may be warranted.

  6. Lesões vesiculares e prurido intenso em paciente com sífilis secundária:manifestação clínica atípica.

    PubMed

    Duarte Bezerra Pinto, Roberta; Rubim Bellott Batista Nascimento, Thiago; Pacheco Bicalho de Andrade, Jhéssica; Policarpo, Fernanda; Ribeiro Estrella, Rogério; Guedes Vilar, Enoi

    2016-06-15

    Syphilis is an infectious disease with mucocutaneous lesions that are characteristic of their stage (primary, secondary, or tertiary). These are not always typical and may have other morphologies and unusual symptoms, making diagnosis difficult. The report herein is of a healthy woman with vesicular lesions associated with intense itching.  The diagnosis of secondary syphilis was confirmed with VDRL 1/512 and FTA Abs positive.  Histopathology showed spongiosis in the epidermis and infiltrated lymphocytes and plasma cell in the dermis.  Clinical improvement occurred after the first dose of benzathine penicillin. In the literature, few cases of vesicular lesions in syphilis have been found and itching is mentioned as uncharacteristic . Histology showing spongiosis is also unusual.

  7. Invoking "Tuskegee": problems in health disparities, genetic assumptions, and history.

    PubMed

    Reverby, Susan M

    2010-08-01

    Since 1972 the word "Tuskegee" has functioned as a metaphor for racism, paternalism, and deadly deception in government-sponsored medical research. There remain new lessons to be considered. We must understand how concepts of race become spoken and written about and then embedded in science that has racist implications. We have to consider how the researchers in the Tuskegee syphilis study assumed that syphilis was almost a different disease in Blacks and Whites, and yet were eager to make race disappear as the study's results would be used to generalize the concern for the dangers of syphilis. If we only look at what happened in that study as the past, or learn from it in narrow ways, we are in danger of re-creating the thinking that made it possible in the first place.

  8. Importance of the so-called 'other' sexually-transmitted diseases.

    PubMed

    Willcox, R R

    1975-08-01

    (1) Some data are presented concerning the frequency and potential morbidity of sexually-transmitted organisms other than T. pallidum or N. gonorrhoeae. (2) Most of the diseases with which these organisms are associated are more prevalent than syphilis and some, at least in one sex, are as common as gonorrhoea. A number appear to carry considerable morbidity, which in the case of Type II herpes virus--if it is responsible for cervical cancer--may ultimately cause more fatalities than syphilis. (3) It is concluded: (a) that, if syphilis and gonorrhoea were reduced to the point of representing no public health concern, many other sexually-transmitted conditions would still remain to pose significant problems: and (b) that health education and other methods of prevention should, where possible, be designed to take into consideration the epidemiological implications of the other organisms listed.

  9. Neurosyphilis in a Man with Human Immunodeficiency Virus

    PubMed Central

    Sadeghani, Khosro; Kallini, Joseph R.

    2014-01-01

    The authors describe a 33-year-old man with human immunodeficiency virus who developed erythematous macules on the palms and soles with subsequent headaches, papilledema, and iritis. They review the salient characteristics of neurosyphilis with a focus on human immunodeficiency virus-positive individuals. The incidence of syphilis has increased since the year 2000 in African Americans, Hispanics, and men who have sex with men. Treponema pallidum is the causative agent of this disease—a fastidious, slowly growing, microaerophilic spirochete. Sexual contact is the most common mode of transmission. The rapid plasma reagin, Venereal Disease Research Laboratory assay, and fluorescent treponemal antibody absorption assay are commonly used to diagnose syphilis. The mainstay treatment is penicillin. Special considerations exist in the natural history and management of syphilis in the setting of human immunodeficiency virus. PMID:25161759

  10. Sexual Risk Behaviors and HIV Infection among Men Who Have Sex with Men Who Use the Internet in Beijing and Urumqi, China

    PubMed Central

    Zou, Huachun; Wu, Zunyou; Yu, Jianping; Li, Min; Ablimit, Muhtar; Li, Fan; Pang, Lin; Juniper, Naomi

    2010-01-01

    Objectives To assess HIV and syphilis infections among men who have sex with men who use the Internet (MSMUI) and their risk behaviors. Methods In 2007, 429 MSMUI were recruited via the Internet in Beijing and Urumqi, China. A questionnaire was administered, and a blood specimen collected and tested for HIV and syphilis. Results Median age of participants was 25 years. Median number of lifetime sexual partners was 10. Ninety point seven percent ever had sex with a cyber-friend. Rates of condom use in the last oral, insertive and receptive anal sex were 9.1%, 66.3% and 60.4% respectively. Infection rates of HIV, syphilis and HIV/syphilis co-infection were 4.8%, 11.4%, and 1.7% respectively. Factors associated with HIV infection were being ≤24 years (OR=2.85, 95% CI: 1.05–7.75), syphilis positive (OR=4.78, 95% CI: 1.68–13.58), used non-water-based liquid as lubricant (OR=8.03, 95% CI: 1.03–62.52) and having bleeding gums or oral ulcers during condom-free oral sex (OR=3.17, 95% CI: 1.13–8.88). Conclusions MSMUI engage in high-risk sexual behaviors and have a high prevalence of HIV and syphilis infections. The internet is the predominant venue for the majority of MSMUI to find sexual partners. It is urgent to implement effective intervention programs targeting this group. PMID:20104115

  11. Acute hypophysitis and hypopituitarism in early syphilitic meningitis in a HIV-infected patient: a case report

    PubMed Central

    2013-01-01

    Background Sexually transmitted diseases and most notably syphilis-infections are rising amongst men who have sex with men. In HIV-co-infected patients, an accelerated clinical course of syphilis neurological involvement is known. Case presentation A 46 year old HIV-positive male patient came in to our emergency department in the late evening with acute fever, rapidly progressive cephalgia and photophobia. Palmar skin efflorescence was evocative of an active syphilis infection. A reactive Treponema pallidum particle agglutination (TPPA) assay with positive Treponema pallidum-specific IgG/IgM immunofluorescence as well as a highly reactive Veneral diseases research laboratory (VDRL) test confirmed the diagnosis. Liquor pleocytosis, liquor protein elevation and a highly positive VDRL test in cerebrospinal fluid (CSF) were interpreted in context of the clinical symptoms as neurosyphilitic manifestations within an early syphilis infection (stage II). Cranial nuclear magnetic resonance scans of the sella turcica, which were performed due to low thyroidea stimulation hormone (TSH) and thyroxin levels, showed signs of hypophysitis such as pituitary gland enlargement and inhomogeneous contrast enhancement. Advanced endocrine laboratory testing revealed hypopituitarism. Fourteen days of intravenous ceftriaxone treatment and levothyroxine- and hydrocortisone-substitution led to complete disappearance of all clinical symptoms. Two months later, nuclear magnetic resonance scan showed normal pituitary size and that the syphilis serology had normalized. Conclusion We report to the best of our knowledge the first case of a HIV-positive patient with acute hypophysitis and hypopituarism due to early neurosyphilis infection. Ceftriaxone treatment and levothyroxine- and hydrocortisone-substitution led to the disappearance of all clinical symptoms. We strongly recommend to exclude syphilis infection in every clinical situation unclear in HIV-patients, especially when additional risk

  12. Increase in sexually transmitted infections among homosexual men in Amsterdam in relation to HAART

    PubMed Central

    Stolte, I.; Dukers, N.; de Wit, J. B F; Fennema, J.; Coutinho, R.

    2001-01-01

    Objectives: We investigated if a rise in rectal gonorrhoea and early syphilis among men who have sex with men (MSM) in Amsterdam coincided with the introduction of highly active antiretroviral therapies (HAART) in July 1996 and determined risk factors for these sexually transmitted infections (STI). Methods: Subjects were patients of the STI clinic of the municipal health service in Amsterdam. Surveillance data (1994–9) represented consultations (n=11 240) of MSM (n=6103). For analyses we used logistic regression. Results: Comparing the periods before and after the introduction of HAART, the infection rate for rectal gonorrhoea increased from 4% to 5.4% (p=.001) and for syphilis, from 0.5% to 0.8% (p = 0.050). Independent risk factors for rectal gonorrhoea (younger age, western nationality, and concurrent infection with another STI) and for early syphilis (non-western nationality and concurrent infection with rectal gonorrhoea) did not change after HAART became available. For rectal gonorrhoea, however, the infection rate increased only among men who had exclusively homosexual contacts (OR 1.38, p<0.01), compared with bisexual men. For early syphilis, the infection rate increased only among men of western nationality (OR 3.38, p<0.01) compared to men of non-western nationality. Conclusions: Infection rates of rectal gonorrhoea and early syphilis increased, indicating a change in sexual behaviour, possibly as a result of the introduction of HAART. For now, it is important to find out how sexual behaviour is changing and to keep monitoring trends in STIs (including HIV) among MSM in Amsterdam. Key Words: rectal gonorrhoea; syphilis; HAART; high risk sexual behaviour; MSM PMID:11402225

  13. An Audit of VDRL Testing from an STI Clinic in India: Analysing the Present Scenario with Focus on Estimating and Optimizing the Turnaround Time

    PubMed Central

    Mehra, Bhanu; Rawat, Deepti; Saxena, Shikhar

    2015-01-01

    Background Timeliness of reporting is of utmost importance to limit the spread of syphilis. The present analysis was undertaken to evaluate the turnaround time of syphilis testing (mainly Venereal disease research laboratory /VDRL test) in a sexually transmitted infections (STI) clinic in India; to find out the possible reasons for delay; to describe the trends of clinical indications for syphilis testing from an STI clinic; to assess the frequency of a positive syphilis serology among STI clinic attendees; and to analyse the follow-up rates of VDRL report collection. Materials and Methods Two hundred consecutive VDRL requests received at the serology laboratory of a tertiary care health facility from the STI clinic of the linked hospital were prospectively analysed to evaluate the above parameters. Results For the 200 requests audited, the mean absolute turnaround time of VDRL test was 7.46±2.81 days. The mean duration of the pre-laboratory, laboratory and post laboratory phases was 0, 4.69±2.13 and 2.77±2.51 days respectively. The interval from specimen receipt to performance of tests (mean duration=4.25±1.96 days) was the major reason for long VDRL turnaround time. The common indications for syphilis testing in STI clinic attendees were lower abdominal pain (33%), vaginal discharge (26.5%) and genital ulcer disease (9%); and the follow-up rate for report collection was 71%. Conclusion Our study highlights the strong need to shift to alternative testing methods, mainly rapid point of care procedures for serodiagnosis of syphilis in order to circumvent the problems of long turnaround time and low patient follow-up rates. PMID:26435966

  14. [Panuveitis with oral and genital ulcer misdiagnosed as Behcet's disease: two cases report and literature review].

    PubMed

    Wang, Y; Yang, L; Zhang, Z L

    2016-10-18

    Here we reported two patients who presented with panuveitis and were transferred from ophthalmologists to rheumatologists, for both the patients had oral and genital ulcers. They were misdiagnosed with Behcet's disease at first glance. Two young males presented with acute uveitis with history of recurrent oral and genital ulcers. They initially presented with symptoms and signs resembling Behcet's disease and were treated with systemic steroids with suboptimal responses. Routine laboratory test revealed syphilis and human immunodeficiency virus (HIV) infection. After treatment of penicillin and anti HIV virus therapy, the panuveitis was relived. The other patient was lost in the follow up. Recently epidemiological data indicate that syphilis and HIV infection increase, which can mimic the manifestation of Behcet's disease. Diagnosis of sexual transmitted diseases, such as HIV or syphilis needs to be ruled out in all cases that mimic the clinical feature of Behcet's disease, especially for those who had a history of high risk behaviors. Every patient should have history analysis in detail. Screening of sexual transmitted diseases, such as HIV or syphilis is important especially in those rapid progressive panuveitis. Also, other virus infections, such as cytomegalovirus, epstein-barr virus or Herpes simplex virus can cause mucosa ulcers and uveitis. CD4 T cell count is a very important marker to indicate that the patient has immunodeficiency. Erythema nodosa and pseudofolliculitis are the third common clinical manifestation in Chinese Behcet's disease patients. Rheumatologist should watch out for patients without skin involvement when making the diagnosis of Behcet's disease. Syphilis-associated uveitis usually has a good prognosis. Treatment of antibiotics can get good response, 92% uveitis can be relieved, with 67% improved vision. Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a clinically and angiographically distinct manifestation of ocular

  15. Rare presentation of ruptured syphilitic aortic aneurysm with pseudoaneurysm.

    PubMed

    de Almeida Feitosa, Israel Nilton; Dantas Leite Figueiredo, Magda; de Sousa Belem, Lucia; Evelin Soares Filho, Antônio Wilon

    2015-11-01

    We report the interesting case of a rare form of presentation of rupture of the ascending aorta with formation of a pseudoaneurysm, diagnosed following the development of a large mass on the surface of the chest over a period of about eight months. Serological tests were positive for syphilis. Echocardiography and computed tomography angiography were essential to confirm the diagnosis and therapeutic management. Cardiovascular syphilis is a rare entity since the discovery of penicillin. Rupture of an aortic aneurysm with formation of a pseudoaneurysm is a potentially fatal complication. The postoperative period was uneventful and the patient was discharged from hospital within days of surgery.

  16. Jarisch-Herxheimer reaction in a patient with neurosyphilis.

    PubMed Central

    Zifko, U; Lindner, K; Wimberger, D; Volc, B; Grisold, W

    1994-01-01

    A 40 year old man presented with progressive personality changes in the previous six months. Specific serological tests for syphilis in blood and CSF were highly positive and CSF sedimentation showed signs of an inflammatory process. Ten hours after the start of penicillin treatment a severe symptomatic Jarisch-Herxheimer reaction with alteration of level of consciousness, pupillary changes, and focal neurological signs developed. Jarisch-Herxheimer reaction may occur in various settings, particularly in the treatment of syphilis. Investigation of CSF before the treatment may predict a potential risk. Corticosteroid treatment has been suggested for prevention. PMID:8021683

  17. Unilateral sudden hearing loss due to otosyphilis.

    PubMed

    de Goffau, Maaike J; Doelman, Jan C; van Rijswijk, Jeroen B

    2011-09-28

    The differential diagnosis of sudden hearing loss is very extensive. However, in most patients, no underlying pathology will be found and the patient is consequently diagnosed with idiopathic sudden hearing loss. Nevertheless, it is important that one stays alert in everyday routine practice to less common but potentially treatable pathology. We report a case of a 53-year old patient with sudden unilateral hearing loss and tinnitus caused by otosyphilis. Diagnosis, therapy and the incidence of (oto)syphilis are discussed. Also, as ENT-surgeons, it is important to realise that syphilis is still with us, and that its prevalence might well increase in the near future.

  18. HIV Risk Perception and Behavior among Sex Workers in Three Major Urban Centers of Mozambique

    PubMed Central

    Langa, Judite; Sousa, César; Sidat, Mohsin; Kroeger, Karen; McLellan-Lemal, Eleanor; Belani, Hrishikesh; Patel, Shama; Shodell, Daniel; Shodell, Michael; Benech, Irene; Needle, Richard

    2014-01-01

    HIV risk perceptions and behaviors of 236 commercial sex workers from three major Mozambican urban centers were studied using the International Rapid Assessment, Response and Evaluation (I-RARE) methodology. All were offered HIV testing and, in Maputo, syphilis testing was offered as well. Sixty-three of the 236 opted for HIV testing, with 30 (48%) testing positive for HIV. In Maputo, all 30 receiving HIV tests also had syphilis testing, with 6 (20%) found to be positive. Results include interview excerpts and qualitative results using I-RARE methodology and AnSWR-assisted analyses of the interviews and focus group sessions. PMID:24736653

  19. [Syphilitic orchitis: a case report].

    PubMed

    Sekita, Nobuyuki; Nishikawa, Rika; Fujimura, Masaaki; Sugano, Isamu; Mikami, Kazuo

    2012-01-01

    Tertiary syphilis is recently a rare disease in Japan. In this paper, we report a rare case of syphilitic orchitis. The patient was in his early forties. The left scrotal contents were swelling and a low echoic nodule measuring about 30 mm in diameter was detected on ultrasonography. Serum alpha fetoprotein, lactate dehydrogenase, and beta subunit of human chorionic gonadotropin were within the normal range, whereas Treponema pallidum hemagglutination assay and rapid plasma reagin were strongly positive. High orchiectomy was performed for suspicion of testicular tumor. Histological findings showed the non-specific inflammatory granuloma with lympho-plasmatic infiltration. It was diagnosed as granulomatous inflammation of left testis caused by syphilis.

  20. Hieronymi Fracastorii: the Italian scientist who described the "French disease"*

    PubMed Central

    Pesapane, Filippo; Marcelli, Stefano; Nazzaro, Gianluca

    2015-01-01

    Girolamo Fracastoro was a true Italian Renaissance man: he excelled in literature, poetry, music, geography, geology, philosophy, astronomy and, of course, medicine to the point that made Charles-Edward Armory Winslow define him as "a peak unequaled by anyone between Hippocrates and Pasteur". In 1521 Fracastoro wrote the poem "Syphilis Sive de Morbo Gallico" in which was established the use of the term "syphilis" for this terrible and inexplicably transmitted disease, often referred to as "French disease" by the people of the time and by Fracastoro himself. PMID:26560214