Syphilis Essay

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Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. In most cases, syphilis infection is caused by the transmission of the organism during sexual contact. It can also be passed from mother to infant during pregnancy, resulting in congenital syphilis. Because the symptoms of syphilis are diverse and resemble those of many other diseases, the infection is often referred to as the Great Imitator.

Common early signs and symptoms include painless ulcers on the genitalia and fever. Syphilis can be cured with penicillin in the early stages of infection, while untreated syphilis can progress to cause severe and permanent damage to the cardiovascular and nervous systems, resulting in disability and sometimes death. Advances in clinical screening and treatment combined with ongoing public health programs have greatly decreased the occurrence of late-stage syphilis in developed countries. New cases of syphilis continue to pose a public health burden throughout the world.

The World Health Organization (WHO) estimates that in 1999, there were 11.76 million new cases of syphilis among adults worldwide, down from 12.22 million in 1995. Syphilis incidence increased in eastern Europe, central Asia, sub-Saharan Africa, Latin America, and the Caribbean. The largest increase occurred in Latin America and the Caribbean, where new cases more than doubled from 1.26 million in 1995 to 2.93 million in 1999. At least half a million babies are born with congenital syphilis each year, while another half million are stillborn or miscarried due to maternal syphilis.

In response to these alarming statistics, the WHO has made elimination of congenital syphilis one of its global health priorities. In less developed areas, syphilis screening and clinical diagnosis can be difficult and imprecise without laboratory testing, and the infection must be treated with medication to prevent transmission. These clinical resources are not available or accessible for many millions of people throughout the world. Tracking syphilis in an effort to focus on elimination programming is challenging, because no single organization conducts syphilis surveillance globally.

While there is emerging evidence that some form of syphilis may have existed in Europe prior to the 15th century, the major societal impact of syphilis dates back to contact with the Americas after 1492, when the disease made its way back to Europe and swept across the continent. Over the past 500 years, views of syphilis have evolved with society’s changing morals and beliefs about sexuality and gender, pushed along in the 20th century by improved understanding of infectious diseases. In more recent years, much attention has been given to the parallels between the social and political histories of syphilis and the HIV/AIDS epidemic.

The direct social impact of syphilis in the United States came to light in the early 1970s, with the Tuskegee Study (1932-72). Originally commissioned to document the progression of untreated syphilis in poor African-American males, participants were told by researchers that they were being treated for “bad blood,” and were provided free medical examinations and burial insurance. Although penicillin was declared the drug of choice for syphilis in 1947, researchers-with support from professional medical and health services organizations-continued documenting the ravages of untreated syphilis. Fallout from the Tuskegee Study significantly impacts the way clinical research is conducted today, including careful oversight of research proposals and mandated informed consent.

Current and ongoing eradication and reduction efforts, along with ever-changing societal beliefs and knowledge of STDs and sexuality, will determine the future global impact of syphilis.

References:

  1. National Institute of Allergy and Infectious Diseases, “Syphilis,” www.niaid.nih.gov;
  2. Claude Quetel, The History of Syphilis (Johns Hopkins University Press, 1992);
  3. U.S. Centers for Disease Control and Prevention, “Syphilis,” www.cdc.gov;
  4. World Health Organization, “Syphilis,” www.who.int.

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