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• W4241234578 abstract "The first cases of syphilis in Europe were reported over 500 years ago in French soldiers invading Naples, Italy. Since then, the disease has been known by many names, including the great imitator, on account of its broad range of clinical manifestations in addition to genital lesions, and has been well described in the scientific and historical literature. Today, syphilis is readily treated with penicillin, and although common in low-income and middle-income countries where it is often associated with co-infection with HIV, it is scarce in developed settings. Yet syphilis has once again re-emerged in a high-income country, with more than 80 cases being diagnosed in Oklahoma county, OK, USA, over the past few months. The outbreak has spread among intravenous drug users injecting metamfetamine or heroin. The recent outbreak is a reminder that this oft forgotten and highly stigmatised disease remains a threat to public health. In today's Lancet, a new Seminar from Edward W Hook 3rd, focuses on diagnosis and recognition of clinical symptoms, disease management, and prevention strategies for syphilis. Caused by infection with Treponema pallidum, syphilis is generally sexuallly transmitted, but can also be spread by contact with open lesions, blood transfusions, needle sharing, or congenitally. Risk of transmission is highest in the first 2–3 years of infection, after which morbidities, in particular neurosyphilis, are of major concern. Control strategies must move beyond primary prevention interventions such as condom use and abstinence. In 1937, US Surgeon General Thomas Parran, recommended widespread testing, improved public and professional education, timely treatment, and continued research. 80 years later, these recommendations continue to hold true. At-risk populations, such as intravenous drug users and men who have sex with men, should be monitored closely, and blood donor and prenatal screening for syphilis are important measures for preventing syphilis outbreaks. Although far less common now than in the past, syphilis continues to pose a danger to public health and should not be overlooked. SyphilisSyphilis is a chronic bacterial infection caused by Treponema pallidum that is endemic in low-income countries and and occurs at lower rates in middle-income and high-income countries. The disease is of both individual and public health importance and, in addition to its direct morbidity, increases risk of HIV infection and can cause lifelong morbidity in children born to infected mothers. Without treatment the disease can progress over years through a series of clinical stages and lead to irreversible neurological or cardiovascular complications. Full-Text PDF Stillbirth caused by syphilis remains a major global health problemWe read with interest the Seminar by Edward W Hook 3rd (April 15, p 1550),1 but were disappointed that the major public health importance of mother-to-child transmission of syphilis was not mentioned. According to WHO estimates, syphilis caused 350 000 adverse pregnancy outcomes in 2012,2 and The Lancet Series3 on ending preventable stillbirths highlighted that syphilis causes 200 000 stillbirths annually. These adverse outcomes can be prevented with a single dose of penicillin,4 which is one of the most cost-effective health interventions available. Full-Text PDF Syphilis in childrenThe Seminar on syphilis by Edward W Hook 3rd (April 15, p 1550)1 is interesting; however, it does not adequately address the disease characteristics and management in children and therefore should rather have been entitled “syphilis in adults”. Full-Text PDF" @default.
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• W4241234578 date "2017-04-01" @default.
• W4241234578 modified "2023-09-26" @default.
• W4241234578 title "Syphilis: an ancient disease in a modern era" @default.
• W4241234578 doi "https://doi.org/10.1016/s0140-6736(17)30996-0" @default.
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