The return of syphilis to the United States

The return of syphilis to the United States

Archived (at least in the news) the alarm for monkeypox , in the United States worries about the return of syphilis and a general increase in sexually transmitted diseases. Facts, data and a brief history of the French malady

In the United States there is an emergency for cases of sexually transmitted diseases. Eyes focused above all on the French malady, syphilis. The alarm was raised by the Washington Post, citing data from the Centers for Disease Control and Prevention (CDC).


Infection rates for some sexually transmitted diseases (STDs) have been on the rise for years, the Washington Post says. Last year the rate of syphilis cases, with a 26% increase in new infections, peaked since 1991 and the total number of cases peaked since 1948. HIV cases are also on the rise, with an increase of 16% last year.

Source: Cdc

For David Harvey, executive director of the National Coalition of STD Directors, the situation is "out of control" and, in fact, the increase in cases, defined as "dizzying" by the article, is pushing US health authorities to call for new prevention efforts and treatment.

In 2020, there were almost 41,700 cases of syphilis and last year they exceeded 52,000 with an incidence rate of about 16 people per 100,000 – the highest in the last thirty years.

Source: Cdc


In addition to a minor, one of the condoms, which remain the most important tool for preventing all STDs, according to experts reported by the Associated Press , the increase in cases may also be due to other causes such as "inadequate funding" to support prevention and “Delays in diagnosis and treatment” due to the pandemic and also “the use of drugs and alcohol which may have contributed to risky sexual behavior”.


Syphilis, a disease with more than 400 different names that identify it and known for famous deaths such as those of Robert Schumann, Guy de Maupassant and Paul Gauguin, is an STD caused by the bacterium Treponema pallidum .

Its origin remains a mystery. Difficult to date it with precision, the first epidemic dates back to 1495 precisely in Italy, in Naples, after the descent into the peninsula of the French king Charles VIII with his army. When this moved north, the disease spread throughout the country and in Europe, reaching as far as the East. This explains why the name by which it is known throughout Europe is mal French , except in France, where it has instead taken the name of mal napolitain .

Worldwide, according to the Higher Institute of Health (ISS), it is the third most common bacterial STD after chlamydia and gonorrhea. Serological tests are available to identify it.

It is also transmitted through the blood and, in pregnancy, especially after the third month, the mother can infect the fetus, in this case it is congenital. In the United States, the Washington Post writes, a decade ago there were only 300 annual cases of congenital syphilis; last year they rose to nearly 2,700 and 211 of these cases involved children who died even before they were born or infant deaths.

Source: Cdc


Syphilis develops in several stages: primary, secondary, latent, late. Each stage has different duration and symptoms, ranging from ulcers on the genitals, anus, mouth and throat to pink spots on the trunk and limbs. If these visible manifestations disappear naturally, the disease, on the other hand, if not treated, continues its course until the latent stage.

This phase can last up to two years, the symptoms are absent but the person is still ill. However, most people, if treated correctly, recover.

The late stage, on the other hand, occurs many years after the infection (10-30 years), if the disease has not been treated. At this point, as the ISS reports, it can affect any organ and the most serious manifestations, which can cause death, are those affecting the cardiovascular system and the central nervous system, while the milder ones affect the skin. Bones, tendons, stomach, liver, spleen and lungs may also be affected at this stage.


The antibiotic therapy of choice for the treatment of syphilis, says the ISS, is the use of parenteral penicillin. The preparation, dosage and duration of treatment depend on the stage of the disease and its clinical manifestations.

Penicillin has been shown to be highly effective in preventing the transmission of the infection to the fetus in pregnant women with syphilis.

In addition to antibiotic treatment, the infected person must refrain from any sexual activity until the lesions have completely healed. Furthermore, it is necessary to carry out diagnostic tests and treatment on sexual partners as well. A previous infection does not confer permanent immunity to a subject who has been adequately treated and cured, who can therefore become infected again in the event of a new exposure.


Prevention, as in all STIs, is based on the use of condoms in all casual sexual intercourse, with each new partner and with each partner whose state of health is unknown.


The US health authorities, according to the Associated Press , are working on new approaches to tackle the surge in cases, thinking, for example, of a home test for STDs in order to identify them and be able to treat them as soon as possible. But, as another expert remarked, "a key part of any effort must work to increase the use of condoms."

Harvey's group and some other public health organizations are pursuing a proposal for more federal funding, including at least $ 500 million for dedicated STD clinics and Leandro Mena, director of the Cdc's STD Prevention Division, is is striving to reduce stigma, expand screening and treatment services, and support the development and accessibility of home testing.

Source: Cdc

This is a machine translation from Italian language of a post published on Start Magazine at the URL on Tue, 04 Oct 2022 08:53:02 +0000.