Syphilis Makes Comeback in Europe

Syphilis is back: The sexually transmitted disease long associated with 19th-century bohemian life is making an alarming resurgence in Europe. ''Syphilis used to be a very rare disease,'' said Marita van de Laar, MD, an expert in sexually transmitted diseases at the European Centre for Disease Prevention and Control. ''I'm not sure we can say that anymore.'' Most cases of syphilis are in men, and experts point to more risky sex among gay men as the chief cause for the resurgence. But more cases are being seen among heterosexuals, both men and women, too.

BY admin

December 22 2007 1:00 AM ET

Syphilis is back:
The sexually transmitted disease long associated with
19th-century bohemian life is making an alarming resurgence
in Europe.

''Syphilis used
to be a very rare disease,'' said Marita van de Laar, MD,
an expert in sexually transmitted diseases at the European
Centre for Disease Prevention and Control. ''I'm not
sure we can say that anymore.''

Most cases of
syphilis are in men, and experts point to more risky sex
among gay men as the chief cause for the resurgence. But
more cases are being seen among heterosexuals, both
men and women, too.

Syphilis was the
sexual scourge of the 19th century and is believed to
have killed artists like poet Charles Baudelaire, composer
Robert Schumann, and painter Paul Gauguin. But the
widespread use of penicillin in the 1950s all but
wiped it out in the Western world.

In the last
decade, however, syphilis has unexpectedly returned, driven
by risky sexual behavior and outbreaks in major cities
across Europe, including London, Amsterdam, Paris, and
Berlin.

– In the
United Kingdom syphilis cases have leaped more than
10-fold for men and women in the past decade to 3,702
in 2006, according to the Health Protection Agency.
Among men in England, the syphilis rate jumped from
one per 100,000 in 1997 to nine per 100,000 last year.

– In
Germany the rate among men was fewer than two per 100,000 in
1991; by 2003, it was six per 100,000.

– In
France there were 428 cases in 2003 -- almost 16 times the
number just three years earlier.

– In the
Netherlands cases doubled from 2000 to 2004. In Amsterdam up
to 31 men per 100,000 were infected, while the rate
was much lower in other regions.

Similar trends
have been seen in the United States.

In 2000 syphilis
infection rates were so low that the Centers for Disease
Control and Prevention embarked on a plan to eliminate the
disease. But about 9,800 cases were reported in 2006.

Van de Laar said
syphilis's reappearance was so surprising that many
doctors initially had trouble diagnosing the disease.

Though syphilis
these days mainly affects urban gay men, experts worry
that the disease could also rebound in the general
population if stronger efforts to fight it are not
taken soon.

In 2005, U.K.
authorities reported that syphilis was spreading across the
entire country and that more heterosexual men and women were
being infected.

''These increases
may lead to increases in diagnoses of congenital
syphilis over the coming years,'' said Kate Swan, a
spokeswoman for the Health Protection Agency.

Pregnant women
with syphilis can pass congenital syphilis on to their
babies. Nearly half of all babies infected with syphilis
while they are in the womb die shortly before or after
birth.

Syphilis is a
bacterial disease causing symptoms that include ulcers,
sores, and rashes. In extreme cases it can result in
dementia or fatally damage the heart, respiratory, and
central nervous systems. Syphilis is treatable with
antibiotics if caught early.

Once there are
more than just a few isolated cases, containing the
disease is difficult.

Advances made in
treating AIDS may have inadvertently boosted syphilis's
spread.

''The evidence
points to an increase in unsafe sexual behavior since
antiretrovirals for AIDS came along in 1996,'' said Van de
Laar.

After decades of
being instructed to use condoms and to limit the number
of sexual partners, some people are probably suffering from
''safe sex fatigue,'' Van de Laar said. In turn, that
has contributed to the spike in syphilis cases.

The Internet has
also allowed people to find sexual partners more easily
than before, and some experts link the rise of dating
websites to the jump in syphilis cases.

For some men, the
Internet connections can be especially dangerous.

''Networks of
HIV-positive men to find other positive men have sprung up
on the Internet,'' said Jonathan Elford, an AIDS
epidemiologist at London's City University.

While men with
HIV having unprotected sex with each other are not at risk
of passing on HIV, other diseases like syphilis can still be
spread. Among gay men who have syphilis in Britain,
nearly half have HIV, Elford said.

Amid this
resurgence, some officials are now attacking the epidemic
online.

Every day, health
workers at the Terrence Higgins Trust, Europe's largest
AIDS charity, log into chat rooms on a popular British gay
dating website. Their job is to spread safe-sex
messages and answer any related questions from men
online.

''We know that
men are arranging hookups for sex online,'' said Mark
Thompson, the charity's deputy head of health promotion.
''So we decided to tap into cyberspace to try reaching
them before unsafe sex might happen.''

The trust's
health workers disclose their identities and work-related
intentions as soon as they begin their shifts.

Health officials
like Van de Laar and Elford applaud such Internet-based
initiatives.

''It's definitely
worth trying,'' Van de Laar said. ''If we don't do
enough to stop syphilis in the gay community now, we could
potentially be dealing with a much bigger risk in the
future.'' (Maria Cheng, AP)

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