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Syphilis


University of Kansas Hospital Dana Hawkinson, head of infectious disease sounded the alarm -- on Valentine's Day -- for a 100% increase in the incidence of Syphilis appearing in all age groups from teenagers to seniors. What is more alarming, Hawkinson claims that these cases are antibiotic resistant.

Nothing that I know of could be more frightening. The world including the medical profession has forgotten the world wide epidemic of syphilis, the mortality and the  suffering it caused, nor do we remember the high degree of infectiousness of that little spirochete. It did not jump off the drinking fountain to infect you, but putting your mouth on the faucet got you. Syphilis was the reason for those thin paper toilet seat protectors you always wondered about.

Naples 1494 French and Spanish alternately occupied Naples. Some Spanish sailers who sailed with Columbus had picked up a strange disease in the Indies. With irresistible tales to tell of their voyage, they quickly passed it on to the ladies of Naples, who in fair turn passed it along to the French. The French called it the Spanish disease and the Spanish, the French disease.

Often confused with leprosy, Syphilis had no effective treatment. All sorts of things were tried. They used Guaiacum, mercury and later heavy metals.  Hieronymus Fracastorius (1483-1553) a physician and a poet wrote– Syphilis sive Morbus Gallicus – the shepherd-sufferer gave the disease its name. (Translated shepherd or swineherd)
Treponema pallidum Because of the extreme effectiveness of penicillin against syphilis, the disease is all but forgotten. Long ago the first laboratory test with every hospital admission was a VDRL or Wasserman. The health department enforced isolation and close follow up with all family and contacts. If we had done that with the AIDS epidemic, it would not have become the killer that it did. The health department today, however, is impotent. Bothe diagnosis and treatment are dictated by politics. The Health Department of old hardly exists. The laissez-faire political solutions favor individual liberties over the common good and motivate treatment for which there is a profit rather than public health for which there is not. Young doctors may not recognize the disease. A microscope is required for the positive identification of a chancer, and microscopy is becoming a lost art among physicians.
2,465 years ago Hippocrates stemmed the tide of the plague in Athens by burning the homes and the bodies of the victims with fires all over the city. A tribal chief in Africa contained Ebola by the same technique and locking down the village. Isolation is the only way to contain an epidemic with the infectivity of syphilis, isolation until the successful completion of treatment. Given a high degree of antibiotic resistance, that isolation might require a tertiary hospital's isolation ward.    
Meanwhile the U of Washington has developed a new condom that is thin, adherent, strongly antiseptic and dissolves after use. I doubt that it will stop the spread of syphilis, however. Mealy kissing, can transmit the disease, and already the distribution throughout all ages including seniors, suggests a complementary non-sexual transmission of the drug resistant spirochete.

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