The Renaissance and the Scientific Revolution
Lois N. Magner, Oliver J. Kim in A History of Medicine, 2017
If diseases were catalogued in terms of etiological agents instead of means of transmission, syphilis would be described as a member of the treponematosis family, that is, diseases caused by members of the Treponema group of spirochetes (corkscrew-shaped bacteria). Although these microbes grow slowly, once established in a suitable host they multiply with inexorable patience and persistence. Syphilis is one of four clinically distinct human treponematoses; the others are known as pinta, yaws, and bejel. Some bacteriologists believe that pinta, yaws, bejel, and syphilis are caused by variants of an ancestral spirochete that adapted to different patterns of climate and human behavior. The nonvenereal treponematoses are probably descendants of ancient childhood diseases. As people migrated to cooler areas and wore more clothing, nonvenereal transmission was inhibited. Pinta, a disease endemic in Mexico and Central America, is characterized by skin eruptions of varying severity. Until Treponema carateum was discovered, pinta was classified among the fungal skin diseases. Yaws, a disease caused by Treponema pertenue, flourishes in hot, moist climates. Like syphilis, yaws leads to destruction of tissue, joints, and bone. Bejel (nonvenereal endemic syphilis) is generally acquired in childhood among rural populations living in warm, arid regions. Like syphilis, bejel has a latent phase, and afflicted individuals may be infectious for many years.
Benzylpenicillin (Penicillin G)
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Similar to syphilis, Pen G is the recommended treatment for yaws, which is caused by Treponema pallidum pertenue, a bacterium that is spread by skin-to-skin contact in humid tropical regions (Taber and Feigin, 1979; Mitjà et al., 2013; Stamm, 2015). As with syphilis, clinical manifestations can be divided into three stages, but unlike syphilis, mother-to-child transmission does not occur. A major campaign to eradicate yaws in the 1950s and 1960s, by mass treatment of affected communities with long-acting, injectable penicillin, reduced the number of cases by 95% worldwide, but yaws has reappeared in recent years in Africa, Asia, and the western Pacific. In countries where the prevalence of active yaws is over 10%, the whole population is often given a single i.m. injection of 1.2 or 2.4 million units (0.9 or 1.8 g) of benzathine Pen G. Alternatively, this treatment may be given only to active cases and all their contacts (Brown, 1985; Willcox, 1985). More recently it has been shown that one oral dose of azithromycin is as effective as intramuscular penicillin, and the WHO launched a new initiative to eradicate yaws by 2020 (Mitjà et al., 2013). The treatment and management of yaws has been reviewed (Mitjà et al., 2013; Stamm, 2015; Marks et al., 2015).
History of public health in Pacific Island countries
Milton J. Lewis, Kerrie L. MacPherson in Public Health in Asia and the Pacific, 2007
Of endemic infections, yaws and hepatitis B were probable companions. Yaws, a bacterial treponemal infection (related to syphilis), is transmitted by direct contact between children, or adults and children, with open sores from the infection, usually on the legs. The infection can progress to disfigurement. Significant proportions of skeletal lesions in prehistoric samples of bones from the Solomon Islands and the Marianas are considered to be consequent to yaws (Buckley and Tayles 2003: 303–324; Pietrusewsky, Douglas and Ikehara-Quebral 1997: 315–342). Those infected with yaws are immune to venereal syphilis, a phenomenon that is initially advantageous, but leads to problems following yaws eradication. Tropical ulcers (non-yaws) due to infection of minor scratches or insect bites are likely to have been a major source of morbidity since this was the case following contact, especially in PNG (Spencer 1998: 261–267).
Infectious diseases among Ethiopian immigrants in Israel: a descriptive literature review
Published in Pathogens and Global Health, 2021
Yulia Treister-Goltzman, Ali Alhoashle, Roni Peleg
Syphilis is very common among EI with a positivity serology rate of about 8–12% among adults [4,51]. There was no evidence of skin or cardiovascular involvement among EI with positive serology for syphilis. There was no evidence of neuropsychiatric disease among individuals who had positive serology for treponema in their spinal fluid [51]. Congenital syphilis among EI comprised 28.6% of all syphilis cases in Israel [4]. There appear to be two reasons for this high prevalence rate of positive serology for syphilis among EI. The first is classic sexual transmission, which is supported by the jump in the prevalence of positive serology among 15–44-year-olds [4], and the association of positive serology with the length of stay in refugee camps in Addis Ababa among EI who participated in the Solomon Operation (OR = 3.87) [23]. The second reason is the disease Yaws (endemic treponematoses) caused by Treponema pertenue, which is very common in Africa. The clinical course is very benign among EI, which also supports this cause [51].
Expanding syphilis testing: a scoping review of syphilis testing interventions among key populations
Published in Expert Review of Anti-infective Therapy, 2018
Jason J. Ong, Hongyun Fu, M. Kumi Smith, Joseph D. Tucker
POC testing involves conducting syphilis testing with results given within a short time, at or near the site of patient care by trained health providers [24]. POC testing by trained outreach staff or community health workers might be an important strategy to reach key population in addition to health providers. POC tests to detect treponemal antibodies are increasingly accessible and perform well in the field [9,11]. These automated POC platforms are portable, enable anonymous testing, and are relatively easy to use, eliminating the need for venipuncture and laboratory support. Important trade-offs are that though POC tests have generally comparable performance characteristics to laboratory-based testing, POC tests have poorer sensitivity, especially at lower RPR levels (<1:16)[25]. Another limitation is that most POC syphilis tests detect only anti-treponemal-specific antibodies. However, there is one commercially available POC test in some countries which incorporates testing for both treponemal and non-treponemal antibodies. Compared to conventional laboratory testing, it has a sensitivity of 89.8% (95% CI: 87.3–91.9) and specificity of 99.3% (95% CI: 97.0–99.9) for treponemal antibodies, and sensitivity of 94.2% (95% CI: 91.8–96.0) and specificity of 62.2% (95% CI: 57.5–66.6) for non-treponemal antibodies[26]. Development of further combination POC tests would be useful for those treated for past syphilis or in settings with endemic yaws.
Serologic false-positive reactions for syphilis in children of adenoidal hypertrophy:2 case reports and review of the literature
Published in Acta Clinica Belgica, 2021
Wei Wang, Xuzhou Fan, Xuelian Huang, Jingmei Yan, Jianfeng Luan
Treponematoses are infections caused by the spirochetal organisms of the Treponema species. These causes mainly include syphilis and nonvenereal or endemic treponematoses (ETs) consisting of yaws, bejel and pinta [14]. Unlike syphilis, the nonvenereal treponematoses are mainly transmitted through skin-to-skin contact, and children under 15 years of age are more susceptible to these diseases in tropical and subtropical areas. It is almost impossible to distinguish these diseases from each other by morphology or by serological tests [15]. The patient’s disease state may also lead to false positive reactions in serological tests of ETs. So the establishment of the diagnosis of ETs can be even more difficult in countries with poor laboratory diagnostics but high rates of syphilis.