Epidemiology of syphilis

Age-standardized death from syphilis per 100,000 inhabitants in 2004.[1]
  no data
  <35
  35–70
  70–105
  105–140
  140–175
  175–210
  210–245
  245–280
  280–315
  315–350
  350–500
  >500

Syphilis is a bacterial infection transmitted by sexual contact[2] and is believed to have infected 12 million people in 1999 with greater than 90% of cases in the developing world.[3] It affects between 700,000 and 1.6 million pregnancies a year, resulting in spontaneous abortions, stillbirths, and congenital syphilis.[4] In Sub-Saharan Africa syphilis contributes to approximately 20% of perinatal deaths.[4]

In the developed world, syphilis infections were in decline until the 1980s and 1990s due to widespread use of antibiotics. Since the year 2000, rates of syphilis have been increasing in the US, UK, Australia, and Europe primarily among men who have sex with men (MSM).[3] This is attributed to unsafe sexual practices.[3] A sexually transmitted infection (STI) Surveillance study done by the Centers for Disease Control and Prevention in 2016 showed that men who have sex with men only account for over half (52%) of the 27,814 cases during that year. Nationally, the highest rates of primary and secondary syphilis in 2016 were observed among men aged 20–34 years, among men in the West, and among Black men.[5]

Increased rates among heterosexuals have occurred in China and Russia since the 1990s.[3] Syphilis increases the risk of HIV transmission by two to five times and co-infection is common (30–60% in a number of urban centers).[3][6]

Untreated, it has a mortality rate of 8% to 58%, with a greater death rate in males.[6] The higher incidence of mortality among males compared to females is not well understood, but is thought to be related to immunological differences across gender.[7] The symptoms of syphilis have become less severe over the 19th and 20th century in part due to widespread availability of effective treatment and partly due to decreasing virulence of the spirochete.[8] With early treatment few complications result.[9]

  1. ^ "WHO Disease and injury country estimates". World Health Organization (WHO). 2004. Retrieved 11 November 2009.
  2. ^ "Syphilis - Symptoms and causes". Mayo Clinic. Retrieved 2018-04-25.
  3. ^ a b c d e Stamm LV (February 2010). "Global challenge of antibiotic-resistant Treponema pallidum". Antimicrobial Agents and Chemotherapy. 54 (2): 583–9. doi:10.1128/AAC.01095-09. PMC 2812177. PMID 19805553.
  4. ^ a b Woods CR (June 2009). "Congenital syphilis-persisting pestilence". The Pediatric Infectious Disease Journal. 28 (6): 536–7. doi:10.1097/INF.0b013e3181ac8a69. PMID 19483520.
  5. ^ "Syphilis - 2016 STD Surveillance Report". www.cdc.gov. 2017-10-17. Retrieved 2018-04-04.
  6. ^ a b Kent ME, Romanelli F (February 2008). "Reexamining syphilis: an update on epidemiology, clinical manifestations, and management". The Annals of Pharmacotherapy. 42 (2): 226–36. doi:10.1345/aph.1K086. PMID 18212261. S2CID 23899851.
  7. ^ Peterman, Thomas A.; Kidd, Sarah E. (2019). "Trends in Deaths Due to Syphilis, United States, 1968-2015". Sexually Transmitted Diseases. 46 (1): 37–40. doi:10.1097/OLQ.0000000000000899. ISSN 1537-4521. PMC 6743072. PMID 30044338.
  8. ^ Mullooly C, Higgins SP (August 2010). "Secondary syphilis: the classical triad of skin rash, mucosal ulceration and lymphadenopathy". International Journal of STD & AIDS. 21 (8): 537–45. doi:10.1258/ijsa.2010.010243. PMID 20975084. S2CID 207198662.
  9. ^ Eccleston K, Collins L, Higgins SP (March 2008). "Primary syphilis". International Journal of STD & AIDS. 19 (3): 145–51. doi:10.1258/ijsa.2007.007258. PMID 18397550. S2CID 19931104.