Knock knock. Who’s there? Syphilis…Again

A few years ago a friend told me a story about how a young guy whose life was saved by a doctor – and the story stuck in my mind. You would think that that’s what doctors are for – they save lives (they really do – I’m a living example) so maybe there’s nothing so special about this? But what was incredible about J.’s story was that the life-saving was, in a way, very unglamorous.

It involved no fancy operations or cutting edge technology. In fact, what was important was that the doctor was old (and once served in the military). Old enough to remember the diseases soldiers used to get a lot – including syphilis. He remembered the early symptoms and was able to identify ‘the pox’, from which the young man suffered, at a stage at which a younger doctor possibly couldn’t.

If he’d had been treated by someone who went to medical school after syphilis supposedly slipped into medical history, the disease might not have been identified and he would likely have been exposed to its awful consequences. And syphilis’ symptoms and consequences are not a walk in the park and include everything from skin ulceration (including in the genital and rectal areas), cardiovascular issues and very serious neurological problems (friendly advice: do NOT google image syphilis). Although many people infected with syphilis do not have any symptoms for years, they remain at risk for late complications if they are not properly taken care of. Untreated, syphilis is very bad for you: it has a mortality of 8% to 58% (and watch out – it discriminates and has a greater death rate in males).

I think this much is obvious, but let’s just get it out there: syphilis is a sexually transmitted disease and one we tend to associate with days long gone and the deaths of the likes of Franz Schubert, Arthur Schopenhauer and Édouard Manet. There’s a problem, however: syphilis is back and on the large. According to the American Centers for Disease Control between 2005 and 2006, the number of reported syphilis cases increased 11.8 percent! The story J. told me was not some freak case – it was indicative of a trend.

The world is no stranger to syphilis – it’s not some recent animal-borne mutant disease like bird-flu, but humanity’s companion for hundreds of years. The exact origin of syphilis is unknown, by the best supported hypothesis proposes it was carried to Europe by the returning crewmen from Christopher Columbus’s voyage to the Americas. The first written records of an outbreak of syphilis in Europe date to  1494/1495 and come from Naples, Italy.  It was very common in Europe during the 18th and 19th centuries. Later, the rise and widespread use of antibiotics curtailed its spread and during the early 20th century infections declined rapidly. However, this trend was reversed in the 1980s and 1990s. Since the year 2000, rates of syphilis have been increasing in the USA, Canada, the UK, Australia and Europe.

The problem now is that because antibiotics almost rid humanity of this disease, it’s basically off the radar for most doctors. Syphilis is considered a Victorian disease – your family doctor doesn’t expect something straight out of Dickens when you go to see them about an embarrassing itch (and more often than not you might not even go see the doctor because it is embarrassing for most people to talk about sex and funny-looking genitals). The rise in syphilis infections is undoubtedly a bad thing – that a potentially deadly disease is getting more people sick is never good news. But…it’s news. And people read news – including doctors. And syphilis is now news enough to get back into places like the Lancet – so doctors (and their patients) are becoming increasingly aware of the fact that syphilis is a problem once more. Hopefully, this will mean more diagnoses, more treated people and ultimately fewer infections…again and maybe, just maybe for good this time?