To all Muslims &Non-Muslims
----- ATTENTION PLEASE-------STD on RISE-----How to be SAFE-----NEWS & ARTICLE----
----- ATTENTION PLEASE-------STD on RISE-----How to be SAFE-----NEWS & ARTICLE----
Aware yourself about STD (Sexually Trasmitted Disease), as they are widely spreading throughout WEST (USA, EUROPE, CANADA, AUSTRALIA).
Check Report. After Report read what it is all about.
http://www.mitchellrepublic.com/event/article/id/69274/group/homepage/
[h=1]STDs rise sharply in SD[/h]Safe-sex practices likely in decline, epidemiologist says.By: Chris Huber, The Daily Republic
- STD testing
Mitchell Area Family Planning nurse Natalie Vandrongelen shows how an STD urinalysis test is conducted. (Chris Huber/Republic)
Sexually transmitted diseases are on a sudden and startling rise in South Dakota.
From the start of the year through the end of July, new cases of chlamydia, gonorrhea, HIV/AIDS and syphilis are well above their five-year median averages, according to an infectious disease report released each month by the South Dakota Department of Health.
Physicians are required under state law to disclose diagnoses of some contagious diseases, including STDs, to the department.
So far this year, there have been 2,124 cases of chlamydia reported in the state, a 24 percent increase over the five-year median average. Gonorrhea is up 58 percent over the five-year median average with 316 cases reported.
Another and more alarming STD popping up in South Dakota is syphilis. Only nine cases have been reported so far this year, but because the disease is so rare, that equates to a 350 percent increase over the median average.
A distressing component of the data is South Dakotas diversion from more positive national trends. A nationwide study released in 2010 by the U.S. Centers for Disease Control and Prevention found that cases of reported gonorrhea per 100,000 people dropped by 16 percent from 2006 to 2010. But in South Dakota, that number increased by 23 percent per 100,000 people.
Dr. Lon Kightlinger, South Dakotas state epidemiologist, is concerned but said the explanation is simple: People arent having safe sex.
Gonorrhea, chlamydia and syphilis are all caused by a bacterium that can live in reproductive and urinary tracts of women and men. They are spread through sexual contact, and the disease can spread by fluid transmission even without male ejaculation.
Because they can lead to more serious complications, all diagnosed cases of gonorrhea and syphilis are investigated, and sexual partners of a person who is diagnosed with the diseases are contacted by the state and told to go in for treatment.
This can go a long ways to helping stop these diseases from spreading, Kightlinger said. But it is still alarming to see how this disease can start with one person and spread like a web.
Geographic, age distribution
The majority, 66 percent, of the new gonorrhea cases this year happened in the western one-third of the state. Those numbers prompted a visit from the CDC to American Indian reservations in the western half of the state to help curb the numbers.
They were mainly here to educate and treat people with the disease, Kightlinger said.
Sexually transmitted diseases arent exclusive to certain areas of the state, though.
In Davison County, for example, STDs also are up this year. Four cases of gonorrhea have been reported and 41 cases of chlamydia in just the first seven months of the year. In all of 2011, the county had four reported cases of gonorrhea and 62 cases of chlamydia. Between 2006 and 2011, only 13 cases of gonorrhea were reported in the county.
The numbers for Mitchell arent shocking, but they are still increasing, Kightlinger said. This is something that affects the entire state.
Though STDs strike in many areas of the state, they are mostly limited to younger people.
A 2010 study by the CDC found that even though young people ages 15 to 24 represent only 25 percent of the sexually experienced population, they acquire nearly half of all new STDs in the United States. Seventy-two percent of the new chlamydia cases in South Dakota so far this year have come from people in that age group. For gonorrhea, its 59 percent.
Kightlinger said an increase in STDs among the young isnt because young people are becoming more sexually active. He determined that from a behavioral risk survey given to high school students across the state. Somewhere between 45 percent and 48 percent of high school students are sexually active, and that hasnt changed in the past decade.
When asked if that means young people are being less safe when they have sex, Kightlinger said as an epidemiologist its hard for him to make that connection without having numbers to back it up.
But as a journalist, I think it would be safe for you to make that assumption, he said.
He thinks parents need to talk with their children about the dangers of these diseases.
I think the perception is that these young people can just take a pill and everything will be better, Kightlinger said. While the antibiotics are great, that is not the best approach.
Future risks
Many symptoms of the diseases may seem minor and sometimes cause no symptoms at all, but leaving these diseases untreated can cause significant health risks in the future.
Untreated gonorrhea and chlamydia, for example, can steal a young womans chance of having her own children later in life. The CDC suggests that each year, untreated STDs cause at least 24,000 women in the United States to become infertile.
Studies also suggest that people with gonorrhea, chlamydia or syphilis are at increased risk for HIV.
While they account for the largest percentage of new cases of STDs in South Dakota, young people are not the only age group contracting the diseases. Twenty percent of new chlamydia and gonorrhea cases this year in the state came from people in the 25 to 39 age group, and 2 percent came from the 40- to 64-year-olds.
This years nine cases of syphilis have Kightlinger especially concerned.
This is something we are worried about, because in the late 1990s to early 2000s, we didnt have syphilis in South Dakota, Kightlinger said.
Occasional cases would occur when someone contracted it from a different state, but Kightlinger said these new cases were contracted in South Dakota, specifically in the Sioux Falls area.
Every case of syphilis this year was contracted by a man. Men who have sex with other men are at a higher risk for contraction of the disease, and Kightlinger said that was the case with some of the people who contracted the disease this year in South Dakota, but not all of them.
Six of the cases have come from the age group 40 to 64, and the other three have come from the 25 to 39 age group.
Awareness, education key
Perhaps the biggest weapon against these diseases is knowledge.
These things are largely preventable, Kightlinger said. If people know they are out there and know how dangerous they can be, they will be less likely to participate in the risky behavior that can cause them.
Natalie Vandrongelen is a nurse at Mitchell Area Family Planning and is working to help diagnose and prevent STDs.
The clinic provides STD tests to anyone who would like one, and because the clinic is a state entity, most tests are provided at little to no cost. Billing is based on salary and family size on a sliding scale, so many patients pay nothing.
Bacterial testing for STDs such as gonorrhea and chlamydia can be done with a swabbing technique. The results are ready in about 15 minutes.
Some people feel uncomfortable with a swab test, so we also offer a urine test which is sent to the state, and results are done in about a week, Vandrongelen said.
The clinic routinely tests everyone 24 and younger at the clinic unless they say they dont want the test.
As many as 80 percent of women with STDs can show no symptoms at all, and by offering more tests, Vandrongelen hopes to curb womens chances of passing on the disease.
We are starting to see more people come in to get tested just because they had a new partner, and that is very encouraging, she said. Males are starting to be tested more often as well.
The clinic also works on preventing STDs. Condoms are free and readily available in several places throughout the clinic.
Vandrogelen makes several presentations to the high school throughout the year about the dangers of STDs and the options available for testing. She also works with Dakota Wesleyan University and Mitchell Technical Institute.
We just want to make sure everyone gets tested and treated, she said.
http://en.wikipedia.org/wiki/Syphilis
WHAT IS SYPHILIS?
[h=1]Syphilis[/h]From Wikipedia, the free encyclopedia
| Syphilis | |
|---|---|
| Classification and external resources | |
 Electron micrograph of Treponema pallidum | |
| ICD-10 | A50-A53 |
| ICD-9 | 090-097 |
| DiseasesDB | 29054 |
| MedlinePlus | 001327 |
| eMedicine | med/2224 emerg/563derm/413 |
| MeSH | D013587 |
The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary). The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration), secondary syphilis with a diffuse rash which frequently involves the palms of the hands and soles of the feet, latent syphilis with little to no symptoms, and tertiary syphilis with gummas, neurological, or cardiac symptoms. It has, however, been known as "the great imitator" due to its frequent atypical presentations. Diagnosis is usually via blood tests; however, the bacteria can also be visualized under a microscope. Syphilis can be effectively treated with antibiotics, specifically the preferred intramuscular penicillin G (given intravenously for neurosyphilis), or else ceftriaxone, and in those who have a severe pencillin allergy, oral doxycyclineor azithromycin.
Syphilis is believed to have infected 12 million people worldwide in 1999, with greater than 90% of cases in the developing world. After decreasing dramatically since the widespread availability of penicillin in the 1940s, rates of infection have increased since the turn of the millennium in many countries, often in combination with human immunodeficiency virus (HIV). This has been attributed partly to unsafe sexual practices among men who have sex with men, increased promiscuity, prostitution, and decreasing use of barrier protection.[SUP][1][/SUP][SUP][2][/SUP][SUP][3][/SUP]
[h=2]Contents[/h] [hide] |
[h=2]Signs and symptoms[/h]Syphilis can present in one of four different stages: primary, secondary, latent, and tertiary,[SUP][4][/SUP] and may also occur congenitally.[SUP][5][/SUP] It was referred to as "the great imitator" by Sir William Osler due to its varied presentations.[SUP][4][/SUP][SUP][6][/SUP]
[h=3]Primary[/h]
Primary syphilis is typically acquired by direct sexual contact with the infectious lesions of another person.[SUP][7][/SUP] Approximately 3 to 90 days after the initial exposure (average 21 days) a skin lesion, called a chancre, appears at the point of contact.[SUP][4][/SUP] This is classically (40% of the time) a single, firm, painless, non-itchy skin ulceration with a clean base and sharp borders between 0.3 and 3.0 cm in size.[SUP][4][/SUP] The lesion, however, may take on almost any form.[SUP][8][/SUP] In the classic form, it evolves from a macule to a papule and finally to an erosion or ulcer.[SUP][8][/SUP] Occasionally, multiple lesions may be present (~40%),[SUP][4][/SUP] with multiple lesions more common when coinfected with HIV. Lesions may be painful or tender (30%), and they may occur outside of the genitals (27%). The most common location in women is the cervix (44%), the penis in heterosexual men (99%), and anally and rectally relatively commonly in men who have sex with men (34%).[SUP][8][/SUP] Lymph node enlargement frequently (80%) occurs around the area of infection,[SUP][4][/SUP] occurring seven to 10 days after chancre formation.[SUP][8][/SUP] The lesion may persist for three to six weeks without treatment.[SUP][4][/SUP]
[h=3]Secondary[/h]
Typical presentation of secondary syphilis with a rash on the palms of the hands
Secondary syphilis occurs approximately four to ten weeks after the primary infection.[SUP][4][/SUP] While secondary disease is known for the many different ways it can manifest, symptoms most commonly involve the skin, mucous membranes, and lymph nodes.[SUP][9][/SUP] There may be a symmetrical, reddish-pink, non-itchy rash on the trunk and extremities, including the palms and soles.[SUP][4][/SUP][SUP][10][/SUP] The rash may become maculopapular or pustular. It may form flat, broad, whitish, wart-like lesions known as condyloma latum on mucous membranes. All of these lesions harbor bacteria and are infectious. Other symptoms may include fever, sore throat, malaise, weight loss, hair loss, and headache.[SUP][4][/SUP] Rare manifestations include hepatitis, kidney disease, arthritis,periostitis, optic neuritis, uveitis, and interstitial keratitis.[SUP][4][/SUP][SUP][11][/SUP] The acute symptoms usually resolve after three to six weeks;[SUP][11][/SUP] however, about 25% of people may present with a recurrence of secondary symptoms. Many people who present with secondary syphilis (4085% of women, 2065% of men) do not report previously having had the classic chancre of primary syphilis.[SUP][9][/SUP]
[h=3]Latent[/h]Latent syphilis is defined as having serologic proof of infection without symptoms of disease.[SUP][7][/SUP] It is further described as either early (less than 1 year after secondary syphilis) or late (more than 1 year after secondary syphilis) in the United States.[SUP][11][/SUP] The United Kingdom uses a cut-off of two years for early and late latent syphilis.[SUP][8][/SUP] Early latent syphilis may have a relapse of symptoms. Late latent syphilis is asymptomatic, and not as contagious as early latent syphilis.[SUP][11][/SUP]
[h=3]Tertiary[/h]
Tertiary syphilis may occur approximately 3 to 15 years after the initial infection, and may be divided into three different forms: gummatous syphilis (15%), late neurosyphilis (6.5%), and cardiovascular syphilis (10%).[SUP][4][/SUP][SUP][11][/SUP] Without treatment, a third of infected people develop tertiary disease.[SUP][11][/SUP]People with tertiary syphilis are not infectious.[SUP][4][/SUP]
Gummatous syphilis or late benign syphilis usually occurs 1 to 46 years after the initial infection, with an average of 15 years. This stage is characterized by the formation of chronic gummas, which are soft, tumor-like balls of inflammation which may vary considerably in size. They typically affect the skin, bone, and liver, but can occur anywhere.[SUP][4][/SUP]
Neurosyphilis refers to an infection involving the central nervous system. It may occur early, being either asymptomatic or in the form of syphiliticmeningitis, or late as meningovascular syphilis, general paresis, or tabes dorsalis, which is associated with poor balance and lightning pains in the lower extremities. Late neurosyphilis typically occurs 4 to 25 years after the initial infection. Meningovascular syphilis typically presents with apathy andseizure, and general paresis with dementia and tabes dorsalis.[SUP][4][/SUP] Also, there may be Argyll Robertson pupils, which are bilateral small pupils that constrict when the person focuses on near objects, but do not constrict when exposed to bright light.
Cardiovascular syphilis usually occurs 1030 years after the initial infection. The most common complication is syphilitic aortitis, which may result inaneurysm formation.[SUP][4][/SUP]
[h=3]Congenital[/h]Congenital syphilis may occur during pregnancy or during birth. Two-thirds of syphilitic infants are born without symptoms. Common symptoms that then develop over the first couple years of life include: hepatosplenomegaly (70%), rash (70%), fever (40%), neurosyphilis (20%), and pneumonitis(20%). If untreated, late congenital syphilis may occur in 40%, including: saddle nose deformation, Higoumenakis sign, saber shin, or Clutton's jointsamong others.[SUP][12][/SUP]
[h=2]Cause[/h][h=3]Bacteriology[/h]
Histopathology of Treponema pallidumspirochetes using a modified Steiner silver stain
Main article: Treponema pallidum
Treponema pallidum subspecies pallidum is a spiral-shaped, Gram-negative, highly mobile bacterium.[SUP][8][/SUP][SUP][13][/SUP] Three other human diseases are caused by related Treponema pallidum, including yaws (subspecies pertenue), pinta (subspecies carateum) and bejel (subspecies endemicum).[SUP][4][/SUP] Unlike subtypepallidum, they do not cause neurological disease.[SUP][12][/SUP] Humans are the only known natural reservoir for subspecies pallidum.[SUP][5][/SUP] It is unable to survive without a host for more than a few days. This is due to its small genome (1.14 MDa) failing to encode the metabolic pathways necessary to make most of its macronutrients. It has a slow doubling time of greater than 30 hours.[SUP][8][/SUP]
[h=3]Transmission[/h]Syphilis is transmitted primarily by sexual contact or during pregnancy from a mother to her fetus; the spirochaete is able to pass through intact mucous membranes or compromised skin.[SUP][4][/SUP][SUP][5][/SUP] It is thus transmissible by kissing near a lesion, as well as oral, vaginal, and anal sex.[SUP][4][/SUP] Approximately 30 to 60% of those exposed to primary or secondary syphilis will get the disease.[SUP][11][/SUP] Its infectivity is exemplified by the fact that an individual inoculated with only 57 organisms has a 50% chance of being infected.[SUP][8][/SUP] Most (60%) of new cases in the United States occur in men who have sex with men. It can be transmitted via blood products. However, it is tested for in many countries and thus the risk is low. The risk of transmission from sharing needlesappears limited.[SUP][4][/SUP] Syphilis cannot be contracted through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing.[SUP][14][/SUP]
[h=2]Diagnosis[/h]
Poster for testing of syphilis, showing a man and a woman bowing their heads in shame (circa 1936)
Syphilis is difficult to diagnose clinically early in its presentation.[SUP][8][/SUP] Confirmation is either via blood tests or direct visual inspection using microscopy. Blood tests are more commonly used, as they are easier to perform.[SUP][4][/SUP] Diagnostic tests are, however, unable to distinguish between the stages of the disease.[SUP][15][/SUP]
[h=3]Blood tests[/h]Blood tests are divided into nontreponemal and treponemal tests.[SUP][8][/SUP] Nontreponemal tests are used initially, and include venereal disease research laboratory (VDRL) and rapid plasma reagin tests. However, as these tests are occasionally false positives, confirmation is required with a treponemal test, such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs).[SUP][4][/SUP] False positives on the nontreponemal tests can occur with some viral infections such as varicella and measles, as well as with lymphoma, tuberculosis, malaria, endocarditis,connective tissue disease, and pregnancy.[SUP][7][/SUP] Treponemal antibody tests usually become positive two to five weeks after the initial infection.[SUP][8][/SUP]Neurosyphilis is diagnosed by finding high numbers of leukocytes (predominately lymphocytes) and high protein levels in the cerebrospinal fluid in the setting of a known syphilis infection.[SUP][4][/SUP][SUP][7][/SUP]
[h=3]Direct testing[/h]Dark ground microscopy of serous fluid from a chancre may be used to make an immediate diagnosis. However, hospitals do not always have equipment or experienced staff members, whereas testing must be done within 10 minutes of acquiring the sample. Sensitivity has been reported to be nearly 80%, thus can only be used to confirm a diagnosis but not rule one out. Two other tests can be carried out on a sample from the chancre: direct fluorescent antibody testing and nucleic acid amplification tests. Direct fluorescent testing uses antibodies tagged with fluorescein, which attach to specific syphilis proteins, while nucleic acid amplification uses techniques, such as the polymerase chain reaction, to detect the presence of specific syphilis genes. These tests are not as time-sensitive, as they do not require living bacteria to make the diagnosis.[SUP][8][/SUP]
[h=2]Prevention[/h]As of 2010, there is no vaccine effective for prevention.[SUP][5][/SUP] Abstinence from intimate physical contact with an infected person is effective at reducing the transmission of syphilis, as is the proper use of a latex condom. Condom use, however, does not completely eliminate the risk.[SUP][16][/SUP][SUP][14][/SUP] Thus, the Centers for Disease Control and Preventionrecommends a long-term, mutually monogamous relationship with an uninfected partner and the avoidance of substances such as alcohol and other drugs that increase risky sexual behavior.[SUP][14][/SUP]
Congenital syphilis in the newborn can be prevented by screening mothers during early pregnancy and treating those who are infected.[SUP][17][/SUP] The United States Preventive Services Task Force(USPSTF) strongly recommends universal screening of all pregnant women,[SUP][18][/SUP] while the World Health Organization recommends all women be tested at their first antenatal visit and again in thethird trimester.[SUP][19][/SUP] If they are positive, they recommend their partners also be treated.[SUP][19][/SUP] Congenital syphilis is, however, still common in the developing world, as many women do not receiveantenatal care at all, and the antenatal care others do receive does not include screening,[SUP][17][/SUP] and it still occasionally occurs in the developed world, as those most likely to acquire syphilis (through drug use, etc.) are least likely to receive care during pregnancy.[SUP][17][/SUP] A number of measures to increase access to testing appear effective at reducing rates of congenital syphilis in low- to middle-income countries.[SUP][19][/SUP]
Syphilis is a notifiable disease in many countries, including Canada[SUP][20][/SUP] the European Union,[SUP][21][/SUP] and the United States.[SUP][22][/SUP] This means health care providers are required to notify public healthauthorities, which will then ideally provide partner notification to the person's partners. [SUP][23][/SUP] Physicians may also encourage patients to send their partners to seek care.[SUP][24][/SUP] The CDC recommends sexually active men who have sex with men are tested at least yearly.[SUP][25][/SUP]
[h=2]Treatment[/h][h=3]Early infections[/h]The first-choice treatment for uncomplicated syphilis remains a single dose of intramuscular penicillin G or a single dose of oral azithromycin.[SUP][26][/SUP] Doxycycline and tetracycline are alternative choices; however, due to the risk of birth defects these are not recommended for pregnant women. Antibiotic resistance has developed to a number of agents, including macrolides, clindamycin, and rifampin.[SUP][5][/SUP] Ceftriaxone, a third-generation cephalosporin antibiotic, may be as effective as penicillin-based treatment.[SUP][4][/SUP]
[h=3]Late infections[/h]For neurosyphilis, due to the poor penetration of penicillin G into the central nervous system, those affected are recommended to be given large doses of intravenous penicillin for a minimum of 10 days.[SUP][4][/SUP][SUP][5][/SUP] If a person is allergic, ceftriaxone may be used or penicillin desensitization attempted. Other late presentations may be treated with once-weekly intramuscular penicillin G for three weeks. If allergic, as in the case of early disease, doxycycline or tetracycline may be used, albeit for a longer duration. Treatment at this stage limits further progression, but has only slight effect on damage which has already occurred.[SUP][4][/SUP]
[h=3]Jarisch-Herxheimer reaction[/h]One of the potential side effects of treatment is the Jarisch-Herxheimer reaction. It frequently starts within one hour and lasts for 24 hours, with symptoms of fever, muscles pains, headache, andtachycardia.[SUP][4][/SUP] It is caused by cytokines released by the immune system in response to lipoproteins released from rupturing syphilis bacteria.[SUP][27][/SUP]
[h=2]Epidemiology[/h]Main article: Epidemiology of syphilis
Age-standardized death from syphilis per 100,000 inhabitants in 2004[SUP][28][/SUP]
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 believed to have infected 12 million people in 1999, with greater than 90% of cases in the developing world.[SUP][5][/SUP] It affects between 700,000 and 1.6 million pregnancies a year, resulting in spontaneous abortions, stillbirths, and congenital syphilis. In sub-Saharan Africa, syphilis contributes to approximately 20% of perinatal deaths.[SUP][12][/SUP] Rates are proportionally higher among intravenous drug users, those who are infected with HIV, and men who have sex with men.[SUP][1][/SUP][SUP][2][/SUP][SUP][3][/SUP] In the United States, rates of syphilis as of 2007 were six times greater in men than women, while they were nearly equal in 1997.[SUP][29][/SUP] African Americans accounted for almost half of all cases in 2010.[SUP][30][/SUP]
Syphilis was very common is Europe during the 18th and 19th centuries. In the developed world during the early 20th century, infections declined rapidly with the widespread use of antibiotics, until the 1980s and 1990s.[SUP][13][/SUP] Since the year 2000, rates of syphilis have been increasing in the USA, Canada, the UK, Australia and Europe, primarily among men who have sex with men.[SUP][5][/SUP] Rates of syphilis among American women have, however, remained stable during this time, and rates among UK women have increased, but at a rate less than that of men.[SUP][31][/SUP] Increased rates among heterosexuals have occurred in China and Russia since the 1990s.[SUP][5][/SUP] This has been attributed to unsafe sexual practices, such as sexual promiscuity, prostitution, and decreasing use of barrier protection.[SUP][5][/SUP][SUP][32][/SUP][SUP][31][/SUP]
Untreated, it has a mortality of 8% to 58%, with a greater death rate in males.[SUP][4][/SUP] The symptoms of syphilis have become less severe over the 19th and 20th centuries, in part due to widespread availability of effective treatment and partly due to decreasing virulence of the spirochaete.[SUP][9][/SUP] With early treatment, few complications result.[SUP][8][/SUP] Syphilis increases the risk of HIV transmission by two to five times, and coinfection is common (3060% in a number of urban centers).[SUP][4][/SUP][SUP][5][/SUP]
[h=2]History[/h]Main article: History of syphilis
Portrait of Gerard de Lairesse byRembrandt van Rijn, circa 166567, oil on canvas - De Lairesse, himself a painter and art theorist, suffered from congenital syphilis that severely deformed his face and eventually blinded him.[SUP][33][/SUP]
The exact origin of syphilis is unknown.[SUP][4][/SUP] Of two primary hypotheses, one proposes syphilis was carried to Europe by the returning crewmen fromChristopher Columbus's voyage to the Americas, the other proposes syphilis existed in Europe previously, but went unrecognized. These are referred to as the "Columbian" and "pre-Columbian" hypotheses, respectively.[SUP][15][/SUP] The Columbian hypothesis is best supported by the available evidence.[SUP][34][/SUP] The first written records of an outbreak of syphilis in Europe occurred in 1494/1495 in Naples, Italy, during a French invasion.[SUP][13][/SUP][SUP][15][/SUP] Due to its being spread by returning French troops, it was initially known as the "French disease", as it is still traditionally referred. In 1530, the name "syphilis" was first used by the Italian physician and poet Girolamo Fracastoro as the title of his Latin poem in dactylic hexameter describing the ravages of the disease in Italy.[SUP][35][/SUP] It was also known historically as the "Great Pox".[SUP][36][/SUP][SUP][37][/SUP]
The causative organism, Treponema pallidum, was first identified by Fritz Schaudinn and Erich Hoffmann in 1905.[SUP][13][/SUP] The first effective treatment (Salvarsan) was developed in 1910 by Paul Ehrlich, which was followed by trials of penicillin and confirmation of its effectiveness in 1943.[SUP][13][/SUP][SUP][36][/SUP] Before the advent of effective treatment, mercury and isolation were commonly used, with treatments often worse than the disease.[SUP][36][/SUP] Many famous historical figures, including Franz Schubert, Arthur Schopenhauer, douard Manet[SUP][13][/SUP] and Adolf Hitler,[SUP][38][/SUP] are believed to have had the disease.
[h=2]Society and culture[/h][h=3]Arts and literature[/h]
The earliest Europe work of art to depict syphilis is Albrecht Drer's Syphilitic Man, a wood cutting believed to represent a Landsknecht, a Northern European mercenary.[SUP][39][/SUP] The myth of the femme fatale or "poison women" of the 19th century is believed to be partly derived from the devastation of syphilis, with classic examples in literature including John Keats' La Belle Dame sans Merci.[SUP][40][/SUP][SUP][41][/SUP]
The artist Jan van der Straet painted a scene of a wealthy man receiving treatment for syphilis with the tropical wood guaiacum sometime around 1580.[SUP][42][/SUP] The title of the work is "Preparation and Use of Guayaco for Treating Syphilis". That the artist chose to include this image in a series of works celebrating the New World indicates how important a treatment, however ineffective, for syphilis was to the European elite at that time. The richly colored and detailed work depicts four servants preparing the concoction while a physician looks on, hiding something behind his back while the hapless patient drinks.[SUP][43][/SUP]
[h=3]Tuskegee and Guatemala studies[/h]See also: Tuskegee syphilis experiment and Syphilis experiments in Guatemala
One of the most infamous United States cases of questionable medical ethics in the 20th century was the Tuskegee syphilis study.[SUP][44][/SUP] The study took place in Tuskegee, Alabama, and was supported by the U.S. Public Health Service (PHS) in partnership with the Tuskegee Institute.[SUP][45][/SUP] The study began in 1932, when syphilis was a widespread problem and there was no safe and effective treatment.[SUP][6][/SUP] The study was designed to measure the progression of untreated syphilis. By 1947, penicillin had been validated as an effective cure for syphilis and was becoming widely used to treat the disease. Study directors, however, continued the study and did not offer the participants treatment with penicillin.[SUP][45][/SUP] This is debated, and some have found that penicillin was given to many of the subjects.[SUP][6][/SUP] The study did not end until 1972.[SUP][45][/SUP]
Syphilis experiments were also carried out in Guatemala from 1946 to 1948. They were United States-sponsored human experiments, conducted during the government of Juan Jos Arvalo with the cooperation of some Guatemalan health ministries and officials. Doctors infected soldiers, prisoners, and mental patients with syphilis and other sexually transmitted diseases, without theinformed consent of the subjects, and then treated them with antibiotics. In October 2010, the U.S. formally apologized to Guatemala for conducting these experiments.[SUP][46][/SUP]
