Sexually transmitted diseases (STDs) are amongst the most common infectious diseases globally. They represent a serious health threat given their potentially serious complications and the fact they increase susceptibility to other infections. Highly sexually active people with multiple sexual partners, those who do not use condoms, drug abusers and commercial sex workers are at high risk. Symptoms should be checked regularly as these infections can have severe long-term consequences for the individual’s and their partner’s health.
A major challenge is the new rise of syphilis. Left untreated, syphilis causes significant complications, although it can be successfully treated with antibiotics. However, in many countries, traditionally in the developing and emerging regions, a failure to diagnose and treat lowers the chance of containment.
Infection rates in Russia and China have increased dramatically since the late 1990s, and in the United States the syphilis prevalence rate has crept upward since 2000, increasing by 11 per cent between 2011 and 2012.1 Significant increases have also been noted in certain European countries, including in the Czech Republic, Denmark, Ireland, Spain, Sweden and the United Kingdom, with several countries reporting more than 30 per cent increases between 2009 and 2010.2
The comeback of a historic disease
The new rise of syphilis is frequently associated with high-risk sexual practices among men who have sex with men (MSM). This group accounts for 75 per cent of all primary and secondary syphilis cases in the United States and prevalence is increasing.3 In other countries, syphilis prevalence among MSM is more than 15 per cent, including in Afghanistan, Argentina, Fiji, Guatemala, Jamaica, Morocco, Nicaragua and Paraguay.4
This group accounts for 75 per cent of all primary and secondary syphilis cases in the United States and prevalence is increasing.3 In other countries, syphilis prevalence among MSM is more than 15 per cent, including in Afghanistan, Argentina, Fiji, Guatemala, Jamaica, Morocco, Nicaragua and Paraguay.4
In the United States, heterosexually transmitted syphilis and congenital syphilis may also be emerging issues.5 Among men who have sex with women only, syphilis cases increased 4 per cent between 2011 and 2012.6 Young people, who acquire nearly half of all new STDs in the United States, and are at a higher risk of acquiring STDs than other age groups for a combination of behavioural, biological and cultural factors, also exhibit a worrying trend. Youth aged 20 to 24 are contracting syphilis at the highest rate, with rates among men aged 20-24 increasing each consecutive year since 2002.7 In several European countries, the diagnosis of syphilis is increasingly common among teenagers 16-19 years old.8
Approximately 1.5 million pregnancies are affected by syphilis every year and congenital syphilis, which occurs when the infection is passed from a pregnant woman to her fetus, is a leading cause of stillbirth and perinatal mortality in many developing countries.9 Since congenital syphilis can be prevented, pregnant women should be tested for syphilis regularly and receive immediate treatment if necessary.