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In 1952, China had the ‘the biggest syphilis epidemic ever recorded’.
Which, they managed very effectively leading to near extinction of
syphilis by the 1960s. It’s however, unfortunate that Zhi-Qiang Chen et al
has highlighted another rise of syphilis from China's national Sexual
Transmitted Disease (STD) surveillance system and sentinel site network.
The data collected and analysed has shown a sharp increase in incidence of
28-fold (1993 to 2005) and an even further increase in congenital syphilis
of 0.01 cases to 19.68 per 100,000 live births (1991 to 2005). One of the
prime reasons for this increase is economic reform leading to economic
migration and in-turn a remerging sex industry (1-2).
However, China is not unique to this trend in sexually transmitted
diseases? England and Wales are showing similar increase in incidents. For
example in Walsall a population of 0.25 million; the increase has been
profound, a 75 fold increase: 0.4 to 31.6 per 100,000 (2000-2005) with a
similar pattern emerging for other sexually-transmitted-diseases such as
Chlamydia (3).
Unlike China, migration has only been linked to increasing HIV
population in England and Wales (4). While the increase in Syphilis has
been linked to sexual risk-taking behaviours demonstrated by the
population at large including the gay and bisexual population (4). Where
there is a distinct lack of information in the article about the gay and
bisexual population considering this is a high risk group.
These finding have just confirmed that Syphilis remains a worldwide
public health problem, with more than 12 million cases in adults and more
than half a million pregnancies yearly (5). Hence, it’s essential to have
robust monitoring; preventative measures and education in place for both
low and high risk groups. These steps may help curb a possible Health
crisis.
2. Hu CK, Ge Y, Chen ST. Control and eradication of syphilis in china.
Beijing Sci Conference 1964: 167-177.
3. Pugh RN, Laverty S, and Simms I, et al. Syphilis clusters in Walsall:
case profiles and public health implications. Communicable Disease and
Public Health 2004; 7: 36-38.
4. Pugh RN. The re-emergence of syphilis and its influence on the HIV
epidemic. Aids and Hepatitis Digest, 106, March 2005; 1-3
5. Global Prevalence and Incidence of Selected Curable Sexually
Transmitted Infections Overview and Estimates". World Health
Organization, 2001.
The ‘Great Mimicker’ Returns: but not only to China
In 1952, China had the ‘the biggest syphilis epidemic ever recorded’.
Which, they managed very effectively leading to near extinction of
syphilis by the 1960s. It’s however, unfortunate that Zhi-Qiang Chen et al
has highlighted another rise of syphilis from China's national Sexual
Transmitted Disease (STD) surveillance system and sentinel site network.
The data collected and analysed has shown a sharp increase in incidence of
28-fold (1993 to 2005) and an even further increase in congenital syphilis
of 0.01 cases to 19.68 per 100,000 live births (1991 to 2005). One of the
prime reasons for this increase is economic reform leading to economic
migration and in-turn a remerging sex industry (1-2).
However, China is not unique to this trend in sexually transmitted
diseases? England and Wales are showing similar increase in incidents. For
example in Walsall a population of 0.25 million; the increase has been
profound, a 75 fold increase: 0.4 to 31.6 per 100,000 (2000-2005) with a
similar pattern emerging for other sexually-transmitted-diseases such as
Chlamydia (3).
Unlike China, migration has only been linked to increasing HIV
population in England and Wales (4). While the increase in Syphilis has
been linked to sexual risk-taking behaviours demonstrated by the
population at large including the gay and bisexual population (4). Where
there is a distinct lack of information in the article about the gay and
bisexual population considering this is a high risk group.
These finding have just confirmed that Syphilis remains a worldwide
public health problem, with more than 12 million cases in adults and more
than half a million pregnancies yearly (5). Hence, it’s essential to have
robust monitoring; preventative measures and education in place for both
low and high risk groups. These steps may help curb a possible Health
crisis.
References:
1. Zhi- Qiang Chen, GUO-Cheng Zhang, Xiang-Dong Gong, Charles Lin, Xin
Qao, Quo-Jun Liang, Xiao-Li Yue, Xiang-Sheng Chen, Myron S Cohen. Lancet
2007; 369: 132-38.
2. Hu CK, Ge Y, Chen ST. Control and eradication of syphilis in china.
Beijing Sci Conference 1964: 167-177.
3. Pugh RN, Laverty S, and Simms I, et al. Syphilis clusters in Walsall:
case profiles and public health implications. Communicable Disease and
Public Health 2004; 7: 36-38.
4. Pugh RN. The re-emergence of syphilis and its influence on the HIV
epidemic. Aids and Hepatitis Digest, 106, March 2005; 1-3
5. Global Prevalence and Incidence of Selected Curable Sexually
Transmitted Infections Overview and Estimates". World Health
Organization, 2001.
Competing interests:
None declared
Competing interests: No competing interests