Gene/Protein Disease Symptom Drug Enzyme Compound
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An outbreak of 1089 cases of infectious syphilis (primary, secondary and early latent) which occurred in the province of Alberta from 1981 to 1987 was analysed by stage of disease, age, sex, sexual preference and geographic distribution. The majority of cases occurred between 1983 and 1985 inclusive. Men accounted for 75.8% of the study population. The majority of men (71%) and women (98.5%) were heterosexual. Of the infected women, 58.7% were North American Indians and many worked as prostitutes. There was clustering in urban locations with 71.8% and 17.7% of cases reported in Edmonton and Calgary, respectively. Clinical signs of syphilis were more commonly present in men than women. Contact tracing played an important role in controlling the outbreak with 15.9% of men and 44.7% of women being diagnosed and treated as a result of this activity.
Int J STD AIDS
PMID:Epidemiology of an outbreak of infectious syphilis in Alberta. 178 32

The Bureau of STD Control continues to combat NYC's epidemic of congenital syphilis. The demographic profile of this population has remained constant with only a clearer identification of previously reported risk factors: most notably poor prenatal care and substance abuse. There is a suggestion of a plateau having occurred in adult and congenital syphilis, possibly caused by saturation effect on the high-risk population. During the period 1989 through 1990, the rates for cocaine/crack use have remained relatively constant among mothers infected with syphilis. A recent study by the Division of Substance Abuse Services of New York State school-age children demonstrated a drop in cocaine use from 14% in 1983 to 6%. If a similar decline is seen in substance abuse in other age groups, the rate of congenital syphilis may diminish.
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PMID:Congenital syphilis in New York City: 1985-1990. 179 20

Clinicians caring for sexually active adolescents are likely to be called on to diagnose and treat many of the STDs discussed in this article. A variety of other STDs not covered here also may be observed, including lymphogranuloma venereum, granuloma inguinale, molluscum contagiosum, scabies, pediculosis, and hepatitis A, B, and C. Some of the special issues related to gay and lesbian youth are discussed in the article by Drs Bidwell and Deisher (see "Adolescent Sexuality: Current Issues," pp 293-302). Nonetheless, it should be mentioned that the same STDs occur in homosexual youths as in their heterosexual counterparts. However, the prevalence rates for many STDs differ between the two groups, and some STDs are rarely seen in heterosexual males. These discrepancies may be explained by a number of determinants including anatomic and physiologic factors (eg, lesbian women have lower rates of STDs), differences in sexual practices (eg, genital-anal and oral-anal contact), and numbers of sexual partners, although this last factor may be less important in adolescents as compared with adult gay men. Discovery of one STD should always prompt a search for others because multiple concurrent infections is the rule rather than the exception. A serologic test for syphilis and a discussion of the potential for HIV infection (possibly testing for HIV as well) should take place at each new encounter for an STD. Some patients, including those with multiple partners, have an increased chance for acquisition of an STD. However, the reality is that any adolescent who has had sexual intercourse could have an STD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sexually transmitted diseases in adolescents: update 1991. 186 93

As part of a case-control study to investigate the high incidence of cervical cancer in Costa Rican women, the seroprevalence of the treponematoses, in particular, syphilis was determined. In each age group, women with a history of two or more sex partners were two to four times more likely to be seroreactive in tests for syphilis than women with zero or one sex partner. The highest percentage of reactive results in the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP) was seen in samples from women aged 50-59 who had had two or more lifetime partners (23.8%). Three observations from our study support reactivity due to syphilis rather than yaws or pinta: (1) a similar percent of reactive rapid plasma reagin (RPR) card test results among MHA-TP reactors in the two age groups of women who were surveyed (42 vs. 49%) was observed; (2) women who were seroreactive in the MHA-TP had multiple risk factors for STD [low socioeconomic status (9.4%), urban residence (22.8%), first intercourse under 16 years of age (14.1%), and multiple sex partners (26.3%)], and (3) only sexually experienced women had reactive results in the MHA-TP test.
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PMID:A population-based serosurveillance of syphilis in Costa Rica. 186 61

We present a study of biopsies taken from skin lesions of 44 patients presenting with primary or secondary syphilis. In most primary lesions erosion or, more often, ulceration was present, with a dense inflammatory infiltrate. In secondary syphilis a wide variety of histological changes was present. Blood vessels were frequently involved, with marked endothelial swelling and often proliferation. Treponemes were demonstrated with the Steiner staining method in all investigated cases of primary syphilis and in 71% of secondary syphilis cases. Treponemes were present throughout the dermis, particularly perivascularly, and in the dermal-epidermal junction zone. In two specimens of secondary syphilis treponemes were located predominantly in the epidermis, but there were always some microorganisms demonstrable in the dermis. The inflammatory infiltrate was often located in a perivascular coat-sleeve-like arrangement. In this study plasma cells and lymphocytes were present in all specimens of primary and secondary syphilis. Syphilitic lesions differed from yaws lesions mostly in the location of treponemes and the affection of blood vessels. In this histopathological study of early syphilis, treponemes did not show the epidermiotropic character of yaws, and blood vessel changes were more pronounced than in yaws. Unfortunately, due to the protean histopathological manifestations described in venereal syphilis and in yaws, these two treponemal diseases cannot always be differentiated on histological grounds alone.
Int J STD AIDS
PMID:Primary and secondary syphilis: a histopathological study. 191 61

The most recent CDC guidelines for treatment of STDs list a number of syndromes for which ceftriaxone is the recommended therapy, including those caused by N. gonorrhoeae and H. ducreyi. The drug has successfully eradicated incubating syphilis. Its use in primary, secondary, and latent syphilis is promising, although adequate data regarding optimal dose and duration of therapy are not yet available. It remains to be seen whether ceftriaxone represents the sun rising on a new era of successful STD treatment or the sun setting on the old penicillin era.
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PMID:Ceftriaxone in treatment of serious infections. Sexually transmitted diseases. 191 18

In Vienna, legalized prostitution is tightly controlled by the advisory board of the Viennese Public Health Service. Registered prostitutes are routinely screened for all important STDs, such as syphilis, HIV, gonorrhea, chlamydial- and yeast-infections, and Trichomonas vaginalis. Furthermore, cytological smears are obtained from the cervix and chest X-rays are performed at least once a year. In all pathological findings, an appropriate therapy is implemented. Presenting data of 1989, out of the 713 weekly controlled registered prostitutes, Neisseria gonorrhoeae was detected in 0.3% of all examinations (110/35,368). In non-registered prostitutes, the infection rate of N. gonorrhoeae was 6.9% (27/354), and so far, 20 times higher than in registered ones. The infection rate of Chlamydia trachomatis, which has been routinely diagnosed in registered prostitutes for several years, has decreased from 20.4% in 1980 to 2.2% in 1989 compared with 31.4% and 10.9% in non-registered prostitutes. In registered prostitutes, the prevalence of genital infections, such as C. trachomatis, T. vaginalis, and yeasts was shown to be 4.9%. The corresponding data in non-registered prostitutes were much higher (18.8%). Due to examinations for cervical malignancy the incidence of Papanicolaou stain IV and V has decreased from 3.1% in 1988 to 1.6% in 1989. There was no serologic evidence for syphilis and HIV infection in both special risk groups. The data demonstrate, that due to a good health surveillance of STD-risk groups, a good information service, and free treatment, the prevalence of STDs can be reduced in prostitutes.
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PMID:Medical health care for Viennese prostitutes. 194 14

The prevalence of viral and bacterial sexually transmitted diseases were studied in 101 men attending a dermatovenereal outpatient clinic in Mogadishu. A control group of 103 healthy adult men were included for the serological part of the study. Serological markers of hepatitis B virus (HBV), human immunodeficiency virus (HIV), cytomegalovirus (CMV) and herpes simplex virus (HSV) were studied. All sera were tested for syphilis markers. HBV serum markers were detected in 84% of the men in the study group and 66% of the healthy controls (P less than 0.005). Hepatitis B virus carriers were detected more frequently in the study group than among the controls. Also, 96% of the men in both groups had CMV antibodies and all of them had antibodies to HSV. No sera were found to contain HIV antibodies. The TPHA-positivity was 10% and 3% in the study and control groups respectively, and 5% of the patients had syphilis IgM antibodies. Sexual contact with prostitutes was recorded in 54% and 48% respectively of patients and controls, and such contact was correlated with TPHA-positivity in the study group. Chlamydia trachomatis antigen was detected in urogenital specimens of 14% of the men in the study group and gonococcal culture was positive in 53% of those with urethral discharge.
Int J STD AIDS 1990 Mar
PMID:Sexually transmitted diseases in men in Mogadishu, Somalia. 196 90

The seroprevalence of human immunodeficiency virus (HIV) infection and syphilis was investigated among 181 female prostitutes in Tegucigalpa, Honduras. 1 particle agglutination test and 2 enzyme immunoassays, as well as 1 immunofluorescence test, were used for the screening of HIV antibodies. Confirmation of positive results by the screening tests was carried out by western blot. The prevalence of HIV seropositivity was 4% (8 women). Specific treponemal antibodies were found in 50% (90/181) of the prostitutes as judged by Treponema pallidum hemagglutination assay (TPHA) and/or fluorescent treponemal antibody-absorption (FTA-ABSIgG) test. As estimated by the positivity of any or both nontreponemal tests (VDRL and RPR), a total of 31 (17%) of 181 women had active syphilis. A good correlation was found between the results obtained by TPHA and FTA-ABSIgG. IgM antibodies were found in 72% of sera positive by TPHA and/or FTA-ABSIgG. 4 of 181 women were found to have antibodies to both HIV and Treponema pallidum.
Int J STD AIDS
PMID:Human immunodeficiency virus infection and syphilis in Hondurian female prostitutes. 204 1

A total of 155 prostitutes inhabiting 4 different districts in Mogadishu, Somalia, were enrolled in a 6 month prospective study of syphilis and HIV infection. Blood samples were taken on entry, at 3 months and at 6 months. Differences were seen between the prostitutes in the 4 districts regarding possible risk factors for the acquisition of STDs. Initially 107 (69%) were found to have syphilis serum markers and 47% had active syphilis as judged by positivity in both Treponema Pallidum Haemagglutination (TPHA) test and non-treponemal (VDRL and RPR) tests. TPHA positivity was correlated to the number of sexual partners. Sixty-nine prostitutes were followed for 6 months. Two of the 16 initially TPHA negative women seroconverted for syphilis during the follow-up. HIV antibodies were detected in one (0.6%) of the 155 prostitutes at the start of the study and one out of 68 seroconverted during the 6 months follow-up. To control the spread of HIV infection health education targeting the risk groups like prostitutes must be given a high priority.
Int J STD AIDS
PMID:Syphilis and human immunodeficiency virus seroconversion during a 6-month follow-up of female prostitutes in Mogadishu, Somalia. 204 3


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