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3 August 2009
Syphilis infections still climbing
by George Atkinson

A Louisiana State University report delivered to the National Foundation for Infectious Diseases reveals a worrying rise in syphilis cases, an increasing prevalence of drug-resistant gonorrhea and the emergence of a new STD - Mycoplasma genitalium. The report also confirmed that the number of cases of Chlamydia trachomatis, the most common reportable infectious disease in the US, is growing steadily.

In 2000, syphilis incidence rates in the U.S. had dropped to the lowest levels ever recorded and there was hope that syphilis could be eliminated totally. But in 2001 rates began to rise among men in the West and the Northeast and have continued to do so since. The majority of these cases have been in men who have sex with men. Rates among women continued to decrease until 2004 when they too began to increase. Soon thereafter in 2006 the feared consequence of increasing numbers of syphilis cases among women, congenital syphilis, also began to rise. Now, health experts are worried that the gains made in syphilis control following the epidemic of the late 1980s could be wiped out.

The report also notes that gonorrhea remains the second most common reportable infectious disease in the U.S. Racial disparities are more pronounced for gonorrhea than any other infectious disease, with 19 times higher case rates in African Americans than whites. But perhaps most worrying is the disease's increasing resistance to currently available antibiotics.

In the 1970s penicillin resistant N. gonorrhoeae was introduced into the U.S. by soldiers returning from the Viet Nam war. The cephalosporin class of drugs is now the mainstay of gonorrhea treatment in the U.S. but there is early evidence that resistance to this class of drugs may be appearing. Should this problem become wide spread there would few options available for treating this highly infectious disease.

Finally, the report details Mycoplasma genitalium, a new STD that was first identified in the early 1980s via a patient complaining of urethritis. An inability to identify subsequent isolates using the methods of classical microbiology foiled research efforts for a decade, however. Then, in the early 1990s, the application of newly developed polymerase chain reaction technology to diagnosis of infections caused by this organism greatly advanced the work. Scientists now know that M. genitalium is an important cause of nongonococcal urethritis in men.

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Source: Louisiana State University

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