SYPHILIS (MORBUS GALLICUS). – 5th most common STI.
Lecture overview.
• History of syphilis - 21st century syphilis
• Epidemiology of 21st century syphilis
• Treponema pallidum –physiology and virulence factors
• Clinical manifestations of syphilis
• Laboratory diagnosis (non culture techniques)
• Treatment / prevention
Syphilis: a disease with history.
• Syphilis: chronic potentially fatal infection; Treponema pallidum
• Spread: sex; intravenous drugs; congenital
• The origins of syphilis –controversial
(a) Columbian Theory
Back from old world to Europe
(b) Pre-Columbian Theory
Hippocrates pox-like infection – 3o syphilis
(c) Evolutionary Theory
Treponema sp. cutaneous in Africa evolved following hand washing
• Syphilis has several synonyms:
The Great Pox; Morbus gallicus (The French disease); The Great Imitator
• Frequently portrayed in art / literature
• Famous syphilitics
• 21st Century: 5th leading STI in UK
Syphilis is a chronic and potentially fatal infection that is caused by treponema pallidum.
It can be spread by sexual intercourse, intravenous drug use and it can also be congenital.
The origin of syphilis is controversial:
There is a Columbian theory, where Christopher columbus was discovering the new world,
they partook in some activities that they were not supposed to and then returned to
Europe. This return voyage coinsided with the outbreak of syphilis.
Could be untrue because before Columbian times there was also reports of syphilis.
There is an evolutionary theory that the treponema species has evolved from a cutaneous
bacteria that is found in bacteria, and with the advent of hand- washing, the bacteria then
made that transition into the body, under some evolutionary pressure with the change in
some personal practice with hand washing.
But this is unproven, it is very difficult to prove and this is a historical analysis not a
microbiological analysis.
Syphilis is also known as the great imitator; this is because the clinical manifestations look
like something totally different.
, Spirochaetaceae: treponema.
Genus/species/subsp. Disease Mode of spread Manifestations
Treponema carateum Pinta Transmitted by Direct Skin lesions
skin contact (Central – scarring
South America disfigurement
Treponema pallidum Bejel Transmitted by Oral lesions
Subspecies. Contaminated eating
endemicum utensils (Africa/Asia)
Treponema pallidum Yaws Direct skin contact Skin lesions
Subsp. pertenue (S.America/Africa/Asia) destruction of
lymph
nodes /bones
Treponema pallidum Syphilis Transmitted -Sexual / Primary –
Subsp. pallidum congenital (worldwide) tertiary syphilis
There are different species in the treponema genus.
There is treponema carateum which causes the disease pinta, this is found in central and
south america
Syphilis: epidemiology in the 21st century.
• Reduction in late 1940s
• 2011: 2,900 (2002 - 2011: 87% increase)
2014: 4,317 (2011 -2014: 49% increase)
2015: 5,288 (2014 -2015: 22% increase)
8,692 in 2022
• Wide range of age groups
• Increase: Multi-factoral
• 6.3 million cases worldwide/year
Lecture overview.
• History of syphilis - 21st century syphilis
• Epidemiology of 21st century syphilis
• Treponema pallidum –physiology and virulence factors
• Clinical manifestations of syphilis
• Laboratory diagnosis (non culture techniques)
• Treatment / prevention
Syphilis: a disease with history.
• Syphilis: chronic potentially fatal infection; Treponema pallidum
• Spread: sex; intravenous drugs; congenital
• The origins of syphilis –controversial
(a) Columbian Theory
Back from old world to Europe
(b) Pre-Columbian Theory
Hippocrates pox-like infection – 3o syphilis
(c) Evolutionary Theory
Treponema sp. cutaneous in Africa evolved following hand washing
• Syphilis has several synonyms:
The Great Pox; Morbus gallicus (The French disease); The Great Imitator
• Frequently portrayed in art / literature
• Famous syphilitics
• 21st Century: 5th leading STI in UK
Syphilis is a chronic and potentially fatal infection that is caused by treponema pallidum.
It can be spread by sexual intercourse, intravenous drug use and it can also be congenital.
The origin of syphilis is controversial:
There is a Columbian theory, where Christopher columbus was discovering the new world,
they partook in some activities that they were not supposed to and then returned to
Europe. This return voyage coinsided with the outbreak of syphilis.
Could be untrue because before Columbian times there was also reports of syphilis.
There is an evolutionary theory that the treponema species has evolved from a cutaneous
bacteria that is found in bacteria, and with the advent of hand- washing, the bacteria then
made that transition into the body, under some evolutionary pressure with the change in
some personal practice with hand washing.
But this is unproven, it is very difficult to prove and this is a historical analysis not a
microbiological analysis.
Syphilis is also known as the great imitator; this is because the clinical manifestations look
like something totally different.
, Spirochaetaceae: treponema.
Genus/species/subsp. Disease Mode of spread Manifestations
Treponema carateum Pinta Transmitted by Direct Skin lesions
skin contact (Central – scarring
South America disfigurement
Treponema pallidum Bejel Transmitted by Oral lesions
Subspecies. Contaminated eating
endemicum utensils (Africa/Asia)
Treponema pallidum Yaws Direct skin contact Skin lesions
Subsp. pertenue (S.America/Africa/Asia) destruction of
lymph
nodes /bones
Treponema pallidum Syphilis Transmitted -Sexual / Primary –
Subsp. pallidum congenital (worldwide) tertiary syphilis
There are different species in the treponema genus.
There is treponema carateum which causes the disease pinta, this is found in central and
south america
Syphilis: epidemiology in the 21st century.
• Reduction in late 1940s
• 2011: 2,900 (2002 - 2011: 87% increase)
2014: 4,317 (2011 -2014: 49% increase)
2015: 5,288 (2014 -2015: 22% increase)
8,692 in 2022
• Wide range of age groups
• Increase: Multi-factoral
• 6.3 million cases worldwide/year
