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The return of syphilis, to a day called “Cupid's disease”

The return of syphilis is, according to my intellectual position, a “thing” more than expected!

The last thing a person can think about me is that I am a conservative. Cross creed three times! Libertarian in the extreme I've been, as long as it didn't involve children or animals people like that generate me disgust 😡 as long as it was consensual. No, it is not. SCORE!  However, forgive me the most sensitive, I was never a fan of “expressions of great affection” on the public road!

It is true that I was, yes, with Vera, there at “Belo Ramo”.

It was not well lit and, from time to time, the priest would appear, shooing away all the couples who were “working out” there. I already talked about vera and the text that talks about it is under review!

AIDS as an Aerodynamic Brake

AIDS served as an aerodynamic brake, in such a way that, having Fátima rescued me from the streets in 1981/1982, in 1985 there was absolutely nothing similar to what I saw!

In this way, and I know that many people disagree, disagreed and will disagree, AIDS has changed, and I change “pacas”, people's sexual behavior.

With the “chronification of AIDS” and HIV infection, the great fear has passed and, as a matter of fact, things are no longer as they were, and although NEVER it is an extreme word, I believe that it will never be as it was, one day… Everything passes….

So, as a kind of “general release, let's go back to the carnival” it could, as well as it could and could, provoke…

… The return of syphilis…

… As demonstrated by the European Center for Disease Prevention and Control (ECDC), which recently published its annual epidemiological report and a technical report, Noting that Syphilis notifications have increased by 70% across Europe since 2010. (Yes, Io-io is here, a little bit of Brazil Ia-iá…

We talked to Andrew Amato-Gauci, head of HIV, the sexually transmitted program of ECDC viral infections and hepatitis, about this worrying trend and what action needs to be taken.

What are the key trends highlighted in the recent ECDC report?

The return of syphilis is, in general, the trend is a constant and significant increase in the rate of syphilis diagnoses reported across Europe since 2010. The second trend is in the proportion of male and female diagnostic rates. In 2000, syphilis diagnoses were reported in proportion to 1,4 men for 1 woman. 

Based on the most recent numbers, this ratio is from xnumx men to xnumx woman, so it is a really substantial increase. 

A Closer Look

When we look at this more closely in Europe, also using the available information on how syphilis is transmitted, we find that the epidemic is growing mainly among men who have sex with men.

We also looked at countries outside Europe, including the US, Canada, Australia, and Japan, and found very similar trends in increased syphilis reporting in all of these countries.

In the US, which has very good data on syphilis, there is also an increase among women, as well as an increase in congenital syphilis.

We have not seen this trend only in the European Union, and among men, but in fact, in the last two years we have begun to see more cases among women; so maybe we are just late and need to keep an eye on any such developments. 

What led you to examine syphilis in detail in this report?

At ECDC, we work to identify, evaluate, and then study potential threats from communicable diseases. We evaluate evidence from scientific studies and projects, analyze technical data, and collect our own data from European member states.

We then produce scientific advice or technical reports that can inform public health policy decisions in member states.

Network of Specialists in Sexually Transmitted Infections (in the past, “venereal diseases”).

We have a network of nominated specialists working on sexually transmitted infections (STDs) from all member states, and the network's coordination committee meets at least once a year. At 2018, the committee raised concerns about the rise in syphilis that doctors were observing and asked us to analyze the epidemiology of syphilis, assess the level of risk, and indicate options for responding to that increase.

What is the impact of syphilis on affected people?

This question seems to me something generated by a horse!

Syphilis is a bacterial infection, but it is quite complicated in the sense that may result in chronic infection with long-term health consequences. We usually talk about primary syphilis, secondary and tertiary.

Most people with primary syphilis develop a small ulcer called cancer ten days to three weeks after exposure. This ulcer is usually visible in a man because it is in the penis, but in a woman it can be inside the vagina and disappear completely.

I went through it! A girl with very dark eyes looked at me, smiled, “tame me” and slaughtered me! Days later the ulcer mentioned here appeared. It is ugly, has “hard edges” and seems to hold a liquid with no noticeable properties!

When the doctor told me it was syphilis, I got P for life and said, metaphorically, that “would kill her ”! The doctor explained to me what was going on and I had to go to her with the sad and badly received news that resulted in the breakup of this brief affair!

In the tongue, or in the throat ”!

However, the ulcer can appear anywhere that it has had contact with the bacteria, which is transmitted in sexual fluids, and may be in the rectum, tongue or throat.

If you feel you do not realize the ulcer or do not treat it, the infection becomes what we call secondary syphilis.

Bacteria begin to spread throughout the body and the usual signs of secondary infection are rashes, usually starting on the palms and soles. 

You may also have hair loss and flu-like symptoms.

If you again do not realize that this is syphilis, the infection can turn into the most dangerous tertiary syphilis.

Ten years!

Tertiary syphilis can take ten years to develop. At this point, bacteria are beginning to erode your nervous system. 

May cause serious damage to the brain and heart and if not treated, can lead to death!

At any stage, it is very simple to treat syphilis with penicillin. However, if you treat it late, the damage it has already caused is not reversible, so it is important to treat it early.

Another important thing to understand about syphilis is that if a woman has syphilis when she becomes pregnant or becomes infected during pregnancy, she can also pass on the infection to her child. 

We call this congenital syphilis which can lead to very serious complications during pregnancy, various fetal deformities or even result in stillbirth or that the baby dies soon after birth.

What is causing the rise in syphilis rates you have observed?

The increase is not just in Europe, it is a phenomenon of the western world and there are probably many different factors behind it. 

Obviously, there is a clear relationship between risky sexual behavior and syphilis. When the HIV epidemic started in the 80s, people started using a lot more condoms. As a side effect of this, rates of syphilis and other sexually transmitted diseases have dropped across the Western world.

 It seems that now that HIV is seen as yet another chronic but treatable infection, people are less interested in condoms and safer sex, and this is probably one of the main factors behind the rise in syphilis cases.

There are a few other specific factors. For example, for men who have sex with men, who are the most affected group, it is clear from many studies that there has been an increase in anal sex without a condom. 

There has also been a general increase in the number of sexual partners, and one of the reasons may be the increased popularity of social networking or dating apps that make it easier for you to find sexual partners. 

Pre-exposure to HIV prophylaxis (PrEP) has only recently arrived as a possibility to prevent HIV infection. With this option, people seem to be less concerned with HIV infection during sex. 

But not using condoms, especially with new or casual partners, also means that you open yourself to the possibility of other sexually transmitted infections, such as syphilis. 

Heterosexual populations in other parts of the world, such as the US, are seeing an increase in syphilis in women, and we are starting to see it in Europe. 

This is a bit more complicated. 

Of course, it is also related to having multiple sexual partners and condomless sex. In addition, we know that using alcohol or drugs impairs safer sexual behavior and there is also an association with sex work. Social vulnerabilities such as poverty and incarceration are also known to be associated with syphilis.

Access to health care is very important. If you miss your primary infection, the only way to know that you have syphilis is to go to a doctor and ask for a test. If you don't take a test, you just won't know you own it and would pass it on unknowingly to your sexual partners.

Testing is a very important element of what we are emphasizing. People who are at risk or at risk of infection should regularly request a check-up and blood test - it is a very simple blood test.

How should we respond to news that syphilis is increasing?

First, everyone should read the report! In the report, we suggest evidence-based actions.

In general, we need to recognize the general tendency to increase STIs and take steps to address it. 

Syphilis is rising rapidly and data also show similar increases in gonorrhea, chlamydia and other infections. We are seeing this epidemic evolving and somewhat overshadowed by other health events, so we need to spread the word.

We would like to see more efforts in promoting safer sexual behaviors, promoting consistent condom use, and encouraging people who do not consistently use condoms to perform for frequent testing. For example, people who take PrEP usually get an STD test every three months, and that's great, because you can diagnose an infection very early, treat it, and reduce the chance of transmission.

We suggest several other answers, such as effective partner management services. In specialized clinics dealing with syphilis, there would normally be a designated health professional (usually a nurse) who would ask the person who was diagnosed with syphilis if they know who may have passed on the syphilis or if it has already passed. about this. 

This nurse then helps the person send an anonymous or confidential message to these sexual partners to ask them to take the test, again trying to stop the transmission.

We also believe in the importance of education for clinicians and the sexually active population in general.

Many clinicians believe that syphilis died in the 1980 decade, so they are not as aware as they should be that syphilis is on the rise and should be tested more often even in people without symptoms. 

School sex education should not just be about HIV. Young people should be aware of syphilis and other bacterial STDs that are so easily treated but so easily lost.

There are interventions that we would like member states to adopt, such as having a national STI strategy, as few countries currently have. We would also like to see national action plans to control syphilis.

Another example: there is evidence that the 'checkpoints' are working well. 

They are essentially low-threshold clinics, which do not look like formal clinics, and have been introduced in a number of European cities, including Barcelona, ​​Athens and London. 

People can just show up and take a test. 

These services are very effective, especially for certain groups of men who have sex with men who are most at risk.

Translated by Claudio Afonso (name formally adopted in honor of my Father) in 17 November 2019 from the ceiling written and published by Greta Hughson em August 29st, 2019

For more information, visit the ECDC website..

This feature appeared in the August issue of 2019 from Eurobulletin.

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