Re-emergence of syphilis in the UK: the new epidemic phases

To characterize the re-emergence of infectious syphilis in the United Kingdom between 1997 and 2003, the authors conducted a retrospective analysis of surveillance data from genitourinary medicine clinics and additional data collected through enhanced surveillance.

Results of the analysis showed that from 1997 through 2002, syphilis diagnoses (primary, secondary and early latent) were up by 213 percent in heterosexual males, 1,412 percent in men who have sex with men (MSM), and 22 percent in females. A series of outbreaks have driven the increases through October 2003, chiefly in Manchester (528 cases) and London (1,222 cases). The majority of cases were MSM, and all the outbreaks were geographically localized. HIV co-infection was reported in a high percentage of cases. Oral sex was often reported as a route of transmission.

Syphilis has re-emerged in response to behavior change, probably driven by changes in the HIV epidemic, the authors concluded. The future course of the epidemic is difficult to predict and control remains elusive.

Reference:
Simms I, Fenton KA, Ashton M et al. The re-emergence of syphilis in the United Kingdom: the new epidemic phases. Sex Tran Dis 32(4) 220-226 (04.05.05)