Syphilis Re-emerging

These findings are important for MSIDS (multi systemic infectious disease disease syndrome  or Lyme with friends) patients because people with false positive testing results for Syphilis may have Lyme Disease.

When writer of The Joy Luck Club, Amy Tan, asked her doctor to test her for Lyme he insisted she didn’t have LD because it was too rare and proceeded to test her for Syphilis.

Origin of modern syphilis and emergence of a pandemic Treponema pallidum cluster
Natasha Arora, Verena J. Schuenemann[…]Homayoun C. Bagheri
Nature Microbiology 2, Article number: 16245 (2016)
Published online:
05 December 2016

The abrupt onslaught of the syphilis pandemic that started in the late fifteenth century established this devastating infectious disease as one of the most feared in human history1. Surprisingly, despite the availability of effective antibiotic treatment since the mid-twentieth century, this bacterial infection, which is caused by Treponema pallidum subsp. pallidum (TPA), has been re-emerging globally in the last few decades with an estimated 10.6 million cases in 2008 (ref. 2). Although resistance to penicillin has not yet been identified, an increasing number of strains fail to respond to the second-line antibiotic azithromycin3. Little is known about the genetic patterns in current infections or the evolutionary origins of the disease due to the low quantities of treponemal DNA in clinical samples and difficulties in cultivating the pathogen4. Here, we used DNA capture and whole-genome sequencing to successfully interrogate genome-wide variation from syphilis patient specimens, combined with laboratory samples of TPA and two other subspecies. Phylogenetic comparisons based on the sequenced genomes indicate that the TPA strains examined share a common ancestor after the fifteenth century, within the early modern era. Moreover, most contemporary strains are azithromycin-resistant and are members of a globally dominant cluster, named here as SS14-Ω. The cluster diversified from a common ancestor in the mid-twentieth century subsequent to the discovery of antibiotics. Its recent phylogenetic divergence and global presence point to the emergence of a pandemic strain cluster.

“Perhaps most concerning, the past two years have seen a cluster of cases of syphilis of the eye, and a rise in cases of congenital syphilis—something even developing countries have been able to eliminate.

The disease is curable with antibiotics, but it’s a bit of a secret agent, transmissible through almost every sexual means and erupting as a tiny lesion about a month after exposure. At various stages of the infection, it might cause no symptoms or a puzzling array of them. If gone undiagnosed, it can cause everything from disfigurement to seizures.”  By Daniel Wolfe

“TB, rare cancers and pneumonias — all of these were documented, if unusual, expressions of syphilis before the antibiotic era,” says Joan McKenna, a research physiologist whose 1986 article in the journal Medical Hypotheses first presented the AIDS-syphilis connection.
McKenna found an unlikely ally in Sandra Larsen, MD, then a syphilis expert at the CDC. “The clinical manifestations of syphilis, which have taken various forms over the century, have now been transformed to mimic the appearance of the opportunistic infections and cancers that may accompany HIV infection, as well as the clinical symptoms of AIDS itself,” Larsen wrote. McKenna began sending AIDS patients in for confirmatory syphilis tests, even when they’d first tested negative. “We had people showing up negative on the initial tests even when they had known infections and tertiary symptoms,” she says. These syphilis cases were being missed.”
Others interested in the AIDS-syphilis link scrapped the theory in the late ’80s, when doctors treating HIVers with IV antibiotics found that they still sickened and died. But the idea that a new form of chronic syphilis may be mistaken for HIV-related infections, has been kept alive by Toronto researcher John Scythes and colleague Colman Jones. “Repeated studies show that syphilis infection and, particularly, reinfection, may not be detected with current tests,” Jones says. So some of those we say are cured of syphilis may instead be being missed. The CDC estimated there were 325,000 cases of untreated syphilis at the end of the 1970s. Where did they go?”
New research into syphilis’ suburban cousinBorrelia burgdorferi, the spirochete that causes Lyme disease — has bolstered the case for better tests. Recently researchers have successfully cultured B. burgdorferi from the blood of Lyme disease patients supposedly cured by antibiotics and found a cyst-like form of the Lyme spirochete, adopted in response to meds, which is often missed with standard microscopy. Might syphilis similarly adapt to avoid antibiotics and detection? “There is much we do not yet know,” says Willy Burgdorfer, PhD, the Lyme spirochete’s discoverer. “But T. pallidum does behave in ways very similar to B. burgdorferi.” (2009)

“Far from eradicating syphilis, antibiotics are driving the disease underground and increasing the difficulty of detection. Although the incidence of disease has more than tripled since 1955, the chancre and secondary rash no longer are commonly seen. Undoubtedly, some of these lesions are being suppressed and the disease masked by the indiscriminate use of antibiotics. The ominous prospect of a widespread resurgence of the disease in its tertiary forms looms ahead” (Pereyra and Voller, 1970)…..We urge that the possible direct causal involvement of spirochetes and their round bodies to symptoms of immune deficiency be carefully and vigorously investigated.”

This review argues that syphilis has been underdiagnosed and under treated… we suggest that latent syphilis is a chronic active immunological condition that drives the AIDS process and that non-treponemal tests have failed to associate syphilis with immune suppression since this screening concept was developed in 1906. In light of the overwhelming association between a past history of syphilis and HIV seroconversion, more sensitive tools, including recombinant antigen-based immunological tests and direct detection (PCR) technology, are needed to adequately assess the role of latent syphilis in persons with HIV/AIDS. Repeating older syphilis reinoculation studies may help establish a successful animal model for AIDS, and resolve many paradoxes in HIV science.  (Syphilis fact sheet with symptoms)  In the US in 2015, there were nearly 75,000 cases of Syphilis.  Syphilis has more than doubled in Las Vegas since 2012.  Health Department in Mississippi says Syphilis cases are up 60% this year.

Cases of syphilis on the rise in Mississippi