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An enzyme-linked immunosorbent assay for IgG antibodies against the flagellum (axial filament) of the Reiter treponeme (flagellum-ELISA) was developed and compared with the fluorescent treponemal antibody absorption (FTA-ABS) test and the Treponema pallidum immobilization (TPI) test with regard to diagnostic sensitivity and specificity. One serum from each of 827 individuals with and without syphilis was studied. In all diagnostic groups of syphilis there was no significant difference between the sensitivity of the FTA-ABS and the flagellum-ELISA, except in treated syphilis, where the FTA-ABS was more sensitive (P less than 0.01). In primary syphilis and in treated syphilis the sensitivity of the flagellum-ELISA was higher than the sensitivity of TPI (P less than 0.01 and P less than or equal to 0.05), respectively); in all other groups there was no significant difference between the sensitivity of TPI and flagellum-ELISA. The specificity of the flagellum-ELISA (99.0%) in 200 sera from blood donors without syphilis was not statistically different from the specificity of FTA-ABS (98.0%) and TPI (99.5%). The flagellum-ELISA seems to be well suited for routine serodiagnosis of syphilis and may replace other treponemal tests.

Systemic treatment modalities for eradication of multiple therapy resistant genital warts are so far not available. In this study laser treated patients with multiple genital warts received postoperatively either interferon alpha-2b subcutaneously (s.c.) 5 x 10' IU or matching placebo three times weekly for four weeks. At the conclusion of the study, 6-8 weeks after discontinuation of therapy, a significantly higher cure rate was found in the group of interferon-treated patients (14 of 27 (52%) patients cured) than among placebo treated patients (5 of 22 (23%) patients cured) (p < 0-05). The side effects of fever, chills, myalgia, headache and leukopenia occurred more commonly in the interferon treated group than in the placebo group. However, only three of 32 patients discontinued interferon therapy because of side effects. We conclude that the addition of s.c. administered interferon alpha-2b to laser treated patients with chronic therapy resistant genital warts is fairly well tolerated and that it significantly enhances the chance ofeliminating the disease. IntroductionThe optimal treatment modality has not been established in patients with recalcitrant multiple genital warts. A variety of ablative treatments for podophyllin resistant genital warts are available, including cryosurgery, electrocautery and laser therapy.

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