How infectious is syphilis?

Schober, Paul; Gabriel, Gleice Fernanda Costa Pinto; White, Patrick; Felton, W F; Thin, R N

doi:10.1136/sti.59.4.217

Cited by 38 publications

(37 citation statements)

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“…Individuals with lesions of early syphilis are most likely to transmit T. pallidum. While the risk of infection in exposed individuals is approximately 30% (range, 10%-80%) (4)(5)(6), inoculation studies with the Nichols strain of T. pallidum suggest that the intradermal ID 50 is only 57 organisms (7). The natural history of T. pallidum infection is summarized in Figure 1.…”

Section: The Natural History Of Syphilis Primary Syphilis -Transmissimentioning

confidence: 99%

Syphilis: using modern approaches to understand an old disease

Lukehart²

2011

J. Clin. Invest.

201

168

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Syphilis is a fascinating and perplexing infection, with protean clinical manifestations and both diagnostic and management ambiguities. Treponema pallidum subsp. pallidum, the agent of syphilis, is challenging to study in part because it cannot be cultured or genetically manipulated. Here, we review recent progress in the application of modern molecular techniques to understanding the biological basis of this multistage disease and to the development of new tools for diagnosis, for predicting efficacy of treatment with alternative antibiotics, and for studying the transmission of infection through population networks.

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Section: The Natural History Of Syphilis Primary Syphilis -Transmissimentioning

confidence: 99%

Syphilis: using modern approaches to understand an old disease

Lukehart²

2011

J. Clin. Invest.

201

168

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“…Syphilis is acquired by direct contact, usually sexual, with active primary or secondary lesions. Studies have shown that 16 to 30% of individuals who have had sexual contact with a syphilis-infected person in the preceding 30 days become infected (205,274); actual transmission rates may be much higher (6,106,271). Infection also occurs when organisms cross the placenta to infect the fetus in a pregnant woman.…”

Section: Introductionmentioning

confidence: 99%

Biological Basis for Syphilis

2006

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SUMMARY Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subsp. pallidum. Clinical manifestations separate the disease into stages; late stages of disease are now uncommon compared to the preantibiotic era. T. pallidum has an unusually small genome and lacks genes that encode many metabolic functions and classical virulence factors. The organism is extremely sensitive to environmental conditions and has not been continuously cultivated in vitro. Nonetheless, T. pallidum is highly infectious and survives for decades in the untreated host. Early syphilis lesions result from the host's immune response to the treponemes. Bacterial clearance and resolution of early lesions results from a delayed hypersensitivity response, although some organisms escape to cause persistent infection. One factor contributing to T. pallidum's chronicity is the paucity of integral outer membrane proteins, rendering intact organisms virtually invisible to the immune system. Antigenic variation of TprK, a putative surface-exposed protein, is likely to contribute to immune evasion. T. pallidum remains exquisitely sensitive to penicillin, but macrolide resistance has recently been identified in a number of geographic regions. The development of a syphilis vaccine, thus far elusive, would have a significant positive impact on global health.

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“…To our knowledge, this is the only study to identify factors associated with a greater likelihood of concordance between men. There is only one other study published that estimates infection rates between men within sexual partnerships 6. This previous study also did not include index cases with early latent syphilis as we have.…”

Section: Discussionmentioning

confidence: 95%

“…Most studies on syphilis transmission are more than three decades old 2–5. Only one study, from 1983, specifically examined syphilis among male partners of men 6. In this study, 76 index men with primary or secondary syphilis had 98 male sexual contacts, with 48 (49%) of contacts diagnosed with early syphilis.…”

Section: Introductionmentioning

confidence: 99%