Doctor training urged to fight syphilis spread (Reuters)

CHICAGO (Reuters) - Syphilis is making a comeback indeveloped countries, spurred by illicit drug use and high-risksexual behaviors, and many doctors are unprepared to recognizeand treat it, U.S. researchers said on Monday.

They said syphilis has been on the rise since the beginningof the 21st century in high-income countries, but because thedisease had been well controlled in the 1990s, doctors may notbe screening for it.

"The key message here is that syphilis is again on the risein several developing countries. In many of these countries weare seeing very high rates in men who have sex with men," saidDr. Kevin Fenton of the U.S. Centers for Disease Control andPrevention, whose study appears in the journal Lancet.

Fenton said the resurgence demands new training effortsamong health-care professionals. "In many countries, physiciansmay have lost some of the skill sets associated with diagnosingsyphilis," Fenton said in a telephone interview.

The CDC last week said the U.S. syphilis rate rose onceagain in 2007, marking the seventh consecutive year ofincreases. Homosexual and bisexual men accounted for 64 percentof syphilis cases in 2007, up from about 5 percent in 1999.

Syphilis infects some 12 million people worldwide everyyear. Most cases are acquired through sexual contact with asyphilis sore. Pregnant women can pass it on to their babies.

The recent resurgence is among a sub-group of men who havesex with men and engage in high-risk sex with multiplepartners.

If not addressed, Fenton said the disease could become farmore widespread.

"We have seen with other epidemics of sexually transmitteddiseases that even if the initial rise occurs in men who havesex with men, it is unlikely to stay in that group for any longperiods of time," Fenton said.

"The data suggest we are now seeing increases amongheterosexuals in the U.S. and in Europe as well," he said.

Fenton and colleagues argue that the resurgence calls forswift public health intervention, including screening programsto prevent the spread of the infection, mass media campaigns,efforts to change behavior in high-risk groups and distributionof condoms.

"Efforts must be made to incorporate and evaluate newdiagnostics tools, social network approaches, innovativeevidence-based prevention interventions, robust diseasesurveillance and systematic monitoring and evaluation ofprevention, treatment and care activities," they wrote.

Like many other sexually transmitted diseases, syphilisraises the likelihood of infection by or transmission of thehuman immunodeficiency virus, which causes AIDS.

Syphilis is caused by the bacterium Treponema palladium. Itstarts out as a sore, but progresses to a rash, fever, andeventually can cause blindness, paralysis and dementia.

(Editing by Will Dunham and Philip Barbara)