03/17/08

UNITED STATES:  Doctor Training Urged to Fight Syphilis Spread

Many doctors are ill-prepared to respond to the current resurgence of syphilis in developed nations, US researchers said in a new report.

Syphilis has been on the rise in high-income nations since the beginning of the 21st century, the authors said. "In many of these countries we are seeing very high rates in men who have sex with men [MSM]," said Dr. Kevin Fenton, the study's lead author and the director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. Yet, "In many countries, physicians may have lost some of the skill sets associated with diagnosing syphilis."

CDC last week reported that US syphilis rates were up in 2007, the seventh consecutive year in which an increase was documented. The proportion of cases diagnosed among MSM rose from 5 percent in 1999 to 64 percent in 2007. The increase is particularly concentrated among a subgroup: MSM who have high-risk sex with multiple partners.

The authors said the evidence makes the case for quick intervention steps, including increased screening, media campaigns, condom distribution, and outreaches to change the behavior of those most at risk.

"Efforts must be made to incorporate and evaluate new diagnostic tools, social network approaches, innovative evidence-based prevention interventions, robust disease surveillance, and systematic monitoring and evaluation of prevention, treatment, and care activities," the authors wrote.

Fenton stressed the importance of addressing the growing problem: "We have seen with other epidemics of [STDs] that even if the initial rise occurs in [MSM], it is unlikely to stay in that group for any long periods of time. The data suggest we are now seeing increases among heterosexuals in the US and in Europe as well."

The full report, "Infectious Syphilis in High-Income Settings in the 21st Century," was published in The Lancet (2008;8(4):244-253).

Source: Reuters:: Julie Steenhuysen; Courtesy of the CDC National Center for HIV, STD, and TB Prevention