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Syphilis April 8, 2010

Syphilis April 8, 2010. http://www.bium.univ-paris5.fr/sfhd/musee/image12.htm. Origins of Syphilis. First unambiguous case of syphilis recorded in 1495 From New World.

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Syphilis April 8, 2010

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  1. SyphilisApril 8, 2010 http://www.bium.univ-paris5.fr/sfhd/musee/image12.htm

  2. Origins of Syphilis • First unambiguous case of syphilis recorded in 1495 • From New World The Faster Times “Travel’s With “Lapham’s Quarterly”: Christopher Columbus Will Trade Cotton For Gold, 1493” (http://thefastertimes.com/slowtravel/2009/11/05/travels-with-laphams-quarterly-christopher-columbus-will-trade-cotton-for-gold-1493/)

  3. Origins of Syphilis • Treponemapallidumpallidum • Other, non-syphilitic, T. pallidum subspecies existed in the Old World • Humanity has been evolving with T. pallidum for at least 1.5 million years Wikipedia: Yaws

  4. Origins of Syphilis • Phylogenic and bone evidence confirm that Syphilis arose in the New World 6 Suite101.com: Skeletons – London’s Buried Bones

  5. Epidemiology • Low burden, even in the third world • Most US cases among men, especially MSMs

  6. Symptoms • Secondary • Skin rashes and mucosal lesions • Rarely, more severe symptoms • Primary • 10-90 after infection • Chancres USC School of Medicine’s Microbiology and Immunology on-line: Bacteriology – Chapter 14 (http://pathmicro.med.sc.edu/fox/spiro-neisseria.htm) USC School of Medicine’s Microbiology and Immunology on-line: Bacteriology – Chapter 14 (http://pathmicro.med.sc.edu/fox/spiro-neisseria.htm) 3

  7. Symptoms • Latent Symptoms • None…it’s latent • Can lay dormant for up to 20 years • Tertiary Symptoms • Gummatous lesions in various organs and of the body • Cardiovascular Syphilis • Neurosyphilis • Asymptomatic • Meningovascular • General Paresis of the Insane • TabesDorsalis Baylor University: Leishmaniasis: Visceral or Kala-Azar, Cutaneous, and MucocutaneousLeishmaniasis (Espundia) (http://www.wynman.com/baylor.html)

  8. Symptoms • Congenital • Can be transmitted from mother to child • Causes severe developmental abnormalities, spontaneous abortion, and or postnatal death All of the pain, none of the pleasure…

  9. Transmission Relatively safe…relatively: Not so much: • Contact with sores only (not via tub, utensils, toilets, etc)

  10. Treponemapallidumpallidum • Spirochaete phylum Wadsworth Center. New York State Department of Health. “Disease Carriers: Bacteria: Treponemapallidum (http://www.wadsworth.org/databank/treponem.htm)

  11. It’s a weak little bugger • Can’t be cultivated in vitro for long • Oxygen and heat susceptible • Can’t do genetic modifications • Usually cultivated in rabbits All of the pain and no--…well…

  12. Lack of Virulence • Lack Type III Secretion Mechanism and cytotoxins Pacific Northwest National Library (http://www.pnl.gov/science/highlights/highlight.asp?groupid=853&id=566)

  13. Attachment • Can attach to wide variety of cells and extracellular matrix proteins • Don’t know how. Super powers always do the trick.

  14. Invasion • Stimulate production of matrix metalloproteinase 1 (MMP-1) • Can subsequently invade multiple tissue types T. pallidum Modified from German Cancer Research Center in the Helmhotlz Association (http://www.dkfz.de/en/tumorzellinvasion/research/Tumor_Cell_Invasion.html)

  15. Immune Escape • Lacks lipopolysaccharides (LPS) • Can invade privileged tissues and organs • Slow metabolism and little need for iron …mostly your genitals and various organs, but same idea.

  16. Immune Escape • TprK proteins: Prime antigenic targets made of several variable (v) sections between constant (c) sections • Phase Variation and recombination • Involved in forming lesions The Institute of Cancer Research Picture Gallery 2 (http://www.icr.ac.uk/research/research_sections/structural_biology/teams/barford_team/picture_gallery_two/6913.shtml)

  17. Diagnosis • Dark Field Microscopy • NontreponemalTests • Venereal Disease Research Laboratory (VDRL) • Rapid Plasma Reagin (RPR) • TreponemalTests • Fluorescent Treponemal Antibody Absorption (FTA-ABS) Brookside Associates: OB-GYN 101 Lab – “RPR/VDRL/MHA-TP (Serologic Tests for Syphilis)Darkfield/FTA-ABS Microscopy” (http://www.brooksidepress.org/Products/OBGYN_101/MyDocuments4/Lab/RPR.htm) Prep4md: August 2008 (http://prep4md.blogspot.com/2008_08_01_archive.html)

  18. Archaic Treatment • Used to use Mercury or Malaria co-infection

  19. Modern Treatment • Penicillin and other β-Lactam Antibiotics9 • Intramuscular shot(s) • Jarisch-Herxheimer Reaction • Treat with acetaminophen • Doxycyclin or tetracycline otherwise • Antipsychotics can be used to treat certain neurosyphilissymptoms

  20. Recurring • Can be re-infected with syphilis even after successful treatment

  21. Prevention I pity the fool who don’t wrap his tool. • Abstinence or condom (somewhat)

  22. References • Beltrami J, Weinstock H, Berman S, Et Al . 2006 Mar. Primary and Secondary Syphilis --- United States, 2003--2004. CDC Morbidity and Mortality Weekly Report [serial online]. 55(10):269-73. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5510a1.htm. • CDC. 2010. Syphilis - CDC Fact Sheet. Atlanta, GA: Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm. • Clancy N. 2010. The History of Syphilis. Gainesville, FL: University of Florida. Available from: http://medinfo.ufl.edu/other/histmed/clancy/. • Disease and injury country estimates. Geneva, Switzerland: World Health Organization. Available from: http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html. • Hall CS & Bolan G. 2010. Syphilis and HIV. San Francisco, CA: University of California at San Francisco. Available from: http://hivinsite.ucsf.edu/InSite?page=kb-05-01-04. • Harper KN, Ocampo PS, Steiner BM, George RW, Silverman MS, et al. (2008) On the Origin of the Treponematoses: A Phylogenetic Approach. PLoSNeglTropDis 2(1): e148. http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000148 • Jamess R B. 2010. Syphilis. Health.am. Available from: http://www.health.am/sex/syphilis/. • LaFonda RE, Lukehart SA. 2006. Biological Basis for Syphilis. Clinical Microbiology Reviews 19(1):29-49. • Lee V, Kinghorn G. 2008. Syphilis: An Update. Royal College of Physicians: Clinical Medicine 8(3):330-3. • The Medical News: Syphilis History. The Medical News. Available from: http://www.news-medical.net/health/Syphilis-History.aspx. • MetaPathogen.com: Treponemapallidumsubsppallidum. 2009. Available from: http://www.metapathogen.com/syphilis/ • Rose, M. (1997). Origins of Syphilis. Archaeology, 50(1). http://www.archaeology.org/9701/newsbriefs/syphilis.html

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