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Syphilis rates skyrocket in China

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    Syphilis rates skyrocket in China 00:01 12 January 2007 NewScientist.com news service Roxanne Khamsi The rate of syphilis in China has skyrocketed, increasing
    Message 1 of 1 , Mar 10, 2007
      Syphilis rates skyrocket in China
      • 00:01 12 January 2007
      • NewScientist.com news service
      • Roxanne Khamsi

      The rate of syphilis in China has skyrocketed, increasing 25-fold since the early 1990s, according to a new report from a government health agency. Researchers blame the re-emergence of the sexually transmitted disease on increases in prostitution and premarital sex, inadequate screening services, and other factors.

      When the Communist party assumed power in China in 1949, the country was experiencing one of the worst syphilis epidemics in human history. At the time an estimated 5% of people in some large cities carried the disease.

      The new government enacted swift changes to stem the syphilis epidemic. For example, it implemented wide screening and free treatment for the disease and clamped down on prostitution. These changes led to the virtual elimination of syphilis within China.

      However new data from China suggest that the rapid social and economic changes there over the past two decades have encouraged the re-emergence of the disease. Data from hospitals and STD clinics around the country report that the rate of syphilis has jumped from 0.2 cases per 100,000 people in 1993 to 5.7 per 100,000 in 2005. In the city of Shanghai the rate is estimated to be as high as 55 cases per 100,000 individuals. The data comes from an analysis by China’s National Center for STD Control in Nanjing.

      Myron Cohen at the University of North Carolina in Chapel Hill, US, who worked with the Chinese researchers on the study, expects the rate of syphilis infection to continue rising: “It’s going to get worse before it gets better.”

      Devastating dementia

      Syphilis is an infection caused by the bacterium Treponema pallidum and can cause devastating dementia or deadly heart disease if left untreated. As well as spreading through sexual contact, the infection can also be passed from a woman to her baby during pregnancy or delivery. This can cause birth defects, including bone and heart abnormalities, or spontaneous abortion of the fetus.

      The researchers found that the number of children born with syphilis has surged from 0.01 cases per 100,000 live births in 1991 to 20 per 100,000 in 2005. This translates into about 3400 infected infants a year. Part of this leap is due to increased screening for the disease among newborns, Cohen explains.

      Experts point to a number of causes behind the return of syphilis in China, including the re-emergence of prostitution, more premarital sex and a large migrant population of male workers. They add that adult screening programmes have deteriorated.

      Natural immunity

      Cohen speculates that young adults might be particularly susceptible to syphilis because they lack immunity caused by prior infection. This type of natural immunity is thought to provide some protection (see Syphilis cycles not driven by risky sex).

      The rates of syphilis in China now exceed that of countries such as the US, where an estimated 2.7 people per 100,000 are believed to carry it. “In both relative and absolute terms, the 25-times increased risk of syphilis reported dwarfs that seen in the US, Canada and Europe,” says epidemiologist David Fisman of the Hospital for Sick Children in Toronto, Ontario.

      The researchers say China should boost screening rates and increase the availability of medicine to treat syphilis infection: a course of antibiotics such as penicillin can clear the body of the disease. They add that the country also needs to launch a public awareness campaign to alert people to the problem and promote the use of condoms, which can prevent transmission.

      Journal reference: Lancet (vol 369, p 132)


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