Cupid! This is your month, of flowers and candy and poems. Lovers, pierced by your arrows, rejoice. But sometimes Cupid’s barbs may be cruel, for romance brings sex, which, occasionally and we hope rarely, brings a sexually transmitted disease. A potentially lethal one is syphilis.
Let us, in this month of ardor, contemplate the centuries-old bacterium that has no vaccine, that transmits from person to person, that infects embryos, and that invades the body stealthily. Initially syphilis may show as a rash on palms and heels, a fever, a headache, a sore throat, muscle aches, a painless sore — hardly sufficient to spur a panicked visit to an Emergency Room, especially since those symptoms will vanish. The person, still infected, can think whatever ailed him/her has passed. The disease is now latent, waiting to burst forth after as long as a decade, maybe longer. Up to 30% of those infected will develop the characteristic dementia or “saddle nose” that mark the disease. That patient can pass the bacterium to a fetus, who may be born with no visible symptoms, or may have difficulty seeing, walking, hearing, thinking — or may die.
In the 1400s, when the French Army invaded Naples, physicians called it a French disease, though, depending on political leanings, the disease has been linked to Germany, Poland and Italy. The term is traced to a 16th century shepherd, Syphilis, infected because he angered Apollo. Venereologists have discussed whether the disease existed in Biblical times, as well as where it began, evoking today’s search for “Region One” with COVID.
Until the discovery of penicillin, we had no safe effective treatments. Anecdotal treatments, like sweat baths, mercury and opium, may have placated sufferers, but didn’t work. In 1910, physicians prescribed injections of arsenic-based Salvarsan, but the side effects could include deafness. Thank scientists for the breakthrough: penicillin. Starting in 1943, physicians administered this cure. If given early, penicillin can “cure” syphilis, stopping the consequences. If given later, it rarely can reverse those consequences.
Steadily the syphilis cases fell. The data showcase the miracle. From 1923 to 1925, syphilis was the 10th leading cause of death in the United States, roughly 17,515 deaths a year. In 1943 the country had more than 575,000 cases of all stages.
Enter penicillin. Cases of primary and secondary syphilis fell from 94,957 in 1946 to 6.454 in 1955. Today’s medical students rarely see evidence of secondary syphilis. Annual deaths from syphilis went from 586 in 1968 to 94 in 1984. During 1968-2015 there were 6,498 deaths attributed to syphilis. Annual syphilis deaths decreased from 586 in 1968 to 94 in 1984. Between 24 to 46 annually since 1998. Cases reached a nadir in 2001. By 2001, most physicians stopped routinely testing patients with dementia for syphilis.
The trend now inches upward: syphilis is back. Since 2001, the rate has increased almost every year. In 2019, the country had 129,813 cases of all stages, double that from 2014. From 2018 to 2019, it increased 11.2%. We can prevent syphilis in newborns: If a pregnant woman is treated at least 30 days before giving birth, the baby will have no symptoms. But in 2019, 1,870 babies were born with syphilis; 128 of them died.
We still have penicillin. Penicillin, though, is necessary but not sufficient to squash this bacterium. We also need the United States government, specifically the public health personnel in states, cities, and counties, just as we needed them to vanquish polio, diphtheria, tetanus, measles. These workers are warriors against disease.
In the last 10 years, Uncle Sam has hung back from the battle. As we have cut public health spending, the cases have risen.
If we wanted, we could take this lethal arrow from Cupid’s quiver; but so many Americans so loathe government that they would rather watch syphilis rebound than support the government’s public health warriors.
Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.
From The Progressive Populist, February 15, 2022
Blog | Current Issue | Back Issues | Essays | Links
About the Progressive Populist | How to Subscribe | How to Contact Us