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The re-emergence of syphilis in the United Kingdom: The new epidemic
phases.
Sexually Transmitted Diseases 2005;32(4):220-226.
Simms I, Fenton KA, Ashton M, Turner KME, Crawley-Boevey EE, Gorton R,
Thomas DRH, Lynch A, Winter A, Fisher MJ, Lighton L, Maguire HC, Solomou
M.
Abstract
OBJECTIVE: The objective of this study was to characterize the resurgence of
infectious syphilis in the United Kingdom between 1997 and 2003. STUDY: The
authors conducted a retrospective analysis of routine surveillance data from
genitourinary medicine clinics and data collected through enhanced surveillance.
RESULTS: Between 1997 and 2002, diagnoses of primary, secondary, and early
latent syphilis made at genitourinary medicine clinics increased by 213%
in heterosexual males, 1412% in men who have sex with men (MSM), and 22%
in females. These increases have been driven by a series of outbreaks, the
largest of which were seen in Manchester (528) and London (1222) up to the
end of October 2003. All the outbreaks have been geographically localized
and the majority of cases occurred in MSM. A high percentage of concurrent
HIV infection was reported, and oral sex was often reported as a route of
transmission. CONCLUSIONS: Syphilis has re-emerged in response to behavior
change, probably driven by changes in the HIV epidemic. The future course
of the epidemic is difficult to predict and control remains elusive.