ArticleSexually transmitted infections2004
Lessons from the syphilis outbreak in homosexual men in east London.
Article in Sexually transmitted infections, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 34 citations in OpenAlex.
- Painful rash with hoarseness: an atypical presentation of syphilis.BMJ case reports · 2018Article
- HIV infection and sex in sex-on-premises venues are associated with a higher risk of syphilis reinfection among men who have sex with men.Postepy dermatologii i alergologii · 2018Article
- Evaluation of the BioPlex 2200 syphilis system as a first-line method of reverse-sequence screening for syphilis diagnosis.Clinical and vaccine immunology : CVI · 2013Article
- An outbreak of syphilis in Darkhan-Uul, Mongolia, January to March 2012.Western Pacific surveillance and response journal : WPSAR · 2012Article
- Laboratory diagnosis of syphilis with automated immunoassays.Journal of clinical laboratory analysis · 2009Article
- Biological basis for syphilis.Clinical microbiology reviews · 2006Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe the epidemiology, presentation, and diagnosis of early syphilis in 103 homosexual men in east London.
methodsA retrospective study using data from KC60 returns, the Health Protection Agency (HPA) enhanced surveillance forms and case notes.
results40 cases of primary (PS), 40 of secondary (SS) and 23 of early latent syphilis were identified, 33% co-infected with HIV. 41% had concurrent sexually transmitted infections (STIs). Pain featured in 35% of PS and itch in 13% of rashes. Dark ground microscopy (DGM), performed in 44 of the symptomatic cases, was positive in 37 (84%) allowing early management. Initial syphilis serology was negative in 15/40 (37%) cases of PS. 51% and 49% opted for parenteral and oral treatment, respectively. In 53/103 (51%) cases oral sex was the only risk factor. 86% of infections were UK acquired. Only 4% of contacts were seen.
conclusionThis outbreak, reflecting the resurgence of syphilis across the United Kingdom, highlights several important points. Painful chancres and itchy rash are common presentations. DGM is a highly sensitive diagnostic tool. Initial negative serological screening tests are common in PS and sero-surveillance for 3 months is recommended. The high prevalence of concomitant STIs indicates ongoing unprotected sexual intercourse. Oral sex is a significant risk factor and is a distinctly "unsafe" practice. Conventional partner notification is ineffective. Other methods of screening of the at-risk homosexual population are warranted. Continued education is required to reduce STI acquisition in homosexual men.
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