Syphilis Is Changing Like We've Never Seen... In Seattle

Summary

This video addresses the rising concerns surrounding syphilis infections, particularly in the United States, where cases have been increasing for years. It discusses the challenges of treating syphilis, including the ongoing shortage of Penicillin G, the painful nature of its injection, and the evolving mutations of the bacteria that cause the disease. The video highlights the difficulties in diagnosing syphilis, especially as the infection can be asymptomatic, and the potential for new strains to emerge, complicating treatment. The speaker urges vigilance and awareness about the growing impact of syphilis on public health, especially as these changes could affect future surveillance and testing programs.

Takeaways

• 😀 Syphilis diagnosis can be difficult due to patients' reluctance to disclose personal medical history.
• 😀 Penicillin G (Pen G) is essential for syphilis treatment but has been in short supply in the U.S. for years.
• 😀 Pen G is administered through a painful deep-muscle injection, which some patients avoid, delaying treatment.
• 😀 There has been a significant rise in syphilis cases in the U.S. and other countries, a trend that started before the pandemic.
• 😀 The bacteria *Treponema pallidum*, which causes syphilis, has evolved and mutated over time, complicating treatment.
• 😀 The mutation of syphilis bacteria increases the risk of creating new strains that could be harder to treat or more virulent.
• 😀 Coinfection and mutations can lead to inter-strain recombination, making syphilis more unpredictable in its progression and transmission.
• 😀 Infections can often be asymptomatic, especially in women, who may not realize they are infected, leading to unknowingly passing the disease on.
• 😀 If syphilis becomes resistant to penicillin, treatment and public health strategies could be significantly impacted.
• 😀 The syphilis bacteria's mutations can change how it spreads, its symptoms, and its response to treatment, especially when HIV is involved.
• 😀 The global increase in syphilis cases and evolving strains highlights the urgent need for continued surveillance and improved medical responses.

Q & A

What are some challenges in confirming the medical history of a syphilis patient?

One major challenge is that patients may not be willing to divulge their full medical history. Without this information, it becomes difficult for medical professionals to confirm the history of syphilis or understand the full scope of the infection.

What is the current issue with Penicillin G (Pen G) in the United States?

There has been an ongoing shortage of Pen G in the United States for several years. Pen G, which is the primary treatment for syphilis, is only licensed to one large company, contributing to limited availability.

Why is Pen G administration difficult for some patients?

Pen G is administered as a painful injection deep into the muscle, which can be daunting for patients. The injection is often in a sensitive area, making it uncomfortable, leading some people to avoid getting the treatment altogether.

How has the FDA tried to alleviate the Pen G supply shortage?

In response to the shortage, the FDA has taken some measures to address supply issues, particularly when syphilis cases have been on the rise. However, the supply problem remains a concern.

What is the trend of syphilis cases in the United States and globally?

Syphilis cases have been increasing in both the U.S. and other countries, a trend that began before the pandemic. This increase has raised concerns about controlling the spread and impact of the disease.

How has the bacteria causing syphilis evolved over time?

The bacteria, Treponema pallidum, has evolved significantly over the years. Genetic research shows it has changed since Europeans first documented syphilis in the 1400s. It is now more genetically diverse and can mutate, leading to concerns about new, potentially more dangerous strains.

What impact could new strains of syphilis have?

New strains of syphilis, created through mutation or coinfection, could lead to changes in the disease's virulence, transmission patterns, and symptoms. This may complicate treatment, especially if mutations result in resistance to penicillin.

How does syphilis typically present in patients, and why is it difficult to diagnose?

Syphilis often starts as an asymptomatic infection, particularly in women, who may not even be aware they have it. A painless chancre (ulcer) might develop internally, making it harder to diagnose until it progresses to later stages.

What is the risk of syphilis transmission from mother to child?

If a pregnant woman is infected with syphilis, she may unknowingly pass it to her child, leading to severe complications. Because many women don't realize they are infected, preventing transmission to the baby becomes a significant concern.

Why is the increasing syphilis burden a global concern?

The global increase in syphilis cases poses a major public health challenge. As infections rise, the likelihood of new strains emerging increases, and the ability to effectively treat the disease may become more difficult, particularly if resistance to antibiotics like penicillin develops.