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Resurgence of Syphilis Calls for Robust Creative Response

High-risk groups, such as men who have sex with men, may benefit from periodic screening

WEDNESDAY, March 19 (HealthDay News) -- A rise in syphilis, particularly among certain groups, calls for renewed attention from clinicians and public health professionals to bolster diagnosis and prevention strategies, according to an article published in the April issue of The Lancet Infectious Diseases.

Kevin A. Fenton, M.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues write that syphilis has resurged in the United States since the early 2000s. In 2004, the rate of primary and secondary disease in black Americans was six times higher than in whites (9.0 versus 1.6 cases per 100,000 population). Cases also increased in men who have sex with men between 2000 and 2005, marked by high rates of HIV co-infection.

Given the importance of early diagnosis for treatment and to prevent its spread, voluntary syphilis screening -- akin to breast-cancer screening -- is advised for high-incidence groups, the researchers write. Sex partners from three months past, plus the duration of symptoms, should be contacted in cases of primary syphilis, and six months plus duration of symptoms for secondary syphilis, they note.

"In developed countries, the low incidence of syphilis over the past two decades and interactions of the disease with HIV infection, have resulted in clinicians who are unfamiliar with the disease's many manifestations," the authors write. "Efforts must be made to incorporate and evaluate new diagnostic tools, social network approaches, innovative evidence-based prevention interventions, robust disease surveillance, and systematic monitoring and evaluation of prevention, treatment and care activities."

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