February 16, 2011
By Staff Reporter
By Andrew Bushe
DUBLIN — Dublin is witnessing an epidemic of the sexually transmitted disease syphilis this year, three of the country’s top medical experts have warned.
"What was once an annual rarity has been transformed into a weekly reality," according to the doctors who run the GUIDE clinic in Dublin’s St James’s Hospital that deals with venereal diseases.
"Unfortunately, many of the cases involve anonymous contacts, untraceable, and these are certain to fuel and maintain the epidemic for some time to come."
Writing in the Irish Medical Times, the doctors say the problem began to emerge with an occasional case in the late spring of last year. Some of the cases had resulted in infection from abroad, but most were acquired in Dublin.
"Cases were initially predominantly in the homosexual/bisexual, but heterosexual acquisitions have also been seen," the doctors said.
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"A predominant feature is that they were largely acquired by people following safe sex practices and caused great surprise to those infected, who thought that what was safe for HIV was also safe for all other STDs.
"Syphilis, as with gonorrhoea, may also be easily acquired by oro-genital contact and this was the comment mode of acquisition in the early days of this Dublin epidemic."
A special control team has been set up with Eastern Regional Health Authority public health experts and the National Diseases Surveillance Center.
The doctors warn colleagues to be on the alert for symptoms. "A missed diagnosis not only affects an individual, but can affect and involve others."
They point out that syphilis, or the "great pox," was the scourge of the last millennium and was even more feared than HIV/AIDS is today prior to the development of effective antibiotics to treat it.
Tertiary syphilis occurs in about 25 percent of those infected.
"To date we have not seen any congenital syphilis in this outbreak," the doctors said. "We are fortunate in having resisted the economic pressures to dismantle routine ante-natal screening for syphilis."
They warn that only about 50 percent of cases will show symptoms though they still pass on the infection.
Symptoms start with a sore that heals in about a month. The second stage is a rash that may appear anywhere on the body. It will also clear up on its own and after this syphilis becomes dormant.
"There may be no sign for many years but left untreated it can still damage your health," the doctors warn.
"There are certain to be cases missed in this current epidemic and some of these will present to cardiologists, hepatologists, urologists, opthalmogists and psychiatrists over the next two to three decades.
"It is incumbent upon all of use to increase our awareness and vigilance of the ‘great masquerader.’ "