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Syphilis in Adolescents and Young Adults

  • Emma Goodstein
  • Kimberly Workowski
Chapter
  • 38 Downloads

Abstract

Less than 20 years ago, infectious syphilis was on the verge of eradication in the United States. Since that time, however, syphilis rates have increased dramatically in the United States particularly among adolescents and young adults. While young, Black MSM have the highest risk of acquiring syphilis, it is important to keep in mind that rates have increased in adolescents and young adults of every age, gender, and sexual orientation. This chapter examines the changing epidemiology of syphilis as well as the microbiology and pathophysiology and clinical manifestations at different stages of the syphilitic infection. It then goes on to consider current approaches to diagnostic testing, including diagnostic testing algorithms, and treatment of the different stages of syphilis. Prevention and other public health considerations such as syphilis screening are also discussed. The chapter ends with other considerations that affect syphilis and its treatment such as HIV coinfection, pregnancy, and syphilis in MSM.

Keywords

Syphilis Adolescents Sexually transmitted infections MSM (men who have sex with men) HIV 

References

  1. 1.
    Centers for Disease Control and Prevention. The national plan to eliminate syphilis from the United States. Atlanta: U.S. Department of Health and Human Services; 1999.Google Scholar
  2. 2.
    Cohen SE, Klausner JD, Engelman J, Philip S. Syphilis in the modern era. Infect Dis Clin N Am. 2013;27(4):705–22.CrossRefGoogle Scholar
  3. 3.
    Centers for Disease Control and Prevention. 2015 Sexually transmitted diseases surveillance. http://www.cdc.gov.proxy.library.emory.edu/std/stats15/syphilis.
  4. 4.
    Morbidity and Mortality Weekly Report (MMWR). Primary and Secondary Syphilis — United States, 2005–2013. 2014;63(18):402–6.Google Scholar
  5. 5.
    Clement ME, Okeke NL, Hicks CB. Treatment of syphilis: a systematic review. JAMA. 2014;312(18):1905–17.  https://doi.org/10.1001/jama.2014.13259.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Clement ME, Hicks CB. Syphilis on the rise: what went wrong? JAMA. 2016;315(21):2281–3.  https://doi.org/10.1001/jama.2016.7073.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Truong HM, Kellogg T, Klausner JD, Katz MH, Dilley J, Knapper K, Chen S, Prabhu R, Grant RM, Louie B, McFarland W. Increases in sexually transmitted infections and sexual risk behaviour without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting? Sex Transm Infect. 2006;82(6):461–6.CrossRefGoogle Scholar
  8. 8.
    Rosser BR, Oakes JM, Horvath KJ, Konstan JA, Danilenko GP, Peterson JL. HIV sexual risk behavior by men who use the Internet to seek sex with men: results of the Men’s INTernet Sex Study-II (MINTS-II). AIDS Behav. 2009;13(3):488–98.  https://doi.org/10.1007/s10461-009-9524-3.CrossRefPubMedGoogle Scholar
  9. 9.
    Chesson HW, Dee TS, Aral SO. AIDS mortality may have contributed to the decline in syphilis rates in the United States in the 1990s. Sex Transm Dis. 2003;30(5):419–24.CrossRefGoogle Scholar
  10. 10.
    US Preventive Services Task Force (USPSTF). Screening for syphilis infection in nonpregnant adults and adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(21):2321–2327.  https://doi.org/10.1001/jama.2016.5824.
  11. 11.
    Centers for Disease Control. Sexually transmitted diseases in adolescents and young adults 2015. http://www.cdc.gov/std/stats14/adolescents.htm
  12. 12.
    Radolf JD, Deka RK, Anand A, Šmajs D, Norgard MV, Yang XF. Treponema pallidum, the syphilis spirochete: making a living as a stealth pathogen. Nat Rev Microbiol. 2016;14(12):744–59.Google Scholar
  13. 13.
    LaFond RE, Lukehart SA. Biological basis for syphilis. Clin Microbiol Rev. 2006;19(1):29–49.CrossRefGoogle Scholar
  14. 14.
    Hook EW. Syphilis. The Lancet. Published Online December 16, 2016.  https://doi.org/10.1016/S0140-6736(16)32411-4.
  15. 15.
    Lukehart SA, Hook EW, Baker-Zander SA, Collier AC, Critchlow CW, Handsfield HH. Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment. Ann Intern Med. 1988;109:855–62.CrossRefGoogle Scholar
  16. 16.
    Oliver SE, Aubin M, Atwell L, Matthias J, Cope A, et al. Ocular syphilis – eight jurisdictions, United States 2014-2015. MMWR. 2016;65(43):1185–8.PubMedGoogle Scholar
  17. 17.
    Clement ME, Hicks CB. RPR and the serologic diagnosis of syphilis. JAMA. 2014;312(18):1922–3.  https://doi.org/10.1001/jama.2014.2087.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Eickhoff CA, Decker CF. Syphilis. Sex Transm Dis. 2016;62(8):280–6. https://www.ncbi.nlm.nih.gov/pubmed/27091635/.
  19. 19.
    Morsheda MG, Singhb AE. Recent trends in the serologic diagnosis of syphilis. Clin Vaccine Immunol. 2015;22(2):137–47.CrossRefGoogle Scholar
  20. 20.
    Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:RR–03):1-137.Google Scholar
  21. 21.
    Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Hawkins J, Queen B, Lowry R, O’Malley Olsen E, Chyen D, Whittle L, Thornton J, Lim C, Yamakawa Y, Brener N, Zaza S. Youth risk behavior surveillance — United States, 2015. Surveillance Summaries. 2016;65(6):1–174.CrossRefGoogle Scholar
  22. 22.
    Cameron CE, Lukehart SA. Current status of syphilis vaccine development: need, challenges, prospects. Vaccine. 2014;32(14):1602–9.  https://doi.org/10.1016/j.vaccine.2013.09.053.CrossRefPubMedGoogle Scholar
  23. 23.
    Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87:183–90.  https://doi.org/10.1136/sti.2010.047514.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Inf. 1999;75:3–17.CrossRefGoogle Scholar
  25. 25.
    Otten MW Jr, Zaidi AA, Peterman TA, et al. High rate of HIV seroconversion among patients attending urban sexually transmitted disease clinics. AIDS. 1994;8:549–53.  https://doi.org/10.1097/00002030-199404000-00020.CrossRefPubMedGoogle Scholar
  26. 26.
    Mayer K. HIV and syphilis. Int J Infect Dis. 2016;45:67.CrossRefGoogle Scholar
  27. 27.
    Braccio S, Sharland M, Ladhani SN. Prevention and treatment of mother-to-child transmission of syphilis. Curr Opin Infect Dis. 2016;29(3):268–74.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Emma Goodstein
    • 1
  • Kimberly Workowski
    • 2
  1. 1.University of Arizona South Campus Family MedicineTucsonUSA
  2. 2.Division of Infectious DiseaseEmory UniversityAtlantaUSA

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