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Pathogens
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Syphilis in the 21st Century
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Syphilis in the 21st Century

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Bacterial Pathogens".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 20755

Special Issue Editor

Dr. Anu Chaudhary

E-Mail Website
Guest Editor
Clinical Immunology Division, Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA 98195, USA
Interests: host-pathogen interactions; determinants of human genetic susceptibility to infections and autoimmunity; salmonella, syphilis, SARS-CoV2; clinical assays for infectious diseases and autoimmune conditions

Special Issue Information

Dear Colleagues,

The global epidemic of syphilis began in the late 15th century and is resurging 600 years later. Despite the availability of diagnostic tests and a mostly effective single dose treatment for early disease, syphilis remains an ascending global public health problem. In developed countries, there is a high incidence among men who have sex with men. In developing nations, syphilis continues to be a leading cause of preventable stillbirth and neonatal death.

With available diagnostic tests and a cure, and no known animal or environmental reservoir, syphilis should be an ideal disease for global elimination. Indeed, a handful of countries have demonstrated success in elimination of mother to child transmission of syphilis. In the clinic, however, the myriad manifestations of disease make diagnosis problematic. In the laboratory, the spirochaete Treponema pallidum subspecies pallidum (T. pallidum), the causative agent of syphilis, evaded in vitro cultivation until very recently. With few surface markers for detection and elimination by the immune system, our understanding of its pathogenic mechanisms remain somewhat limited.

For this Special Issue of Pathogens, we invite authors to submit articles covering multiple aspects of syphilis, including, but not limited to pathogenesis, co-infection, re-infection, improvements in diagnostics and treatment, vaccine development, global health, epidemiology in the background of the ongoing SARS-CoV-2 epidemic, advocacy, response of healthcare systems, education, and public health preparedness.

Dr. Anu Chaudhary
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • syphilis
  • stillbirth
  • vaccine
  • pathogenesis
  • epidemiology

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Published Papers (3 papers)

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Research

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10 pages, 384 KiB  
Article
Geospatial Social Determinants of Health Correlate with Disparities in Syphilis and Congenital Syphilis Cases in California
by Kelly A. Johnson, Robert E. Snyder, Eric C. Tang, Natalie S. de Guzman, Rosalyn E. Plotzker, Ryan Murphy and Kathleen Jacobson
Pathogens 2022, 11(5), 547; https://doi.org/10.3390/pathogens11050547 - 6 May 2022
Cited by 12 | Viewed by 4435
Abstract
Syphilis and congenital syphilis (CS) are increasing in California (CA). From 2015 through 2019, for example, CA cases of early syphilis among reproductive-age females (15–44) and CS each increased by >200%. Certain populations—including people experiencing homelessness, using drugs, and/or belonging to certain racial/ethnic [...] Read more.
Syphilis and congenital syphilis (CS) are increasing in California (CA). From 2015 through 2019, for example, CA cases of early syphilis among reproductive-age females (15–44) and CS each increased by >200%. Certain populations—including people experiencing homelessness, using drugs, and/or belonging to certain racial/ethnic groups—have been disproportionately impacted. We hypothesized that geospatial social determinants of health (SDH) contribute to such health inequities. To demonstrate this, we geospatially described syphilis in CA using the Healthy Places Index (HPI). The HPI is a composite index that assigns a score to each CA census tract based on eight socioeconomic characteristics associated with health (education, housing, transportation, neighborhood conditions, clean environment, and healthcare access as well as economic and social resources). We divided CA census tracts into four quartiles based on HPI scores (with the lowest quartile having the least healthy socioeconomic and environmental conditions), then used 2013–2020 CA sexually transmitted diseases surveillance data to compare overall syphilis (among adults and adolescents) and CS case counts, incidence rates (per 100,000 population or live births), and incidence rate ratios (IRRs) among these quartiles. From 2013 to 2020, across all stages of syphilis and CS, disease burden was greatest in the lowest HPI quartile and smallest in the highest quartile (8308 cases (representing 33.2% of all incidents) versus 3768 (15.1%) for primary and secondary (P&S) syphilis; 5724 (31.6%) versus 2936 (16.2%) for early non-primary non-secondary (NPNS) syphilis; 11,736 (41.9%) versus 3026 (10.8%) for late/unknown duration syphilis; and 849 (61.9%) versus 57 (4.2%) for CS; all with p < 0.001). Using the highest HPI quartile as a reference, the IRRs in the lowest quartile were 17 for CS, 4.5 for late/unknown duration syphilis, 2.6 for P&S syphilis, and 2.3 for early NPNS syphilis. We thus observed a direct relationship between less healthy conditions (per HPI) and syphilis/CS in California, supporting our hypothesis that SDH correlate with disparities in syphilis, especially CS. HPI could inform allocation of resources to: (1) support communities most in need of assistance in preventing syphilis/CS cases and (2) reduce health disparities. Full article
(This article belongs to the Special Issue Syphilis in the 21st Century)
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Review

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14 pages, 655 KiB  
Review
A 2021 Update on Syphilis: Taking Stock from Pathogenesis to Vaccines
by Giorgio Tiecco, Melania Degli Antoni, Samuele Storti, Valentina Marchese, Emanuele Focà, Carlo Torti, Francesco Castelli and Eugenia Quiros-Roldan
Pathogens 2021, 10(11), 1364; https://doi.org/10.3390/pathogens10111364 - 21 Oct 2021
Cited by 24 | Viewed by 7489
Abstract
In 2021 the scientific community’s efforts have been focused on solving the back-breaking challenge of the COVID-19 pandemic, but sexually transmitted infections (STI) are still one of the most common global health problems. Syphilis is a systemic disease caused by the spirochaete Treponema [...] Read more.
In 2021 the scientific community’s efforts have been focused on solving the back-breaking challenge of the COVID-19 pandemic, but sexually transmitted infections (STI) are still one of the most common global health problems. Syphilis is a systemic disease caused by the spirochaete Treponema pallidum (TP) and is one of the oldest known diseases. Its incidence has increased in the last few years and syphilis still remains a contemporary plague that continues to afflict millions of people worldwide. Despite research improvements, syphilis pathogenesis is not completely clear; clinical presentation is very heterogeneous and the diagnosis can sometimes be difficult. Furthermore, few therapeutic options are available, and a vaccine has not been found yet. In this review, we describe the most recent evidence concerning the clinical manifestation, diagnosis, treatment and vaccine prospectives for this disease. Full article
(This article belongs to the Special Issue Syphilis in the 21st Century)

Other

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17 pages, 1725 KiB  
Case Report
Oral Manifestations of Syphilis: Report of Four Cases
by Suné Mulder van Staden, Carl de Villiers, Julandi Alwan, Mpho Moloi and Sibongile Mahlangu
Pathogens 2022, 11(6), 612; https://doi.org/10.3390/pathogens11060612 - 24 May 2022
Cited by 3 | Viewed by 8038
Abstract
Syphilis is an infectious disease caused by Treponema pallidum. Syphilis can present with an array of oral manifestations at different stages of disease progression. This article reports on four cases of syphilis with oral manifestations diagnosed by oral health professionals. Case 1: 18-year-old [...] Read more.
Syphilis is an infectious disease caused by Treponema pallidum. Syphilis can present with an array of oral manifestations at different stages of disease progression. This article reports on four cases of syphilis with oral manifestations diagnosed by oral health professionals. Case 1: 18-year-old female presented with multiple ulcerations and patches involving the hard palate, uvula, retromolar area, and papillary nodules on the tongue. Case 2: 25-year-old male presented with a solitary, exophytic lesion on the anterior tongue. Case 3: 17-year-old female presented with multiple pigmented macules on the palms of hands and soles of feet, as well as multiple exophytic, sessile, soft tissue masses throughout the oral cavity. Case 4: 14-year-old female presented with a solitary, exophytic, verrucous lesion in the incisive papilla area, as well as multiple, coalescing patches involving the soft palate, uvula, and tonsillar areas. All patients were managed by biopsy and serological investigations. Treatment of syphilis was performed at infectious disease clinics with 2.4 million units (MUs) benzathine benzylpenicillin intramuscular (IM) weekly. Oral health professionals need to have knowledge of the oral manifestations of syphilis to ensure that patients are accurately identified and appropriately treated. Full article
(This article belongs to the Special Issue Syphilis in the 21st Century)
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