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Resurgence of an Old Problem

Matthew R. Golden, MD, MPH; Christina M. Marra, MD; King K. Holmes, MD, PhD

JAMA. 2003;290:1510-1514.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

In 1937 US Surgeon General Thomas Parran estimated that 10% of Americans would be infected with syphilis during their lives.¹ Rates of primary and secondary syphilis plummeted with the institution of public health control measures and the advent of penicillin, reaching a nadir in 2000. Since then, rates have continued to decline among women and infants, although overall rates again have begun to climb.²

The dominant epidemiological features of syphilis in the United States today include varying incidence rates by geography, race and sexual orientation, and an association with human immunodeficiency virus (HIV). Syphilis rates among heterosexuals in the United States are highest in the south, where 16 states reported 53% of all US cases in 2001, including 64% of all cases in women.² Syphilis disproportionately affects blacks. In 2001, reported US rates of . . . [Full Text of this Article]

Clinical Manifestations

HIV Infection and Syphilis

Laboratory Diagnosis

Central Nervous System Syphilis

Treatment and Follow-up

Prevention and Elimination of Syphilis

Author Affiliations: Division of Infectious Diseases, the Center for AIDS and STD (Drs Golden, Marra, and Holmes) and Department of Neurology (Dr Marra), University of Washington, Seattle, and Public Health–Seattle and King County (Dr Golden), Seattle, Wash.

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