Clearly ascertaining situation vital to stem rapid spread of syphilis

The Yomiuri ShimbunThe number of syphilis patients has been soaring. Particularly worrying is the spread of infection among young women, and transmissions to unborn fetuses. The Health, Labor and Welfare Ministry must take effective measures.

The number of syphilis patients rose from 875 in 2012, to a provisional figure of 5,820 last year. It was the first time in 44 years that the annual figure had exceeded 5,000.

Typical symptoms can involve a rash appearing all over the body, including the hands and feet, about three months after infection. Symptoms may repeatedly appear and disappear after that. If the infection progresses, it may also cause brain or heart problems.

Syphilis is transmitted primarily through sexual activity. It has been thought that many cases of infection occurred among male homosexuals and women in the sex industry.

The conspicuous number of infections among women in their 20s and 30s is worrying.

Different causes of infection have been cited. It has been said, for instance, that ways of meeting men and women have diversified via the internet, or that coming and going of people between Japan and other countries has become brisk. But there is no data backing up such assertions.

To strengthen preventive measures, it is indispensable to ascertain the actual situation regarding infections.

The health ministry will drastically review the content of the report that doctors are required to make regarding cases of syphilis infection. This was prompted by the conclusion that the report’s present format does not provide enough information as to how infections come about.

Accelerate use of injections

Asking doctors to write in their report a patient’s history of infection, and whether they have worked in the sex industry or used sex services. Making doctors write whether a patient is simultaneously infected with HIV. These ideas are under study. They will be useful in envisioning the transmission route.

Needless to say, it is important for each and every person to try to avoid infection.

If infection with syphilis is suspected, people should be examined at a hospital, public health center or the like, and get treatment swiftly. The bacterium Treponema pallidum, which causes the syphilis infection, can basically be eliminated with antibiotics.

Even after a patient is cured, however, they are not immune, making it necessary for them to be watchful against reinfection. To avoid the risk of sexual transmission between partners, it may also be necessary for them to be screened together.

It is particularly necessary for pregnant women to take precautions. When infected, there are fears of their having a miscarriage or having a premature baby. There have also been cases of transmission to a fetus via the placenta, causing congenital syphilis.

According to surveys by the health ministry, four cases of congenital syphilis were reported in 2013, 13 cases in 2015, and 14 cases in 2016.

Under the new report format for doctors, it will become mandatory to note whether an infected person is pregnant. Syphilis transmitted from a mother to her fetus can also be treated with antibiotics. Likewise, it is important for the transmission to be found at an early stage.

Treatment methods should also be made more efficient. The standard global treatment for syphilis is an injection of antibiotics, while in Japan an infected person is only given medicine orally, as there were incidences of side effects in the past with injections. Adoption of the injection of antibiotics, a single dose of which will suffice as treatment, should be accelerated.

(From The Yomiuri Shimbun, May 14, 2018) Speech


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