The rise and fall of the treponematoses. I. Ecological aspects and international trends. in venereal syphilis.

Abstract

The decline in syphillis attack rates in the armed forces of a number of western countries over the past 80 to 100 years is demonstrated and parallel trends can be seen in the civilian populations. In the USA there was a precipitous decline in the prevalence of both early and late latent syphillis and of late manifest syphillis since the 1940''s. A sharp decrease in primary and secondary syphillis since 1947 or 1950, and a recaudescence beginning in the 1950''s is demonstrated in many countries. Reasons for this decline and rise are discussed, including the use of penicillin. Others factors affecting the incidence of syphillis are periods of expanding economy, increase in travel, changing ethical, moral and behavioral codes associated with increased sexual activity, changing patterns of prostitution, male homosexuality and increased exposure of young people to infection, as well as increasing urbanization and industrialization and increasing use of contraceptives.