Sex in the City? Examining the Syphilis Outbreak in Toronto (2000-2010)

Authors

  • Nafte M.

Keywords:

syphilis, sexually transmitted infections, HIV/AIDs, public health, syndemics, MSM, contagion, stigma

Abstract

In the paper, the author examines what has been described as an epidemic of venereal syphilis in the city of Toronto, Canada from the year 2000 to 2010, as a means of ascertaining whether syphilis is indeed increasing, and if it is interacting syndemically with other infectious ailments, specifically HIV/AIDs. The author presumes, that syphilis might have only been eradicated from the collective memory, and has been busy steadily adapting to various populations for the last five centuries.

Literature

  1. Aadland, D., Finnoff, D., Huang and Kevin, X.D. (2007),  “Syphilis cycles”, Munich Personal ReREc Archive, available at http://mpra.ub.uni-muenchen.de/8722/  (accessed 24 January 24 2011).
  2. Abraham, B., Marih, L., Thevenet, T., Da Silva Marechal, E., Verdet, C., Rozenbaum, W. and Pialoux, G. (2005), “Outbreak of syphilis among HIV-infected patients: descriptive data from a Parisian hospital”, Sexually Transmitted Diseases, 32 (11), pp. 718-719.
  3. ACT AIDS Committee of Toronto (2010), available at: www.actoronto.org/syphilis  (accessed 13 March 2011).
  4. Barré-Sinoussi, F., Chermann, J., Rey, F., Nugeyre, M., Chamaret, S.,  Gruest, J., Dauguet, C., Axler-Blin, C., Vézinet-Brun, F., Rouzioux, C., Rozenbaum, W., and Montagnier, L. (1983), “Isolation of a T-Lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS)”, Science New Series, Vol. 220 (4599), pp. 868-871.
  5. Bates, A. (2008), “Indecent and demoralising representations”: public anatomy  museums in mid-Victorian England”, Medical History, Vol. 52, pp. 1-22.
  6. Baughn R., and Musher, D. (2005), “Secondary syphilitic lesions”, Clinical Microbiology Reviews, January, 18 (1), pp. 205-216.
  7. Bayne, L., Schmidley, J. and Goodin, D. (1986), “Acute syphilitic meningitis. Its occurrence after clinical and serologic cure of secondary syphilis with penicillin”, G Arch Neuro, Vol. 43, pp.137-138.
  8. Bean, W. (1950), Sir William Osler: aphorisms from his bedside teachings
  9. and writings.  Collected by Robert Bennett Bean, M.D. (1874-1944)? Henry Schuman, New York.
  10. Berkowitz, R. (2003), Stayin Alive: The Invention of Safe Sex, Westview Press.
  11. Berry, C., Hooton, T., Collier, A. and Lukehart, S. (1987), “Neurologic relapse after benzathine penicillin  therapy for secondary syphilis in a patient with HIV infection”, New Eng J Med, Vol. 6, pp.1587-1589.
  12. Birnbaum, N., Goldschmidt, R. and Buffet, W. (1999),           “Resolving the Common Clinical Dilemmas of Syphilis”, American Family Physician, available at: www.aafp.org /afp/990415ap/2233.html
  13. Brandt, A. (1988), “AIDS in Historical Perspective: Four Lessons from the History of Sexually Transmitted Diseases”, American Journal of Public Health, April 78 (4), 367-371.
  14. Bristol, N. (2010), “U.S. reviews human trial participant protections”, The Lancet, 376 (9757), pp. 1975-1976.
  15. Canada Immigration and HIV Reporting (2010), available at: www.ehow.com/facts_6748875_canada-immigration-hiv-reporting-law.html
  16. Canadian Institute of Health Research (2008), available at www.cihr-irsc.gc.ca/e/37839.html
  17. Cartwright, F. (1972), Disease and History, Thomas Y. Crowell Co.
  18. Chen, Z.Q., Zhang, G.C., Gong, X.D., Lin, C., Gao, X., Liang, G.J., Yue, X.L., Chen, X.S. and Cohen, M.S. (2007), “Syphilis in China: results of a national surveillance programme”, The Lancet, Vol. 369 (9556), pp.132-138.
  19. Chesson, H., Heffelfinger, J., Voight, R. and Collins, D. (2005), “Estimates of primary and secondary syphilis rates in persons with HIV in the United States”, Sexually Transmitted Disease, 32 (5), pp. 265-269.
  20. Clark, E.G. and Danbolt, N. (1955), “The Oslo Study of the natural history of untreated syphilis: An  epidemiological investigation based on a restudy of the Boeck-Bruusgaard material, a review and appraisal”, Journal of Chronic Diseases, Vol 2 (3), pp. 311-344.
  21. Coulter, H. (2002),   AIDS and Syphilis: The Hidden Links, B Jain Publishers Ltd.
  22. Dylweski, J. and Duong, M. (2007) “The rash of secondary syphilis”, Canadian Medical Association Journal, 176 (1), pp. 33-35.
  23. Dowsett, G.W. (1980), “Reaching men who have sex with men in Australia-an overview of AIDS education, community intervention and community attachment strategies”, Aust J Soc Issues, 25, pp.186-198.
  24. Fabricius, J. (1994),            Syphilis in Shakespeare’s England, Jessica Kingsley Publishers, London.
  25. Farmer, P. (1992), AIDS and Accusation: Geography of Blame, University of California Press.
  26. Farmer, P. (1999),  Infections and Inequalities: The Modern Plagues, University of California Press.
  27. Fracastoro H. (1930), De contagione et contagiosis morbis et eorum curatione, libri iii., translated by Wright, W.C., G.P. Putnam’s Sons, New York, NY.
  28. Franzen, C. (2008), “Syphilis in composers and musicians–Mozart, Beethoven,
  29. Paganini, Schubert, Schumann, Smetana”, Eur J Clin Microbiol Infect Dis,
  30. 27, pp. 1151–1157.
  31. Fenton, K., Breban, R., Vardavas, R., Okano, J., Martin, T., Aral, S. and Blower, S. (2008), “Infectious syphilis in high-income settings in the 21st century”, Lancet Infectious Disease, 8, pp. 244-53.
  32. Gilman, S. (1995),   Health and Illness: Images of Difference, Reaktion Books Ltd.
  33. Golden M.R., Marra, C. and Holmes, K. (2003), “Update on Syphilis: Resurgence of an Old Problem”, JAMA, 290 (11), pp. 1510-4.
  34. Golomb, J., Santaniello, W. and Lehrer, R. (1999),     Nietzsche and Depth Psychology, State University of New York Press.
  35. Gorman, M.E. (1986), “The AIDS epidemic in San Francisco: epidemiological and enthropological perspectives” in Anthropology and Epidemiology,
  36. Janes, C., Stall, R. and Gifford S. (Ed.), D. Reidel Publishing Company, pp.
  37. 157-172.
  38. Goudreau, S.M. (2010), “Accounting for epidemics: mathematical modeling and anthropology in Plagues and Epidemics: Infected Spaces Past and Present, Herring, A.D., and Swedlund A.C. (Ed.), Berg Publishing, pp. 213-230.
  39. Greenspan, R. (2006), Medicine: Perspectives in History and Art, Ponteverde Press, Alexandria, Virginia.
  40. Hay, P., Tam, F., Kitchen, V. (1990), “Gummatous lesions in men infected with human immunodeficiency virus and syphilis”, Genitourin Med, 66, pp.374-379.
  41. Hayden, D. (2003),  Pox: Genius, Madness, and the Mystery of Syphilis, Basic Books,  New York.
  42. Herring, A. and Swedlund,  A. (2010), “Plagues and epidemics in anthropological perspective” in Plagues and Epidemics: Infected Spaces Past and Present, Herring, A.D. and Swedlund, A.C. (Ed.), Berg Publishing, pp. 213-230.
  43. Holcomb, R.C. (1938), Who gave the world syphilis? The Haitian myth, Archives of Dermatology, 37(4), pp. 735-736.
  44. Howles, J. (1943), A Synoposis of Clinical Syphilis, The C.V. Mosby Co, St. Louis, MO.
  45. Inhorn, C. and Brown, P. (1990), The anthropology of infectious disease, Annual Review of Anthropology,19 (89), pp.1-17.
  46. Jones, J. (1993), Bad Blood: The Tuskegee Syphilis Experiment, Free Press, New York.
  47. Jorgensen, J., Tikjob G. and Weisman, K. (1986), “Neurosyphilis after treatment of latent syphilis with benzathine penicillin”, Genitourin Med, 62, pp. 129-131.
  48. Kararizoui, E., Mitsonis, C., Dimopoulos, N., Gkiatas, K., Markou, I. and Kalfakis, N. (2006), “Psychosis or Simply a New Manifestation of Neurosyphilis?”, The Journal of International Medical Research, 34, pp. 335-337.
  49. Karp, G., Schlaeffer, F., Jotkowitz, A. and Riesenberg, K. (2009), “Syphilis and HIV co-infection”, European Journal of Internal Medicine, 20 (1), pp. 9-13.
  50. Kent, M. and Romanelli, F. (2008), “Reexamining syphilis: an update on epidemiology, clinical manifestations, and management”, The Annals of Pharmacotherapy, 42, pp. 226-236.
  51. Klausner, J., Kent, C., Wong, W., McCright, J. and Katz, M. (2005), “The public health response to epidemic syphilis, San Francisco, 1999–2004”, Sexually Transmitted Diseases, October supplement 32 (10), pp. S11–S18.
  52. Kofoed, K., Gerstoft, J., Mathiesen, L. and Benfield, T. (2006), “Syphilis and human immunodeficiency virus (HIV)-1 coinfection: influence on CD4 T-cell count, HIV-1 viral load, and treatment response”, Sexually Transmitted Diseases, 33 (3), pp. 143-148.
  53. Leber, A., MacPherson, P. and Lee, C. (2008), “Epidemiology of infectious syphilis in Ottawa”, Canadian Journal of Public Health, 99 (5), pp. 401-405.
  54. MacPherson, D. and Gushulak, B. (2008), “Syphilis in immigrants and the canadian immigration medical examination”, J Immigrant Minority Health, 10, pp. 1-6.
  55. Margulis, L (2004), On Syphilis and Nietzsche’s Madness: spirochetes awake! Daedalus, American Academy of Arts and Sciences.
  56. Margulis, L., Maniotis, A., MacAllister, J., Scythes, J., Brorson, O., Hall, J., Krumbein, W. and Chapman, M. (2009), “Spirochete round bodies Syphilis, Lyme disease and AIDS: Resurgence of the “great imitator”?”, Symbiosis,  47, pp. 51-58.
  57. Miller, B. and Hicks, C. (2010), “Syphilis and HIV: the intersection of two epidemics”, Journal Watch HIV/AIDS Clinical Care, 3, available at: http://aids-clinical-care.jwatch.org/cgi/content/full/2010/903/1
  58. Mishra, S., Walmsley, S.L., Loutfy, M., Kaul, R., Logue, K. and Gold, W. (2008), “Otosyphilis in HIV coinfected individuals: a case series from Toronto,
  59. Canada”, AIDS Patient Care and STDs, 22 (3), pp. 213-219.
  60. Montoya, J., Kent, C., Rotblatt, H., McCright, J., Kerndt, P. and Klausner, J. (2005), “Social marketing campaign significantly associated with increases in syphilis testing among gay and bisexual men in San Francisco”, Sexually Transmitted Diseases, 32 (7), pp. 395-399.
  61. Moore, M. (1939), “Syphilis and public opinion (spirochaeta pallida, homo sapiens and Mrs. Grundy)”, Archives of Dermatology and Syphilology, 39(5), pp. 836-845.
  62. Nnonuka, E. and Ezeoke, A. (2005), “Evaluation of syphilis in patients with HIV infection in Nigeria”, Tropical Medicine & International Health, 10 (1), pp. 58-64.
  63. Operario, D. and Nemoto, T. (2010), “HIV in transgender communities: syndemic dynamics and a need for multicomponent interventions”, Journal of Acquired Immune Deficiencies Syndrome, 55, pp. S91-S93.
  64. Pao, D., Beng, G. and Bingham, J.S. (2002),  “Management issues in syphilis”, Drugs, 62 (10), pp.1447-1461.
  65. Rabelais, F. (1653), Gargantua and Pantagruel in the works of Rabelais, 1894, translated by Doré, G., Moray Press, available at: http://www.gutenberg.org/files/1200/1200-h/p1.htm
  66. Radolf, J. and Lukehart, S. (2006), “Pathogenic treponema: molecular and cellular biology”, Immunology of Syphilis, Caister Academic Press, Wymondham, Norfolk, pp. 285-313.
  67. Radolf, J. and Desrosiers, D. (2009), “Treponema pallidum, the stealth pathogen changes, but how?”, Molecular Microbiology, 72(5), pp. 1081-1086.
  68. Reynolds, D., Evangelista, F., Ward, M., Notenboom, R., Young, E. and D’Cunha, C. (1999), “Syphilis in an urban community”, Canadian Journal of Public Health, 89(4), pp.248-252.
  69. Richardson, R. (2001), Death, Dissection and the Destitute, Phoenix Press.
  70. Rosenberg, C. (1992), “What is an epidemic? AIDS in historical perspective” in Explaining epidemics and other studies in the history of medicine, Rosenberg, C.E. (Ed.), Cambridge University Press, Cambridge, pp. 278-292.
  71. Rosenberg, C. (2003), “What is disease?”, Bulletin of the History of Medicine, 77(3), Johns Hopkins University Press, pp. 491-505.
  72. Sappol, M. (2002), A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in 19th Century America, Princeton University Press.
  73. Saussy, H. (2010), Partner to the Poor: A Paul Farmer Reader, University of California Press.
  74. Schmid, G. (2004), “Economic and programmatic aspects of congenital syphilis prevention”, Bulletin of the World Health Organization.
  75. Sherman, I. (2006), The Power of Plagues, ASM Press, Washington, D.C.
  76. Singer, M. (1996), “Dose of drugs, a touch of violence, a case of AIDS: conceptualizing the SAVA syndemic”, Free Inquiry in Creative Sociology, (24) 2, pp. 99-110.
  77. Singer, M. (2010), “Ecosyndemics: global warming and 21st century plagues” in Herring, A.D. and Swedlund, A.C. (Ed.), Plagues and Epidemics: Infected Spaces Past and Present, Berg Publishing, pp. 21-37.
  78. Singer, M. and Clair, S. (2003), “Syndemics and public health:  reconceptualizing disease in bio-social context”, Medical Anthropology Quarterly, 17 (4), pp. 423-41.
  79. Singer, M., Erickson, P., Badiane, L., Diaz, R., Ortiz, D., Abraham, T. and Nicolaysen, A. (2006), “Syndemics, sex and the city: Understanding sexually transmitted diseases in social and cultural context”, Social Science & Medicine, 63(8), pp.2010-2021.
  80. Smith, M. and Canalis, R. (1998), “Otologic manifestations of AIDS: The otosyphilis connection”, The Laryngoscope, 99 (4), pp. 365-372.
  81. Sontag, S. (1988), AIDS and Its Metaphors, Picador USA, Farrar, Straus and Giroux, New York.
  82. Stall, R., Friedman, M.S. and Catania, J.A. (2007), “Interacting epidemics and gay men’s health: a theory of syndemic production among urban gay men” in Wolitski, R.J., Stall, R., Valdiserri, R.O. (Ed.), Unequal Opportunity: Health Disparities Affecting Gay and Bisexual Men in the United States, NY: Oxford University Press, New York, pp. 251–274.
  83. Toronto Data Fact Sheet (2011), available at: www.toronto.ca/toronto_facts/diversity.htm
  84. Toronto Public Health Sexual Health Information (2008), available at:   www. toronto.ca/health/  sexual health/sh_stds_syphilis.htm
  85. Toronto Public Health Bulletin on Sexually Transmitted and Bloodbourne Diseases (2008), available at:
  86. www.toronto.ca/…/statistics_and_reports/annual_reports/ pdf/2008/2008_sti_ annual_report.pdf
  87. Wallace, R. (1988), “A synergism of plagues”, Environment Research, 47, pp. 1-33.
  88. Wheater, P., Cook, P., Clark, P., Syed, Q. and Bellis, M. (2003), “Re-emerging syphilis: a detrended correspondence analysis of thebehaviour of HIV positive and negative gay men”, BMC Public Health, 3, p. 34.
  89. Wong, W., Chaw, J., Kent, C. and Klausner, J. (2005), “Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002-2003”, Sexually Transmitted Diseases, 32 (7), pp. 458-463.
  90. World Health Organization (2007), Health Impact Assessment, available at: www.who.int/std_diagnostics/publications/manuals/Syphilis_Eng_14May07.pdf
  91. World Health Organization (2008), Regional Strategic Action Plan for the Prevention and Control of Sexually transmitted Infections 2008-2012, available at: www.wpro.who.int/sites/hsi/home.htm
  92. World Health Organization (2009), Global Summary HIV/AIDS, available at: www.who.int/hiv/data/2009_global_summary.png
  93. Xiushan, Y. (2003), “Pharyngeal clinical features of 8 cases of syphilis”, Otolaryngology – Head and Neck Surgery, 10 (1), pp. 23-25.
  94. Young, R. and Meyer, I. (2006), “The trouble with “MSM” and “WSW”: erasure of the sexual-minority person in public health discourse”, American Journal of Public Health, 95(7), pp. 1144-1149.
  95. Zetola, N. and Klausner, J. (2007), “Syphilis and HIV infection: an update”, Clinical Infectious Diseases, 44, pp. 1222-1228.

Published

2021-02-08

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SCIENCE / Articles