Wednesday, December 14, 2016

Syphilis: resistance and epidemiolgy

Instapundit linked to this article on the resistance of syphillis to antibiotics... i.e. Zithromax/azithromycin.

The advantage of Zithromax is that it is a few pills, whereas Penicillin means a shot (and if you have ever seen an allergy to penicillin you know why the pills are preferred). And Zithromax will also cure Gonorrhea and Chlamydia, which often are also present in these patients but may not show up in tests or give symptoms.

But the article wonders what is behind this:

They found that the two current clades (categories) of syphilis infections had a common ancestor in approximately the 18th century. One of these clades, called SS14, has a particular strain (SS14-Ω) that seems to have split from the others sometime in the middle of the twentieth century. (italics mine)....
It’s not clear why SS14-Ω is so successful. There could be a biological explanation, like it having an increased transmission rate, says Arora. But it could also be social or demographic reasons: “Perhaps there’s a strain type that circulates among networks of people more easily.” Isolates of both strains show up with resistance to azithromycin, but resistance is far more prevalent in SS14

 middle of the 20th century? As in "time of the sexual revolution"? Or a bit later, as in after the Gay liberation movement stopped all attempts to close disease spreading bathhouses and bars:?

People with hundreds of sexual contact are more likely to catch HIV and other STD's than a monogamous person, but to say that out loud will get you accused of homophobia or rigidity/moralism.

and since syphilis is more common in HIV positive white men practicing MSM, could the problem be that Azithromycin, which only discourages and doesn't kill the germ, might not be killed by the body's defenses?

Zithromax belongs to a class of antibiotics called macrolides, which are bacteriostatic – meaning they treat infections by preventing bacteria from multiplying and producing the proteins that are essential for their growth. Eventually, the remaining bacteria die or are killed by the immune system, not by the drug itself. This is in contrast to bactericidal antibiotics, which kill bacteria.

we saw a lot of syphilis, including neonatal syphilis, when I worked in Africa. Men worked in town but were forced by company policies and tribal customs (where if you don't have someone working your land, it will be deeded to someone else) to let their wives in the country to tend the farm. Prostitutes spread various STD's and we saw cases after each holiday.

I always wondered why the mines didn't bother to check the local gals and treat their STD's (as the US Army usually did to stop STD's in the good old days).

and don't say: "condoms"... they aren't used in Africa, mainly due to tribal custom, but also the heat and humidity mean that the latex deteriorates so may be useless.

the presence of "male dormitories" at mines and factories in South Africa etc. is one of the big reasons for the spread of heterosexual HIV, along with no circumcision. And it is probably one of the reasons for South Africa's problem with drug resistant TB.

and in Asia, including China, Iran, and parts of Russia, most of the HIV was related to to injection of heroin etc.

But as a whole, in the West, it is same sex male sexual practiccs that spread Syphilis, HIV and other STD's.


The HIV/AIDS epidemic in the 1980s was associated with general declines in the rates of syphilis among the general population in the US and Western Europe, including MSM [1, 8, 9]. The decline continued into the early 1990s and was concurrent with the adoption of safer sex behaviors and the effectiveness of sexual education and HIV/AIDS prevention programs [10, 11].
However, around 1999, intermittent outbreaks of syphilis were reported in many urban areas in the US and Western Europe [8–13]. These outbreaks occurred almost exclusively among MSM and were attributed to increases in risky sexual behaviors such as condomless anal sex (CAS), exchange sex, illicit drug use before sex, multiple sexual partners, and high-risk anonymous sexual contacts [14].
Syphilis outbreaks continue to occur sporadically in the US and Western Europe [3]. Given the continued risk of syphilis transmission, its close association with HIV infection, and the disproportionate disease burden among MSM in the US and Western Europe, there is a need to examine and understand syphilis trends among MSM in both geographic areas.

to check why, you need an x rated investigation, This article is a good place to start, but is probably quite shocking to the general population.

but we docs already know what is going on: not just drug use, and not just a very large number of different sexual partners, but a lot of practices that a normal woman or an ethical prostitute would reject.

read this and weep..

and then tell the damn Pope that his going along with this "who am I to judge" and condemnation of rigid/moral ideas rather than the condemnation of sin is a major reason that this epidemic spreads.

Yes, in the good old days, we had gays sneaking out once in awhile to have sex, but at least we could use shame and fear (of hell, of disease, or being picked up by the cops) to limit their disease spreading behavior.

being judgment free only means they refuse to recognize the reality behind all those rigid moralisms was not hatred of women/ hatred of sex, or  homophobia, but based on experience.

Warniing people of danger is not hatred, but a form of love...

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