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Chapter 12 : The Great Pox Syphilis
Syphilis was so ubiquitous by the 19th century that it could be considered to be the AIDS epidemic of that era. In the 1700s, syphilis was a dangerous but not an explosive infection. Clearly, either the people were developing an increased resistance, or the disease’s pathogenicity was changing. Port cities with their characteristics of high sexual activity and prostitution provide the locale for the possibility of high transmission rates of sexually transmitted diseases. In the past, diseases such as syphilis were called venereal diseases, or VD. The highly infectious secondary stage does not last very long. Then the patient enters the early latent stage, in which he or she appears to be disease-free, i.e. there are no clinical signs. Indeed, the most dangerous time is during the early latent stage, because the infected individual can still transmit to others. Transmission can also occur by blood transfusion, but this is rare, because the spirochetes do not survive longer than 24 to 48 hours under blood bank storage conditions. Syphilis can be transmitted from the mother to the developing fetus via the placental blood supply, resulting in congenital syphilis; this is most likely to occur when the mother is in an active stage of infection. In the chancre stage, syphilis is rarely diagnosed by growth and isolation of Treponema pallidum itself. Fluorescent antibody absorbed tests and hemagglutination assays are used to confirm a positive nontreponemal (nonspecific) test.