Thursday, May 13, 2010

The origin of syphilis

The origin of syphilis
The origin of syphilis ( a treponematosis pullidum) is one of the most controversial problems on the history of infectious diseases.

Syphilis was first recognized as a distinct pathological entity in Europe following epidemics that developed around 1500 that is, shortly after the return of Columbus from his voyage of discovery.

The question is whether syphilis was indigenous to America and was brought to Europe by the sailors of Columbus, or whether it already existed although undiagnosed in the Old World.

Paleopathology is of limited help in the solution of this problem in spite of the fact that syphilis leaves its characteristics marks on the bones.

The difficulty is that there are three other treponematoses, which are nonsexually transmitted: yaws, a tropical disease cause by Treponema pertenue: pinta, endemic in tropical America, caused by Treponema carateum and bejel, a disease of the arid regions of Eurasia, caused by subspecies of Treponema pallidum.

The treponemas, the causative agents of these diseases, are morphological identical and have a common antigenic structure which differs only quantitatively.

In man, partial cross immunity exists between the various treponematoses, which suggest that the four treponemas are four different strains of the same specifies.

It has been suggested that the four treponematoses have a common origin and that they have acquired their individual identity though millennia of evolution.

According to this theory, the oldest disease would be pinta which would have existed in the world for at least 20,000 years and the other three would be derived from it; climatic circumstances, urban living, diet, etc. would have caused an increased virulence of syphilis toward the end of the Middle Ages, and by coincidence the first epidemic would have develop shortly after the return of Columbus.

Other hypothesis include those suggesting that the four treponematoses have always existed in their present form and that they effect various human populations according to physical environment and socio cultural status.

With alterations of the environment and changes in living conditions there would be a concomitant shift in the particular treponematosis affecting a given population.

For example, living in the humid climate of the jungles of South America would favor the development yaws whereas in dry climates yaws would tend to disappear and endemic syphilis would take over.

When hygienic and environmental conditions tend to eliminate other forms of transmission, only the sexual one is left and venereal syphilis prevail Of this is the case, the European epidemics around 1500 would not have been epidemics of a new disease but the recognition of syphilis as a clinical entity distinct from leprosy, with which it had been confused.

In the other words, venereal syphilis would have existed from time immemorial both in the New and the Old World.
The origin of syphilis
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