COMMENTARY

Infectious Syphilis: The Return of an Epidemic

Robert B. Stroube, MD, MPH

Disclosures

May 12, 2008

In This Article

Disease Control in the United States: A Historical Overview

The efforts to control syphilis in the United States essentially began with the appointment of Dr. Thomas Parran as Surgeon General in 1936. He immediately called for a broad-based publicity campaign to call attention to the ravages and costs of uncontrolled syphilis.[3] He estimated that 10% of all Americans would be infected sometime during their lives.[4] That year he sponsored the National Venereal Disease Conference in Washington, DC, and brought together medical, business, and civic leaders to address the syphilis epidemic. In 1938 Congress passed the National Venereal Control Act, which established syphilis control efforts at the national level. Dr. Parran succeeded in making "syphilis" an acceptable word in society.

World War II brought to light the scope of the syphilis problem in the United States. Out of 12 million men called for service, more than 170,000 had to be treated for syphilis before they could go on active duty. "Rapid treatment centers" were established, and between November 1944 and October 1946, more than 50,000 men were treated before they were released from military service. In 1947, 160,000 cases of infectious syphilis were reported.[3]

After the war, the availability of penicillin dramatically changed the picture.[5] Morbidity fell tremendously in the late 1940s and the early 1950s, not just from the use of penicillin specifically for syphilis, but also probably by the widespread use of penicillin for many other conditions. Optimism flourished that the disease would disappear as the number of cases annually dropped to 6500 in the mid-1950s. Unfortunately, cases began to rise after that, and in 1963 case levels were greater than 22,000. Renewed controls were instituted and levels were stabilized.[3]

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