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Nature Reviews. Disease Primers Oct 2017Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or via vertical transmission during pregnancy. T. pallidum is renowned for its... (Review)
Review
Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or via vertical transmission during pregnancy. T. pallidum is renowned for its invasiveness and immune-evasiveness; its clinical manifestations result from local inflammatory responses to replicating spirochaetes and often imitate those of other diseases. The spirochaete has a long latent period during which individuals have no signs or symptoms but can remain infectious. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Syphilis also causes several hundred thousand stillbirths and neonatal deaths every year in developing nations. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase in the prevalence of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen. Strong advocacy and community involvement are needed to ensure that syphilis is given a high priority on the global health agenda. More investment is needed in research on the interaction between HIV and syphilis in MSM as well as into improved diagnostics, a better test of cure, intensified public health measures and, ultimately, a vaccine.
Topics: Algorithms; Humans; Syphilis
PubMed: 29022569
DOI: 10.1038/nrdp.2017.73 -
Clinical Medicine (London, England) Jan 2022Leptospirosis is one of the most important zoonotic bacterial diseases worldwide, commonly affecting resource-poor populations and resulting in significant morbidity and... (Review)
Review
Leptospirosis is one of the most important zoonotic bacterial diseases worldwide, commonly affecting resource-poor populations and resulting in significant morbidity and mortality. This article provides an overview of the epidemiology, clinical manifestations, diagnosis and treatment of human leptospirosis.
Topics: Humans; Leptospira; Leptospirosis
PubMed: 35078790
DOI: 10.7861/clinmed.2021-0784 -
Journal of Veterinary Internal Medicine 2023Since publication of the last consensus statement on leptospirosis in dogs, there has been revision of leptospiral taxonomy and advancements in typing methods,...
Since publication of the last consensus statement on leptospirosis in dogs, there has been revision of leptospiral taxonomy and advancements in typing methods, widespread use of new diagnostic tests and vaccines, and improved understanding of the epidemiology and pathophysiology of the disease. Leptospirosis continues to be prevalent in dogs, including in small breed dogs from urban areas, puppies as young as 11 weeks of age, geriatric dogs, dogs in rural areas, and dogs that have been inadequately vaccinated for leptospirosis (including dogs vaccinated with 2-serovar Leptospira vaccines in some regions). In 2021, the American College of Veterinary Internal Medicine (ACVIM) Board of Regents voted to approve the topic for a revised Consensus Statement. After identification of core panelists, a multidisciplinary group of 6 experts from the fields of veterinary medicine, human medicine, and public health was assembled to vote on the recommendations using the Delphi method. A draft was presented at the 2023 ACVIM Forum, and a written draft posted on the ACVIM website for comment by the membership before submission to the editors of the Journal of Veterinary Internal Medicine. This revised document provides guidance for veterinary practitioners on disease in dogs as well as cats. The level of agreement among the 12 voting members (including core panelists) is provided in association with each recommendation. A denominator lower than 12 reflects abstention of ≥1 panelists either because they considered the recommendation to be outside their scope of expertise or because there was a perceived conflict of interest.
Topics: Animals; Dogs; Humans; United States; Dog Diseases; Leptospirosis; Leptospira; Consensus; Vaccines
PubMed: 37861061
DOI: 10.1111/jvim.16903 -
Revue Scientifique Et Technique... Aug 2015Lyme disease is among the most frequently diagnosed zoonotic tick-borne diseases worldwide. The number of human cases has been on the increase since the first... (Review)
Review
Lyme disease is among the most frequently diagnosed zoonotic tick-borne diseases worldwide. The number of human cases has been on the increase since the first recognition of its aetiological agent. Lyme disease is caused by spirochete bacteria belonging to the genus Borrelia, with B. burgdorferi sensu stricto (s.s.) found in the Americas, and B. afzelii and B. garinii, in addition to B. burgdorferi s.s., in Europe and Asia. Environmental factors, such as human encroachment onto habitats favourable to ticks and their hosts, reduced deforestation, increased human outdoor activities, and climatic factors favouring a wider distribution of tick vectors, have enhanced the impact of the disease on both humans and animals. Clinical manifestations in humans include, in the early phases, erythema migrans, followed several weeks later by neuro-borreliosis (meningo-radiculitis, meningitis or meningo-encephalitis), Lyme arthritis and/or Borrelia lymphocytoma. In dogs, acute signs include fever, general malaise, lameness, lymph node enlargement and polyarthritis, as well as neuro-borreliosis in the chronic form. Diagnosis is mainly serological in both humans and animals, based on either a two-tier approach (an immunoenzymatic test followed by a Western blot confirmatory test) in humans or C(6) peptide, only in dogs. Early treatment with antibiotics, such as doxycycline or amoxicillin, for three weeks usually reduces the risk of chronic disease. Tick control, including the use of tick repellents for both humans and animals, particularly dogs, is highly reliable in preventing transmission. Vaccines are not available to prevent human infection, whereas several vaccines are available to reduce transmission and the clinical manifestations of infection in dogs.
Topics: Animals; Anti-Bacterial Agents; Global Health; Humans; Lyme Disease
PubMed: 26601457
DOI: 10.20506/rst.34.2.2380 -
Revista Brasileira de Enfermagem 2021to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention. (Review)
Review
OBJECTIVES
to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention.
METHODS
integrative review after a search in the databases LILACS and MEDLINE, carried out in March 2018, using the descriptors "syphilis, congenital", "complications", and "signs and symptoms", leading to the selection of 27 researches.
RESULTS
the publications found were published from 1966 to 2017, and most of them were from Latin America and Africa. Negative outcomes, laboratory changes, and the clinical manifestations in congenital syphilis, whether early or delayed, were, respectively: low weight at birth, anemia, hepatosplenomegaly, and dental alterations. The lack of treatment of the pregnant women in the prenatal was the most common occasion in which the opportunity to prevent the complications of congenital syphilis was lost.
CONCLUSIONS
the scientific evidences analyzed showed serious complications of congenital syphilis that could be avoided if early opportunities of diagnosing and treating the pregnant women are not lost during the prenatal.
Topics: Female; Humans; Infant, Newborn; Parturition; Pregnancy; Pregnancy Complications, Infectious; Syphilis; Syphilis, Congenital
PubMed: 34287560
DOI: 10.1590/0034-7167-2019-0318 -
Ugeskrift For Laeger Mar 2022This review focuses on typical and atypical manifestations of neurosyphilis. The manifestations of neurosyphilis are manyfold and may involve many specialties. Today,... (Review)
Review
This review focuses on typical and atypical manifestations of neurosyphilis. The manifestations of neurosyphilis are manyfold and may involve many specialties. Today, clinicians have limited experience with the well-described manifestations of neurosyphilis. Many screening opportunities for men who have sex with men might catch the majority of cases of syphilis in this group. However, a concern could be if disclosure about heterosexuality or, in general, monosymptomatic neurosyphilis constitute a risk for delayed diagnosis.
Topics: Homosexuality, Male; Humans; Male; Neurosyphilis; Sexual and Gender Minorities; Syphilis
PubMed: 35499222
DOI: No ID Found -
Journal of Medical Entomology Mar 2022Lyme disease, caused by Borrelia burgdorferi sensu stricto and most commonly transmitted by Ixodes scapularis Say (Ixodida: Ixodidae), is the most common tick-borne...
Lyme disease, caused by Borrelia burgdorferi sensu stricto and most commonly transmitted by Ixodes scapularis Say (Ixodida: Ixodidae), is the most common tick-borne disease in Maryland. Because B. burgdorferi s.s. is maintained in enzootic cycles among wild mice (Peromyscus spp) and Ixodes spp ticks, differing patterns of parasitism of ticks on mice could impact the infection prevalence with B. burgdorferi. We determined the infection prevalence of Peromyscus spp as well as questing and partially engorged nymphal ticks collected at six sites on private land in five counties in Maryland from May to August 2020. Questing nymph infection prevalence (NIP) was 14%. We trapped 1258 mice and collected 554 ticks and 413 ear tissue samples. The prevalence of infested Peromyscus spp varied based on host age and sex, with older and male mice more likely to be infested. We detected a significant difference amongst the proportion of attached Ixodes and the location of trapping. Similarly, the prevalence of B. burgdorferi infected Peromyscus spp mice varied between locations (average mouse infection prevalence was 40%), with the highest prevalence in locations where Ixodes were the most commonly found ticks. The B. burgdorferi infection prevalence in partially engorged I. scapularis nymphs retrieved from Peromyscus spp was ~36% which lends further support to the host infection prevalence. Local differences in distribution of infected vectors and reservoirs are important factors to consider when planning interventions to reduce Lyme disease risk.
Topics: Animals; Borrelia burgdorferi; Ixodes; Lyme Disease; Male; Maryland; Nymph; Peromyscus; Prevalence; Rodent Diseases; Spirochaetaceae
PubMed: 34971369
DOI: 10.1093/jme/tjab206 -
Clinical Microbiology Reviews Jan 2014The agents of human treponematoses include four closely related members of the genus Treponema: three subspecies of Treponema pallidum plus Treponema carateum. T.... (Review)
Review
The agents of human treponematoses include four closely related members of the genus Treponema: three subspecies of Treponema pallidum plus Treponema carateum. T. pallidum subsp. pallidum causes venereal syphilis, while T. pallidum subsp. pertenue, T. pallidum subsp. endemicum, and T. carateum are the agents of the endemic treponematoses yaws, bejel (or endemic syphilis), and pinta, respectively. All human treponematoses share remarkable similarities in pathogenesis and clinical manifestations, consistent with the high genetic and antigenic relatedness of their etiological agents. Distinctive features have been identified in terms of age of acquisition, most common mode of transmission, and capacity for invasion of the central nervous system and fetus, although the accuracy of these purported differences is debated among investigators and no biological basis for these differences has been identified to date. In 2012, the World Health Organization (WHO) officially set a goal for yaws eradication by 2020. This challenging but potentially feasible endeavor is favored by the adoption of oral azithromycin for mass treatment and the currently focused distribution of yaws and endemic treponematoses and has revived global interest in these fascinating diseases and their causative agents.
Topics: Animals; Disease Eradication; Disease Models, Animal; Endemic Diseases; Treponema; Treponemal Infections
PubMed: 24396138
DOI: 10.1128/CMR.00070-13 -
Deutsches Arzteblatt International Jul 2022
Topics: Humans; Syphilis, Cutaneous; Syphilis
PubMed: 36321683
DOI: 10.3238/arztebl.m2022.0050 -
Australian Journal of General Practice Mar 2024Syphilis infections have been increasing in Australia over the past decade. This phenomenon has been associated with a re-emergence of congenital syphilis. (Review)
Review
BACKGROUND
Syphilis infections have been increasing in Australia over the past decade. This phenomenon has been associated with a re-emergence of congenital syphilis.
OBJECTIVE
The aim of this article is to describe recent epidemiological trends of syphilis infection in Australia, including demographics in which infection rates are rising, such as women of reproductive age. This article also provides an overview of the clinical course and the principles of management for syphilis.
DISCUSSION
Considered by some as a disease of bygone eras, the resurgence of syphilis in Australia requires clinicians to be alert to this infection once again. Increased testing, prompt management and thorough contact tracing are all required to reverse this trend. Congenital syphilis is a potentially devastating yet preventable consequence of rising infections among women of reproductive age. Universal syphilis screening is recommended for all pregnant women at the initial antenatal visit and is now also recommended in the third trimester in several Australian jurisdictions.
Topics: Female; Humans; Pregnancy; Australia; Prenatal Care; Syphilis; Syphilis, Congenital
PubMed: 38437656
DOI: 10.31128/AJGP-08-23-6943