Vol.67 No.4 July 2019
Syphilis: Rapid increase in its incidence in Japan and accurate diagnosis/appropriate treatment
1)Sanda City Hospital, 3-1-1 Keyakidai, Sanda, Hyogo, Japan
2)Infectious Disease Surveillance Center, National Institute of Infectious Diseases
3)Department of Bacteriology I, National Institute of Infectious Diseases
Abstract
According to a Japanese domestic surveillance program, the incidence of syphilis is rapidly increasing in Japan.
In the last 5 years, the incidence has increased by 5.7 fold in males and by 10.4 fold in females.
The estimated incidence in 2017 was 4.6/100,000 (5,819 cases), the highest it has been since 1971. A total of 6,138 cases was reported in 1970, which decreased gradually to under 1,000 cases per year since 1993. However, for the first time in 46 years from 1971, the number of cases increased again to 5,819 cases in 2017. Furthermore, according to preliminary data, 7,002 cases were recorded in 2018. Sentinel surveillance data reported by the Health and Labor Sciences Research explicitly support this phenomenon. Thus, the disease has acquired emergency status and it is important that physicians are aware about the correct method of diagnosis and treatment of syphilis. Syphilis has been called "the great imitator," because of its diverse manifestations; therefore, it is often misdiagnosed. The diagnosis of syphilis (including asymptomatic active syphilis) depends on surrogate markers, such as the serum titers of RPR and TP antibodies, however, the results of these serological tests are sometimes difficult to interpret. Penicillins are, by far, the treatment of first choice for the treatment of syphilis, and in Japan oral administration of amoxicillin 500 mg tid for 4 weeks is standard. Cure is confirmed by confirming symptom resolution and decrease of the antibody titer in the automated calculate method of RPR test to less than half. To suppress the outbreak of syphilis, early and accurate diagnosis plus prompt and appropriate treatment are essential. In addition, it is also important to increase the awareness of people about adopting measures for protection against the infection.
Key word
syphilis, epidemiology, diagnosis, treatment
Received
October 18, 2018
Accepted
February 12, 2019
Jpn. J. Chemother. 67 (4): 466-482, 2019
