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Leading articles |
Department of Child Health, St Georges Hospital, London, UK
Correspondence to:
Dr R Chakraborty, Department of Child Health, St Georges Hospital, 5th Floor, Lanesborough Wing, Blackshaw Road, Tooting, London SW17 0QT, UK; rchakrab@sgul.ac.uk
Accepted for publication 4 September 2007
| The first 150 words of the full text of this article appear below. |
Regardless of origins, syphilis has affected Europeans over many centuries. The first well-documented outbreak occurred in Naples in 1494, rapidly swept throughout Europe and was associated with a myriad of presenting signs and symptoms and a high mortality rate.1 The condition was once a leading cause of dementia and in the pre-antibiotic era caused one out of five of all admissions to psychiatric institutions in the USA.2 In 1943 Mahoney and co-workers first treated cases of syphilis with penicillin. This drug has remained the mainstay of treatment since that time.3
TRANSMISSION
Horizontal transmission among adolescents and adults is primarily sexual, although anecdotal reports cite kissing, contact with infected secretions and blood transfusion as potential sources of acquisition and transmission.4
Transmission to the fetus is usually via the placenta, but may occur during delivery in the presence of maternal genital lesions. The risk of vertical transmission of syphilis from an infected untreated
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