History of Syphilis

Abstract

Evidence-based research now allows clear separation of syphilis from other diseases in its class of treponematoses. Examination of skeletons from populations with clinically diagnosed bejel and yaws revealed bone alterations distinctive to those diseases, clearly separating them from alterations due to syphilis, transcending the limitations of current DNA and immunologic technologies. These insights allowed confident identification of the New World origin of syphilis. Absence of skeletal evidence of any treponemal disease in continental Europe before the time of Columbus excludes it as site of origin of syphilis. Treponemal disease appears to have originated in East Africa with late transmission to England, perhaps as a complication of the slave trade. The original treponemal disease apparently spread from Africa through Asia, entering North America. Approximately 8 millennia later, it mutated to syphilis. Presence of skeletal evidence of syphilis at the site in the Dominican Republic where Columbus landed suggests the route by which it was transmitted to the Old World.

Dental signs attributed to congenital syphilis and its treatments in the Hamann-Todd Skeletal Collection

“…The paucity of bone pathologies in the collection studied and the high age at death of affected individuals, indicate that metallic antibacterial treatments were largely effective, if not in complete elimination of bacterial infection, at least in limiting seriously its pathological effects. Comparison of very infrequent changes found in the Hamman Todd Collection with findings of Steinbock (1976) and Rothschild (2005) of frequencies reaching up to 25% or 13% of bony changes in syphilitic individuals confirms the observation of successful pre-antibiotic treatments. In cases studied here, either mercury was effective or syphilis was asymptomatic more often than in individuals studied by others.…”

“…They are considered to be the caries sicca sequence of calvarial changes, and nodes and expansion with superficial cavitation in long bones (Hackett 1975). However, it should be noted that not all individuals infected with syphilis will develop bony changes, with frequencies of such changes occurring between 10% and 25% (Steinbock 1976) and 2-13% (Rothschild 2005). In congenital syphilis, most cases present with some form of bone manifestations during the early and late stages of the disease, however, in approximately 50% to 75% of cases, the bony changes will be minimal or will heal, thus not appearing in skeletal remains (Steinbock 1976).…”

Infection Dynamics of the Lungworm Rhabdias Pseudosphaerocephala in Its Natural Host, the Cane Toad (Bufo Marinus), and in Novel Hosts (Native Australian Frogs)

“…One of the most important but poorly understood processes may be the introduction of novel pathogens into highly susceptible populations (Prenter et al, 2004), a process responsible for the immense impact of European colonization on the indigenous human population of many Pacific (Willcox, 1980) and South American (Willcox, 1980;Hopkins, 1983;Rothschild, 2005) countries. Although accidents of the introduction process often result in invasive species arriving in their new range without many of their nativerange parasites (Mitchell and Power, 2003;Torchin et al, 2003), there are many cases of parasites being introduced to a novel environment along with their hosts.…”

The Endemic Treponematoses

“…This hypothesis finds its strongest advocates in paleopathologists who claim that the absence of skeletal evidence of syphilis infection in continental Europe prior to Columbus' journey excludes Europe as the site of origin of syphilis (80)(81)(82)(83). Based on the analysis of skeletal remains of Homo erectus, for example, Rothschild et al proposed that treponematoses originated in East Africa during the Pleistocene era (1.5 million years ago) in the form of yaws (83,84). According to his hypothesis, the other two T. pallidum subspecies evolved from the yaws treponeme during its dissemination to Asia, where bejel first appeared, and then to North America, where approximately 8,000 years ago syphilis evolved from bejel (83).…”

“…Based on the analysis of skeletal remains of Homo erectus, for example, Rothschild et al proposed that treponematoses originated in East Africa during the Pleistocene era (1.5 million years ago) in the form of yaws (83,84). According to his hypothesis, the other two T. pallidum subspecies evolved from the yaws treponeme during its dissemination to Asia, where bejel first appeared, and then to North America, where approximately 8,000 years ago syphilis evolved from bejel (83). Reported cases of osseous signs of syphilis infection in the pre-Columbian Old World (85-87) have generally been met by "Columbianist" paleopathologists with skepticism regarding the accuracy of the diagnosis and epidemiological context (83), although some investigators find this evidence convincing of the existence of syphilis in the Old World before Columbus' time (88).…”