Rapid increase of syphilis in Tokyo: an analysis of infectious disease surveillance data from 2007 to 2016
DOI:
https://doi.org/10.5365/wpsar.2017.8.2.006Abstract
The objective of this study was to examine the trends of primary and secondary syphilis in Tokyo between 2007 and 2016 using national infectious disease surveillance data. We analysed all 3269 cases reported during these 10 years. A statistically significant increase in cases was observed after 2010 with a more rapid rate of increase after 2014 mainly in urban areas in Tokyo. The notification rates per 100 000 population in 2010, 2014 and 2016 were 0.9 (n = 113), 2.2 (n = 295) and 8.7 (n = 1190), respectively. Domestic syphilis transmission was suspected in 92.6–99.3% of cases during the period 2007–2016.
Until 2013, the increase was mainly observed among men who have sex with men (MSM); however, heterosexual transmission became more dominant and eventually surpassed transmission among MSM in 2015. In 2016, the notified cases of infections through heterosexual contact were 22.3 and 40.4 times higher in men and women, respectively, compared to those in 2010. The median ages of affected heterosexual men and women were 37 (interquartile range: 28–46) and 26 (interquartile range: 22–32) years, respectively. Reports of oropharyngeal lesions have been increasing among both men and women with syphilis. The number of congenital syphilis cases reported in Tokyo was 0 to 3 cases per year during the study period.
More information and further analysis are needed to explain the reason for this increase.
References
Singh AE, Romanowski B. Syphilis. Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features. Clinical Microbiology Reviews. 1999 Apr;12(2): 187-209. PubMed PMID: 10194456; PubMed Central PMCID: PMC88914.
Willeford WG, Bachmann LH. Syphilis ascendant: a brief history and modern trends. Tropical Diseases, Travel Medicine and Vaccines. 2016;2 pii: 20. Epub 2016 Sep 26. doi: 10.1186/s40794-016-0039-4.
National Institute of Infectious Diseases and Tuberculosis and Infectious Diseases Control Division, Ministry of Health, Labour and Welfare. Syphilis 2008-2014. Infectious Agents Surveillance Report, 2015 Feb;36(2):17-8. Available from: http://www0.nih.go.jp/niid/idsc/iasr/36/420e.pdf
Sugishita Y, Yamagishi T, Arima Y, Hori N, Seki N. Increase in Primary and Secondary Syphilis Notifications in Men in Tokyo, 2007-2013. Japanese Journal of Infectious Diseases. 2016;69(2):154-7. doi: 10.7883/yoken.JJID.2015.312.
Abara WE, Hess KL, Neblett Fanfair R, Bernstein KT, Paz-Bailey G. Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe. A Systematic Review of Trend Studies Published between 2004 and 2015. PLoS One. 2016 Jul 22;11(7):e0159309. doi: 10.1371/journal.pone.0159309. PubMed PMID: 27447943; PubMed Central PMCID: PMC4957774.
European Centre for Disease Prevention and Control. Annual Epidemiological Report 2016 – Syphilis [Internet]. Stockholm: ECDC; 2016 [cited 2017 Mar 9]. Available from: http://ecdc.europa.eu/en/healthtopics/Syphilis/Pages/Annual-epidemiological-report.aspx
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2014 [Internet]. Atlanta: CDC; 2015 [cited 2017 Mar 9]. Available from: https://www.cdc.gov/std/stats14/surv-2014-print.pdf
Bowen V, Su J, Torrone E, Kidd S, Weinstock H. Increase in incidence of congenital syphilis - United States, 2012-2014. Morbidity and Mortality Weekly Report. 2015;64(44):1241-5. doi: 10.15585/mmwr.mm6444a3. PubMed PMID: 26562206.
Saini R, Saini S, Sharma S. Oral Sex, Oral Health and Orogenital Infections. Journal of Global Infectious Diseases. 2010 Jan-Apr; 2(1): 57–62. doi: 10.4103/0974-777X.59252. PubMed PMID: 20300419; PubMed Central PMCID: PMC2840968.
Centers for Disease Control and Prevention. Syphilis-CDC Fact Sheet [Internet]. Atlanta: CDC; Page last reviewed: 2017 Jan 30 [cited 2017 Mar 9]. Available from: https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm