Sunday, June 13, 2010

Another Chinese problem

An increase in the use of prostitutes (and the number of bisexual men) is being blamed for some pretty startlingly bad figures on the recent rise in syphilis in China:

Syphilis was almost wiped out in China 50 years ago, but has increased 10-fold over the past decade to emerge as one of the country's top five infectious diseases, the China Daily said, quoting the ministry of health.

The rate of mother-to-child transmissions jumped alarmingly to 57 cases per 100,000 newborns between 2003 and 2008, from a previous seven cases per 100,000, it said.

What's the rate in Australia, I wonder? This site paints a very mixed picture:

The rates of syphilis in Australia are about 10/100 000, nearly double that in New South Wales, and up to 140/100 000 in the Northern Territory, with a national indigenous rate of 300/100 000.  Despite remaining fairly stable in the heterosexual community, syphilis rates continue to rise in homosexually active men.  Other groups in Australia at risk of syphilis include rural and remote indigenous communities and those from overseas. Most infections are detected in the late latent phase, when the patient is asymptomatic, having passed the early infectious stages unrecognised and undiagnosed. 

The total rate in China, according to this graph that was in the New England Journal of Medicine article that is that basis of this story, indicates a rate of about 20 per 100,000.   So, in fact, the national rate is not all that huge, although I see that some Shanghai is a particularly bad place for it.  But the sharp rise in congenital cases is remarkably steep.  According to the NEJM:

…more than half of pregnant women with syphilis have a spontaneous abortion or stillbirth; and babies with congenital syphilis may have serious, irreversible sequelae with rates of death in infancy of more than 50%

That’s pretty sad.

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