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Chapter 12

HLTB21H3 Chapter Notes - Chapter 12: Chancre, Spirochaete, Gonorrhea


Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat
Chapter
12

Page:
of 13
Don Mills CyberArts
HLTA01 Textbook Notes 1
Chapter 12: The Great Pox Syphilis
1932 – U.S. Public Health Service began a study of the disease
399 poor, black sharecroppers enlisted
oHad latent syphilis but were not informed
Offered financial incentives: free burial service, physical exams, incidental medications
Were told they had “bad blood”
Denied access to treatment
oEven after the development of penicillin in 1947
Called the Tuskegee Syphilis Study
o28 died of syphilis
o100 died of related causes
o40 wives infected
o19 children infected at birth
Eventually Bill Clinton formally apologized to the survivors
A Look Back
Syphilis appeared in 1943
Claim that it was brought to Naples by Spanish troops
oSent to support Alphonso II against French king Charles VIII (invaded Italy in 1494)
30 000 mercenaries fell ill forced their withdrawal
Soldiers of Charles VIII were infected by Neapolitan women
Don Mills CyberArts
HLTA01 Textbook Notes 2
oDisbanded and spread pox throughout Europe
oEx. Some of these mercenaries invaded England in 1496
Epidemic in Europe within 5 years of its arrival
Then European sailors carried it all over the world
Each country had a different name for the disease
oDepending on which nation they disliked and considered unclean
oEx. The French called it “the disease of Naples”
Victims suffered with fevers, open sores, disfiguring scars, disabling pains in joints
2 theories of how Charles VIII’s army contracted this disease
oColumbian and Pre-Columbian
Christopher Columbus visited Americas in 1942
Arrived back in Spain in 1943 with several natives of the West Indies
His crew of 44 disbanded and joined Charles VIII
First mention of disease by Emperor Maximillian in 1495
25 yrs. later, Francisco Lopes de Villalobos claimed syphilis was imported into Europe from
Americas
Initial severity of outbreak favored this idea
Over the years, either resistance increased or pathogenicity changed
o1500s – acute disease with early death
o1600s – extremely dangerous infection, but no acute attacks
o1700s – dangerous but not explosive
o1800s – virulence and number of cases declined
Don Mills CyberArts
HLTA01 Textbook Notes 3
Hypotheses for reason behind dramatic outbreak:
1. New disease introduced to naïve population
Increased rate of transmission by sexual means made disease more virulent
2. European syphilis was derived from yaws
Initially infection was by direct contact (i.e. kissing, drinking shard cups)
Chancre occurring on lips and tongue were unnoticed or mistaken for benign
diseases
3. No precautions against transmission
Early stage chancre and rash self-heal
Later, more severe stages may not have been associated with syphilis
George Sommariva tried mercury as treatment
o1947 – administered orally or topically
Another treatment was guaiacum
oIndigenous to West Indies and South America
oSeen as evidence for Columbian origins
oBut this treatment was introduced 10 years before any mention of Columbian theory
Also, several reports indicate Columbus and crew was healthy
Evidence in bones: scrimshaw patterns and saber thickenings on lower limbs of adults,
notched teeth in children
oSeen in remains of Amerindians
oBut also in Blackfriars of England (70 yrs. before Columbus’ voyage), Metaponto in
Italy (600 BC), Pompeii (79 AD)
So syphilis could have existed in Europe and Asia in a milder form before 1493
oPort cities provide locale for high transmission