History of Syphilis in Timeline

Syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum, progresses through four stages with varying symptoms. Initially, a painless sore (chancre) appears, often multiple. Secondary syphilis manifests as a widespread rash, commonly on palms and soles, and potential mouth/vaginal sores. Latent syphilis, lasting years, presents minimal or no symptoms. Tertiary syphilis can lead to severe complications like gummas, neurological issues, or heart problems. Syphilis's ability to mimic other diseases has earned it the nickname "the great imitator."

1905: Identification of Treponema pallidum

In 1905, Fritz Schaudinn and Erich Hoffmann identified Treponema pallidum as the causative organism of syphilis. This marked a significant milestone in understanding the disease.

1909: Discovery of Arsphenamine

Sahachiro Hata discovered the first effective treatment for syphilis, arsphenamine, in 1909 during a survey of newly synthesized organic arsenical compounds led by Paul Ehrlich.

1910: Introduction of Salvarsan

In 1910, arsphenamine was manufactured and marketed under the trade name Salvarsan by Hoechst AG, becoming the first modern chemotherapeutic agent for treating syphilis.

1916: Use of Mercury Salts for Syphilis Treatment

Mercury salts, such as mercury (II) chloride, were widely used and considered effective treatments for syphilis until as late as 1916.

1928: Discovery of Penicillin

Penicillin was discovered in 1928, marking a significant advancement in the treatment of infectious diseases, including syphilis.

1932: Details of the Tuskegee Study Enrollment

In 1932, the Public Health Service, in collaboration with Tuskegee University, enrolled 600 poor African American men in the Tuskegee Study. Of these, 399 had syphilis, and 201 did not. The men were misled about the purpose and duration of the study and were not treated even after penicillin was proven effective.

1932: Start of the Tuskegee Study

In 1932, the U.S. Public Health Service began the "Tuskegee Study of Untreated Syphilis in the Negro Male" in collaboration with Tuskegee University. The study aimed to observe the natural history of untreated syphilis in African-American men, who were misled to believe they were receiving treatment for 'bad blood'.

1943: Penicillin Proven Effective for Syphilis

In 1943, trials confirmed the effectiveness of penicillin in treating syphilis, establishing it as the main treatment.

1946: Start of the Guatemala Syphilis Experiments

In 1946, unethical syphilis experiments began in Guatemala, where doctors infected soldiers, prostitutes, prisoners, and mental patients without their consent. The experiments were conducted with the cooperation of Guatemalan health officials and resulted in at least 83 deaths.

1948: End of the Guatemala Syphilis Experiments

The unethical syphilis experiments in Guatemala concluded in 1948. Many subjects were treated with antibiotics, but the lack of informed consent and resulting deaths marked the experiment as highly controversial.

1952: Significance of Bacterial Load in Syphilis

Physician Ernest Grin, in 1952, highlighted the importance of bacterial load in his study on syphilis in Bosnia.

1972: Revelation and Aftermath of the Tuskegee Study

In 1972, revelations about the unethical practices of the Tuskegee Study by whistleblower Peter Buxtun led to significant reforms in U.S. clinical study regulations, including requirements for informed consent and accurate reporting of test results.

1972: End of the Tuskegee Study

The Tuskegee Study ended in 1972 after a whistleblower, Peter Buxtun, exposed the ethical failures. This led to significant changes in U.S. law and regulations to protect clinical study participants.

1990: Syphilis Mortality Rate in 1990

In 1990, Syphilis was responsible for 202,000 deaths.

1999: Estimated Global Syphilis Infections

In 1999, it was estimated that 12 million people contracted syphilis, with more than 90% of cases occurring in developing countries.

2000: Rising Syphilis Rates in Developed Countries

After a decline in the 20th century, syphilis rates started increasing again in the US, Canada, the UK, Australia, and Europe after 2000, mainly among men who have sex with men.

October 2010: U.S. Apology for Guatemala Experiments

In October 2010, the U.S. formally apologized to Guatemala for the unethical syphilis experiments conducted between 1946 and 1948. Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius expressed deep regret and outrage over the unethical practices.

2010: Racial Disparities in US Syphilis Cases

In 2010, African Americans represented almost 50% of all syphilis cases in the United States.

2012: Global Syphilis Prevalence and Impact on Pregnancies

In 2012, around 0.5% of adults globally had syphilis, with 6 million new cases. It affected between 700,000 to 1.6 million pregnancies, leading to complications like spontaneous abortions and stillbirths.

2014: Syphilis Rates in the United States

As of 2014, the United States saw about 55,400 new syphilis infections annually, with infection rates continuing to rise.

2015: Cuba Eliminates Mother-to-Child Syphilis Transmission

Cuba became the first country to eliminate mother-to-child transmission of syphilis in 2015.

2015: Discovery of Skeletal Evidence Supporting Pre-Columbian Syphilis

In 2015, new cases of syphilitic-like damage were found in medieval skeletal remains, supporting the hypothesis of syphilis existing in Europe before Columbus.

2015: Global Syphilis Prevalence and Mortality

In 2015, there were approximately 45.4 million cases of syphilis globally, including 6 million new cases. Syphilis caused around 107,000 deaths in 2015.

2015: Global Syphilis Mortality and Impact in Sub-Saharan Africa

Syphilis resulted in about 107,000 deaths in 2015. In sub-Saharan Africa, it contributed to roughly 20% of deaths related to pregnancy and childbirth.

2018: Gender Disparity in US Syphilis Cases

In 2018, approximately 86% of all syphilis cases in the United States were in men.

2020: Study on Syphilis Prevalence in 18th-century London

A 2020 study revealed that over 20% of individuals aged 15-34 in late 18th-century London were treated for syphilis. At the time, the causative agent was unknown, but the disease was known to spread sexually and from mother to child. The study highlighted the significant morbidity and mortality of syphilis in those centuries, exacerbated by the lack of understanding and effective treatments.

2020: Increase in Syphilis Rates in the United States

By 2020, syphilis rates in the United States had increased more than three times compared to previous years, with approximately 86% of cases in 2018 being among men.

2020: Confirmation of Pre-Columbian Treponemal Disease in Europe

In 2020, paleopathologists concluded that there was enough evidence to confirm the existence of treponemal disease, likely including syphilis, in Europe before Columbus's voyages.