By Adam Brimelow
10 November 2011 Last updated at 01:54
Sexual health experts say they are deeply concerned about several outbreaks of syphilis among heterosexual teenagers.
In recent years the infection has been largely confined to older adults, particularly homosexual men.
But clusters of the disease are being seen in Teesside, Hampshire, Rochdale and central Scotland among teenagers.
The British Association for Sexual Health and HIV says there are likely to be other cases going unreported too.
Since the late 1990s there has been a sharp rise in cases of syphilis. Most of these have been in homosexual men, often in their 20s or 30s.
But recently there have been several small outbreaks across Britain of syphilis in heterosexual teenagers – described in detail in the International Journal of STD and Aids.
It should be stressed that the number of cases described is small – the largest outbreak has been just over 30 in a year – but the reports highlight problems in tracing sexual contacts, raising fears of further undiagnosed cases, and the spread of disease within the wider sexually active population.
Peter Greenhouse, a sexual health consultant based in Bristol who speaks for the British Association for Sexual Health and HIV (Bashh), says these cases must be taken seriously.
“Any outbreak of syphilis among young people, among teenagers is unexpected. Syphilis shouldn’t be happening in those groups and we really don’t know why it’s there. So if we can see a small number of outbreaks in a small number of young people it means there must be others going on as well.”
Martin Murchie, president of the Society of Sexual Health Advisers, agrees that the number of cases diagnosed may just be the “tip of the iceberg”.
He says increasing numbers of people, including teenagers, are arranging to have anonymous sex through social networks. He warns that this is making the task of tracing sexual contacts even harder.
“The way that people meet for sex is very different and changing in society. That in itself can be problematic in trying to trace contacts because some people may change their username that they had originally on the social network site, or the health service itself may not be able to access the social networking site.”
‘Risks’ of reforms
Dr Patrick French, a consultant in Genito Urinary Medicine in London, says there is no room for any complacency. He says syphilis is a serious disease that can lead to heart disease, stroke and dementia, and raises the risk of acquiring HIV.
“The worry is that if syphilis gets into the wider sexually active population of young people it could then become a common and endemic infection. Before syphilis became unusual in the UK in the 1980s it was a major cause of ill health and that’s no longer the case. So it’s a very important infection to try and prevent.”
Many experts fear that sexual health services in England may be hampered by the government’s proposals to move them from the NHS to local council control.
Peter Greenhouse, from Bashh, says: “Some of the services may be privatised or cut down in terms of resources, so we may lose some of our health adviser teams.”
But the Department of Health rejected these concerns.
A spokesman said: “Our reforms won’t fragment sexual health services. Under our plans, the responsibility for most sexual health services will go to local councils. This will allow councils to make crucial links between improving sexual health and their other responsibilities.”