China was facing one of the worst syphilis epidemics in human history when the Communist party took power and worked to eliminate the disease, helping to nearly eliminate it for 20 years from 1964.
 
Myron Cohen, the lead researcher from the University of North Carolina, said the study showed a syphilis epidemic "of such scope and magnitude that it will require terrific effort to intervene".
 
"It's surprising that a country which was once striking for its complete absence of STDs [sexually transmitted diseases] now has such a massive problem."
 

FACTS ON SYPHILIS

  • Generally transmitted through bodily fluids, and congenitally from pregnant mother to child
  • Sores on genitals develop in three weeks
  • Symptoms include fever, sore throat, swollen lymph glands
  • Risk of damage to brain, spinal cord, heart, skin and bones
  • Penicillin or antibiotics provide a cure
  • Was called the Great Pox in the 16th century
  • China had 5.7 cases of primary and secondary syphilis per 100,000 people in 2005 compared with 2.7 cases in the US in 2004
Cohen and his Chinese colleagues from the National Centre for STD Control in Nanjing, examined nationwide surveillance data from 1989 to 2005.
 
The study showed an increase from 0.2 cases of syphilis infection per 100,000 people in 1993 to 6.5 cases six years later.
 
Because of the absence of the disease for two decades, the younger population has no natural immunity to the disease, the report said.
 
More alarmingly, congenital syphilis which passes from mother to baby in the womb saw a jump of almost 72 per cent on average every year from 1991 to 2005.
 
Congenital syphilis could lead to miscarriage or stillbirth, while surviving babies face the risk of damage to the brain, liver and other organs.
 
The highest rates of infection were detected in the urban regions, including the cities of Shanghai, Beijing and the rich coastal provinces of Guangdong, Hainan and Zhejiang.
 
Contributing factors
 
The study linked the re-emergence to economic reforms and globalisation in China.
 
"These changes have led to income gaps and a cultural climate that favours re-emergence of prostitution due to a substantial majority of men and a large migrant population of male workers.
 
"Sexually active individuals would be completely susceptible to this infection," said the report, which was based on data drawn from China's sexually transmitted disease surveillance system and population-based registries in specific geographic areas.
 
Major syphilis outbreaks have been recorded in Canada, US and Britain but these are largely focused on specific groups such as sex workers and gay men, unlike the generalised problem China is faced with.
 
Dr John Zenilman, a professor of medicine at Johns Hopkins University who was not part of the research team, said the breakdown of rigid societies, such as in the former Soviet states, often produced conditions for the perfect disease storm.
 
"This outbreak is the collateral damage of capitalism and a freer society, coupled with lower investments into public health".
 
The World Health Organisation recorded 12 million new Syphilis cases in 1999 with 90% of them occurring in developing countries.
 
Syphilis infection also increases the rate of HIV transmission by up to six times.