The government should intensify its efforts to control the spread of syphilis, which has become one of the nation's top five epidemics, an epidemiologist has urged.

"Currently, the spread of this curable sexually transmitted disease isn't getting the attention it deserves," Gong Xiangdong, a researcher with the Nanjing-based National Center for STD (Sexually Transmitted Disease) Control said during an interview with China Daily.

Since the early 1990s, the infection rate in China has skyrocketed, growing 60-fold. In 2006, a government report put the incidence of syphilis cases at 13 in every 100,000.

The figure is based on reports from 26 supervision units around the country, which receive details of patient admissions from government STD clinics.

"The true picture could be even worse," Gong said. "A sizable number of people with the condition most likely seek medical help from private practitioners, pharmacists or other facilities, and those cases go largely unreported."

Despite Gong's dire view, China has yet to devise an efficient State-level support mechanism to detect and control syphilis, neither of which is costly or difficult.

The sexually transmitted disease is caused mainly by a germ that can be treated with antibiotics. A course of penicillin can kill the bacterium and costs no more than 200 yuan (US$26), Gong said.

If left untreated, however, it can lead to genital ulcers, and cause damage to the cardiovascular and nervous systems, and even the brain. In extreme cases, it can result in death, he said.

On average, a person will become infected by having sex just two times with someone already suffering from the disease, He Zhixin, a doctor with the STD Control Center of the Peking Union Medical College Hospital, said.

"In my experience, for every one case diagnosed, there are probably seven or eight others that go unreported. Syphilis patients usually have multiple partners," he said.

Apart from sexual contact, the infection can also be passed from a woman to her baby during pregnancy. This can lead to miscarriages and birth defects, including bone and heart abnormalities.

Official statistics show that the number of children born with syphilis has surged from 0.01 cases per 100,000 live births in 1991, to 20 per 100,000 in 2005. That equates to about 3,400 infected infants being born every year.

"If nothing is done to stem the spread of the disease, the country will face even higher rates among newborns, and that could one day destroy the whole nation," Gong warned.

Within China, syphilis is most prevalent in the coastal boomtowns. According to official data, Shanghai tops the list with 55.3 cases per 100,000, followed by Zhejiang (35.9), Fujian (26.8), Beijing (24.9), and the Pearl River delta (14-21).

Among the groups most at risk are prostitutes and their clients, the gay community, and the vast shifting population, especially migrant workers who often spend long periods away from their spouses, Gong said.

He said that an incidence rate of 15-19 percent was last year detected among certain groups of the urban gay population.

"It is high time the government set up a national screening and treatment network that covers primarily those in high-risk groups," Gong said. "The disease can be easily contained with the right technological support."

Syphilis was virtually non-existent for 20 years after the founding of the new China in 1949 because the government of the time implemented widespread screening and provided free treatment for the disease. It also clamped down on prostitution.

Researchers blame the resurgence on changing sexual habits, including having sexual intercourse at an earlier age, having more partners before marriage, and poor use of condoms.

Using condoms is an effective way to curb the spread of the disease, Gong said, citing an existing campaign to distribute free condoms to prostitutes.

"It's a goodwill initiative, but I have come across a lot of prostitutes who have complained that the free condoms are of low quality," Gong said.

(China Daily March 31, 2007)