Health officials in Michigan report a unique cluster of syphilis infections in women's eyes, possibly indicating a new, more systemic strain. This cluster involves five women connected to a single infected man they met online, sparking concerns about the adaptation of the syphilis bacteria.
The cluster was disclosed by the Michigan Department of Health and Human Services (MDHHS) in the most recent edition of the Morbidity and Mortality Weekly Report, a journal published by the Centers for Disease Control and Prevention (CDC).
Eye Syphilis Outbreak
Ocular syphilis, an infection of the eye caused by the spread of Treponema pallidum bacteria, is a known complication of untreated syphilis, potentially leading to blindness and other severe consequences. However, it is uncommon, occurring in about 1% of syphilis cases, usually in those with late-stage syphilis, individuals aged 65 or older, injection drug users, and those with HIV.
In a rare occurrence, a cluster of five women in Michigan experienced early-stage ocular syphilis, defying the typical demographic associations. Notably, this cluster is the first documented instance linked by heterosexual transmission.
The series of cases unfolded in March 2022 when the initial patient, referred to as Patient A, reported blurry vision, fear of blindness, and genital lesions. She had syphilis and identified a single-sex partner online. The state health department attempted to contact the man, but he resisted cooperation.
Subsequent cases (Patients B to E) reported similar symptoms and the same online meeting partner. Despite outreach efforts, the common male partner provided minimal information, claimed to have left the state, and evaded scheduled medical appointments.
The investigation revealed that the male partner had sought medical attention in January 2022 for ulcerative genital and anal lesions, initially treated as presumed herpes. However, subsequent tests disproved herpes, and no syphilis testing was conducted at that time.
The cluster raises concerns about potential adaptations in the syphilis bacteria, emphasizing the importance of timely and comprehensive testing and treatment to prevent severe complications.
Unidentified Strain Raises Concerns, Highlights Ongoing Surge in National STI Cases
In May, the man linked to the syphilis cluster was examined and showed no signs of syphilis, vision issues, or hearing impairment, though laboratory tests confirmed early latent syphilis. This stage occurs within a year of initial infection when symptoms seemingly resolve but the disease persists.
The man, who had multiple sex partners, declined to reveal their identities. Health officials speculated the man may carry a strain of T. pallidum more prone to causing ocular and neurosyphilis, yet strain identification proved elusive due to the absence of suitable lesions for genetic testing.
All individuals involved received treatment for their infections, and no further cases in Michigan have been traced back to the cluster. While officials hope to have curtailed the spread of the unidentified T. pallidum strain, comprehensive surveillance and partner identification are crucial for confirmation.
Despite this unique cluster, the broader landscape of sexually transmitted infections in the US remains alarming, with escalating rates of syphilis, chlamydia, and gonorrhea reported over the years. A CDC report highlighted a 74% increase in national syphilis cases from 2017 to 2021, with the number of babies born with syphilis in 2022 exceeding tenfold that of 2012.
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