UNSW Embryology

Abnormal Development- Sexually Transmitted Diseases

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Introduction

Worldwide Annual incidence of curable STDs (excluding AIDS) is 333 million cases (WHO Statistics, 1996). Apart from AIDS, the four most common (by incidence) STDs at present are: Trichomoniasis (170 million), Chlamydial infections (89 million), Gonococcal infections (62 million) and Syphilis (12 million). Syphilis is the most deadly and can also be transmitted to the fetus (see Syphilis Notes). The syphilis spirochete treponema pallidum causes the disease, and its complete genomic sequence (2) was published in the Journal Science in1998.

These are preventable diseases.

Data Source- WHO Fact Sheet N 110- March 1996

The Australian NHMRC (1988) recommends neonates be assessed for follow-up care under the following conditions.

(see the NHMRC WWW Page)

Birthweight less than 1500g or gestational age less than 32 weeks
Small-for-gestational-age neonates
Perinatal asphyxia
Apgar score less than 3 at 5 minutes
clinical evidence of neurological dysfunction
delay in onset of spontaneous respiration for more than 5 minutes and requiring mechanical ventilation
Clinical evidence of central nervous system abnormalities ie., seizures, hypotonia
Hyperbilirubinaemia of greater than 350umol/l in full term neonates
Genetic, dysmorphic or metabolic disorders or a family history of serious genetic disorder
Perinatal or serious neonatal infection including children of mothers who are HIV positive
Psychosocial problems eg., infants of drug-addicted or alcoholic mothers.

WWW Links

For Normal Childhood Development see Publications (or NHMRC WWW Page)

References

Congenital syphilis: still a reality in 1996 Michael D Humphrey and David L Bradford MJA 1996; 165: 382
- Link to eMJA WWW article
- Medline Reference
- Abstract: Despite the widespread use of penicillin for more than 50 years, syphilis continues to be a problematic health issue in many parts of the world. In Australia, congenital syphilis is again a significant cause of stillbirth, preterm labour and neonatal disease in some areas (including central and northern Australia). Control mechanisms based on screening, reliable treatment protocols, contact-tracing and adequate follow-up appear to be less effective than they were in the past. It is difficult to discuss such a socially stigmatizing disease when it is clear that some community groups are at high risk, and may be offended by and feel disempowered in the face of well-meaning medical debate. If congenital syphilis is to be eradicated, new approaches are required. These include public-awareness campaigns to stress the need for antenatal care in affected communities; involving the community in efforts to prevent syphilis; providing culturally appropriate services; improving notification and surveillance systems; improving the management of pregnant women who present to maternity units without prior booking; and improving the management of syphilis in pregnancy. There is a need to raise awareness that antenatal care is important not only for the mother's health but also for the wellbeing of the baby.
Complete genome sequence of Treponema pallidum, the syphilis spirochete. Fraser CM, Norris SJ, Weinstock GM, White O, Sutton GG, Dodson R, Gwinn M, Hickey EK, Clayton R, Ketchum KA, Sodergren E, Hardham JM, McLeod MP, Salzberg S, Peterson J, Khalak H, Richardson D, Howell JK, Chidambaram M, Utterback T, McDonald L, Artiach P, Bowman C, Cotton MD, Venter JC, et al Science 1998 Jul 17;281(5375):375-88
- Link to Medline Reference

About Notes

Lecture notes from the Embryology Program compiled and written by Dr Mark Hill.
Note Links to OMIM Entries are copies of originals for computers without internet access. Computers with internet access can directly access the database.

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Date Last Modified: 19/3/99
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