Sexually Transmitted Infections

Woodcock, K

doi: 10.1136/sti.51.3.153pmid: 1173564

Various aspects of the British statistics relating to sexually-transmitted diseases are examined. Defects in these are illustrated by data from a series of surveys. It is suggested that the information being collected and published is incomplete by an unknown amount, inadequate because it tells only of laboratory diagnoses, and unusable at a local level because it relates to no identifiable population. Some suggestions are made as to how the data collected might be made more useful: the first and most important is that a working party should decide for what purposes the statistics are required.

Van Der Sluis, J J; Menke, H E

doi: 10.1136/sti.51.3.158pmid: 237599

It is demonstrated that IgG fractions with isoelectric points above 7.6, isolated from pooled syphilitic sera, are able to elevate the thymol turbidity. The effect increases with increasing isoelectric points of the isolated fraction. IgG from individual syphilitic patients exerts a stronger effect on the thymol turbidity than normal IgG. It is concluded that elevated amounts of these basic immunoglobulins are present in the sera of syphilitic subjects.

Van Der Sluis, J J; Menke, H E; Neumann, H

doi: 10.1136/sti.51.3.161pmid: 237600

By differential IgG measurements of sera of 27 patients with early infectious syphilis, it was found that infection with T. pallidium results in a preferential synthesis of IgG immunoglobulins characterized by high isoelectric points. The decrease in total IgG level observed after 6 weeks of treatment can to a large extent be accounted for by the decrease in basic IgG concentration. The relationship between the total and basic IgG levels and the number of T. pallidum present in the body during the three early stages of the disease studied is discussed.

Pampiglione, S; Wilkinson, A E

doi: 10.1136/sti.51.3.165pmid: 1095143

In a survey of 333 pygmies in the Cameroon 4.5 percent. were found to have clinical evidence of yaws. This was also found in 10 per cent. of the inhabitants of camps in Zaire. The results of VDRL and FTA-ABS tests on a sample of the population are presented. These provide evidence of a very high incidence of treponemal disease, 80 to 90 percent. of the population showing serological evidence of infection. Active transmission is taking place in both areas but more frequently in Zaire.

Schultz, W W; Thomas, D W

doi: 10.1136/sti.51.3.170pmid: 166724

Lyosomal myeloperoxidase activity in human phagocytic leucocytes was stimulated by incubation with virulent (T1) and avirulent (T4) forms of Neisseria gonorrhoeae. The amount of activity, assayed by bacterial iodination (125-iodine) after 30 min. exposure to the pagocytes in the absence of serum, was about fifty times greater in cells infected with T4 strains. In the presence of heated human serum, or its IgG component, myeloperoxidase activity increased, but T1-Stimulated activity was significantly less than that of T4 and was not proportional to multiplicity of infection. From these results and from those of a previous study we conclude that T1 can stimulate leucocyte myeloperoxidase activity from an extracellular location, that for this activity a serum fraction is required, and that this may be a mechanism responsible for some of the killing of the membrane associated T1.

Wallin, J; Gnarpe, H

doi: 10.1136/sti.51.3.174pmid: 806326

A probably sifnificant difference (p smaller that 0.05) in the occurrence of gonorrhoea was found between women with and without concomitant C. albicans infection. Although this difference could support the recently reported inhibitory effect by C. albicans on N. gonorrhoeae in vitro another explanation might be the possibility that too many women with vaginal candidiasis and no risk for a gonococcal infection were included in the material. There was nothing to support the in vivo effect of C. albicans on N. gonorrhoeae as negative gonococcal cultures in women known to have been exposed to N. gonorrhoeae could not be correlated with the presence of C. albicans. Until the clinical importance of the inhibitory factor of C. albicans has been studied further, the clinician has to be aware of the possibility of false negative gonococcal cultures from women with vaginal candidiasis.

Rahim, G

doi: 10.1136/sti.51.3.179pmid: 1139277

1,223 ambulant patients with gonorrhoea were each treated with a single dose of eight tablets of cotrimoxazole. 1,069 patients were followed up (794 males and 275 females). Of these, only 46 (4%) failed to respond. Cotrimoxazole in the dosage used was well tolerated by all the patients, with very few side-effects. There was clear evidence that cotrimoxazole did not mask concomitant syphilitic infections; neither did it produce a gonococcal carrier state. The incidence of post-gonococcal non-specific urethritis was 6 per cent. At present cotrimoxazole seems to be the most useful alternative to penicillin in the treatment of gonorrhoea.

Taylor, P K; Seth, A D

doi: 10.1136/sti.51.3.183pmid: 1139278

396 male patients with gonococcal urethritis were treated by one of three treatment schedules. Of 132 patients treated with 2.4 m.u. procaine penicillin plus 2 g. probenecid, 109 were followed. There were three (2.8 per cent) recurrences in the first week and none in the second. Of 132 patients treated with 2 g. ampicillin plus 2 g. probenecid, 112 were followed. There were four (3.6 per cent.) recurrences in the first week and three (2.6 per cent.) in the second (total of 6.2 per cent.). Of 132 patients treated with 3 g. ampicillin plus 2 g. probenecid, 115 were followed. There was one (0.8 per cent.) recurrence in the first week and five (4.4 per cent.) in the second (total of 5.2 per cent.). A close correlation was found between the sensitivities of gonococcal strains to ampicillin and to penicillin. The overall sensitivity pattern of N. gonorrhoeae to penicillin had not changed at The London Hospital since the last report in 1972, but there was further evidence of cross-resistance between penicillin and cotrimoxazole.

Panikabutra, K

doi: 10.1136/sti.51.3.188pmid: 124616

513 cases of uncomplicated gonorrhoea in females with positive results to cultures were treated with two regimens of treatment between January 1, 1972, and February 28, 1973, at the Department for Females, Bangrak Hospital, Bangkok. The highest incidence was found in the age group 20 to 24 years (215 out of 513). The patients were divided into two groups. In the first, probenecid 1 g. was given orally 1 hour before an intramuscular injection of 4 million units fortified procaine penicillin, and in the second an intramuscular injection of 2 g. spectinomycin dihydrochloride was given. 335 cases were followed in the first group and there were no failures; 132 cases were followed in the second group and there was one failure (0.7 per cent.). The fact that gonococci were found in the rectum in 23.7 per cent. of cases (117 out of 493) indicates that rectal tests are of considerable importance and should be included in the routine investigations. There was no evidence that gonorrhoeal infection of the rectum was more resistant to treatment than infection at other sites.

Eriksson, G; Wanger, L

doi: 10.1136/sti.51.3.192pmid: 806327

The frequency of Neisseria gonorrhoeae, Trichomonas vaginalis, and Candida albicans has been studied over a period of one year in women attending a venereal diseases clinic. A total of 1,347 women were investigated, all coming from the same catchment area. Gonorrhoea was established at the first visit in 506 patients (38 per cent.), who constituted 97.5 per cent. of the total number of cases of gonorrhoea. Trichomonas vaginalis was found in 272 (20 per cent.) and Candida albicans in 233 (17 per cent.). 176 patients (13 per cent.) had more than one pathogen. Of the patients attending, 22 per cent. (292 women) were so-called "named contacts". The frequency of gonorrhoea established at the first visit in these patients (64 per cent.), was significantly higher, but the frequency of symptoms did not differ from that in other gonorrhoea patients. The number of asymptomatic cases was so large that a single compulsory examination is undoubtedly very useful from the epidemiological point of view, but the value of repeated specimen collections for gonorrhoea is debatable. Complications of gonorrhoea were observed in 29 patients (6 per cent.) at the first visit.