Question

On syphilis from Proc. R. Soc. Lond. B (Suppl) 271, $174-5176 (2004) S174 2003 The Royal Society DO 10.1098/rsbl.2003.0131 CHANGES IN THE SYMPTOMS OF SYPHILIS AFTER 1496 Syphilis, caused by the spirochaete Treponema pallidum, occurs in three stages. Primary syphilis is characterized by an indurated ulcer at the point of infection (the 'chancre']. This is followed by secondary syphilis, typically involving fever, a sore throat and a rash, but other symptoms may occur Finally, tertiary syphilis occurs after a latent period that usually lasts for many years and has the most severe symptoms. These include the 'gummas' or gummy tumours formed in virtually any body tissue, and neurological damage sometimes leading to insanity (Wright & Csonka 1996). These stages of syphilis can be distinguished in descriptions of the disease from authors in the sixteenth and seventeenth centuries, but in its early years the progress of the disease seems to have been faster many of the symptoms were much more severe, and some symptoms were reported that are completely absent nowadays. The following is a description of secondary syphilis, written by Ulrich von Hutten (1519), himself a sufferer .truly when it first began, it was so horrible to behold that one would scarce think the Disease that now reigneth to be of the same kind. They had Boills that stood out like Acorns, from whence issued such filthy stinking Matter, that whosoever came within the Scent, believed himself infected. The Colour of these was of a dark Green and the very Aspect as shocking as the pain itself, which yet was as if the Sick had laid upon a fire. (Von Hutten (1519),translation from Major (1945), p. 31.) The contrast between this and the description of some of the symptoms of modern secondary syphilis from a modern textbook is striking. The lesions are numerous, variable and affect many systems. Inevitably there is a symmetrical, non irritating rash and generalized painless lymphadenopathy. Constitutional symptoms are mild or absent they include headaches, which are often nocturnal, malaise, slight fever, and aches in joints and muscles. The rash is commonly macular, pale red and sometimes so faint as to be appreciated only in tangential light... Pustular and necrotic lesions are rarely seen in temperate climates but still occur in tropical regions. (Wright & Csonka 1996, p. 711) 9. Syphilis was first described as a disease in 1496 in Europe. Based on the above how has the effect of the disease on humans changed over time? (2) 10. Why does a disease have different effect on patients now compared to before-propose an evolutionary explanation. Explain your answer in detail. (5) now reigneth to be of the same kind. They had Boills that stood out like Acorns, from whence issued such filthy stinking Matter, that whosoever came within the Scent, believed himself infected. The Colour of these was of a dark Green and the very Aspect as shocking as the pain itself, which yet was as if the Sick had laid upon a fire. (Von Hutten (1519), translation from Major (194S), p. 31.) The contrast between this and the description of some of the symptoms of modern secondary syphilis from a modern textbook is striking. The lesions are numerous, variable and affect many systems. Inevitably there is a symmetrical, non- irritating rash and generalized painless lymphadenopathy. Constitutional symptoms are mild or absent they include headaches, which are often nocturnal, malaise, slight fever, and aches in joints and muscles. The rash is commonty macular, pale red and sometimes so faint as to be appreciated only in tangential light... Pustular and necrotic lesions are rarely seen in temperate climates but still occur in tropical regions. (Wright & Csonka 1996, p. 711) 9 Syphilis was first described as a disease in 1496 in Europe. Based on the above how has the effect of the disease on humans changed over time? (2) 10. Why does a disease have different effect on patients now compared to before-propose an evolutionary explanation. Explain your answer in detail. (5) 11. If a mutation made syphilis vector-borne in 1519, what would you predict about the virulence of the disease relative to its virulence in 1496? Explain your answer. (3) DoI om Proc. R. Soc. Lond. B(Suppl)1271, 5174-5176 (2004) 5174 8 2003 The Royal Society DO 10.1098/rsbl.2003.0131 CHANGES IN THE SYMPTOMS OF SYPHILIS AFTER 1496 Syphilis, caused by the spirochaete Treponema pallidum, occurs in three stages. Primary syphilis is characterized by an indurated ulcer at the point of infection (the 'chancre'). This is followed by secondary syphilis, typically involving fever, a sore throat and a rash, but other symptoms may occur. Finally, tertiary syphilils occurs after a latent period that usually lasts for many years and has the most severe symptoms. These include the 'gummas' or gummy tumours formed in virtually any body tissue, and neurological damage sometimes leading to insanity (Wright & Csonka 1996). These stages of syphilis can be distinguished in descriptions of the disease from authors in the sixteenth and seventeenth centuries, but in its early years the progress of the disease seems to have been faster many of the completely absent nowadays. The following Hutten (1519), himself a sufferer. symptoms were much more severe, and some symptoms were reported that are is a description of secondary syphilis, written by Ulrich von ..truly when it fir now reigneth to be of the same kind. They had Boils that stood out like Acorns, from whence issued such filthy s of these was of a dark Green and the very Aspect as shocking as the pain itself, which yet was as if the Sick had laid upon a fire. (Von Hutten (1519), translation from Major (1945). p. 31.) st began, it was so horrible to behold that one would scarce think the Disease that tinking Matter, that whosoever came within the Scent, believed himself infected. The Colour The contrast between this and the description of some of the symptoms of modern secondary syphilis from a modern textbook is striking. The lesions are numerous, variable and affect many systems. Inevitably there is a symmetrical, non- irritating rash and generalized painless lymphadenopathy. Constitutional symptoms are mild or absent; they include headaches, which are often nocturnal, malaise, slight fever, and aches in joints and muscles. The rash is commonly macular, pale red and sometimes so faint as to be appreciated only in tangential light. Pustular and necrotic lesions are rarely seen in temperate climates but still occur in tropical regions. (Wright & Csonka 1996, p. 711) Syphilis was first described as a disease in 1496 in Europe. Based on the above how has the effect of the disease on humans changed over time? (2) 9. y does a disease have different effect on patients now compared to before-propose an evolutionary explanation. Explain your answer in detail. (5) 10. Wh 10.1098/rsbl.2003.0131 CHANGES IN THE SYMPTOMS OF SYPHILIS AFTER 1496 yphilis, caused by the spirochaete Treponema pallidum, occurs in three stages. Primary syphilis is ch aracterized by an indurated ulcer at the point of infection (the 'chancre'). This is followed by secondary syphilis, typically involving fever, a sore throat and a rash, but other symptoms may occur Finally, tertiary syphilis occurs after a latent period that usually lasts for many years and has the most vere symptoms. These include the 'gummas' or gummy tumours formed in virtually any body tissue, and neurological damage sometimes leading to insanity (Wright & Csonka 1996). These stages of syphills can be distinguished in descriptions of the disease from authors in the sixteenth and seventeenth centuries, but in its early years the progress of the disease seems to have been faster, many of the completely absent nowadays. The following is a description of secondary syphilis, written by Ulrich vor Hutten (1519), himself a sufferer. symptoms were much more severe, and some symptoms were reported that are an, it was so horrible to behold that one would scarce think the Disease that now reigneth to be of the same kind. They had Boils that stood out like Acorns, from whence issued such filthy stinking Matter, that whosoever ca of these was of a dark Green and the very Aspect as shocking as the pain itself, which yet was as if Sick had laid upon a fire. (Von Hutten (1519), translation from Major (1945), p. 31.) me within the Scent, believed himself infected. The Colour the The contrast between this and the description of some of the symptoms of modern secondary syphilis from a modern textbook is striking. The lesions are numerous, variable and affect many systems. Inevitably there is a symmetrical, non- irritating rash and generalized painless lymphadenopathy. Constitutional symptoms are mild or absent they include headaches, which are often nocturnal, malaise, slight fever, and aches in joints and muscles. The rash is commonly macular, pale red and sometimes so faint as to be appreciated only in tangential light... Pustular and necrotic lesions are rarely seen in temperate climates but still occur in tropical regions. (Wright & Csonka 1996, p. 711) Syphilis was first described as a disease in 1496 in Europe. Based on the above how has the effect of the disease on humans changed over time? (2) 9. 10. Why does a disease have different effect on patients now compared to before-propose an evolutionary explanation. Explain your answer in detail. (5)

Answer 1

9. Based on the above, it is clearly observed that severity and spread of syphilis become faster now as compared to the time when it was first discovered. From the sixteenth century, the spread of disease become faster now.

10. The syphilis have different effect now as compared to before because the bacteria responsible for causing this disease "treponema pallidium" evolved in the course of time due to drug resistance that it become more virulent and spread fast from one host to another.