Epidemiology : re-emerging in Westernized countries. Repeated epidemics of primary and secondary syphilis infection in the USA over the past 50 yr have previously been attributed to social and behavioural changes. These epidemics represent a rare example of unforced, endogenous oscillations in disease incidence, with an 811-yr period that is predicted by the natural dynamics of syphilis infection, to which there is partially protective immunity. This conclusion is supported by the absence of oscillations in gonorrhoea cases, where a protective immune response is absent. Increased synchrony of syphilis oscillations across cities over time has been demonstrated, providing empirical evidence for an increasingly connected sexual network in the USAref. A syphilis outbreak that started in 2003 is worsening in Canyon County and parts of southern Idaho. Since the outbreak began, the Southwest District Health Department has found 104 cases of the sexually transmitted disease in its region, which covers 6 counties in southwestern Idaho. Most of the cases have been in Canyon County. The cases have been spread evenly among men and women. 50% of those infected have been jailed in the past, and 70% admitted to being users of methamphetamine. One 15-year-old girl has been diagnosed twice in the past 2 years with the disease. 7 babies have been born with the disease in the district since 2003, enough of a bump to make Idaho the state with the 6th-highest rate of congenital syphilis in the nation. During 2003 -- the latest year that figures are available -- 4 babies were born with syphilis in Idaho. Some scattered cases have been diagnosed in Ada County, and Lincoln County and the Twin Falls area have also seen an increase. Health department officials said in 2004 that the outbreak began with a case in Homedale and was quickly spreading among the young Hispanic population. In 1999, there were 2 cases of syphilis in Southwest District Health's region, and none in 2000. 1 case was confirmed in 2001, 9 cases in 2002, 38 in 2003 and 46 in 2004. So far, 20 cases have been confirmed in 2005. In 2003, the CDC reported a syphilis infection rate of 3.4 per every 100 000 people in Idaho, compared to a rate of 3.9 per 100 000 in Washington, and zero cases in Montana. Oregon also had a syphilis infection rate of 3.4 per 100 000 people in 2003. As with the recent outbreak of lymphogranuloma venereum, this outbreak of Treponema pallidum infection is linked to methamphetamine abuse

=> great pox / syphilis / lues (as opposed to small pox; Syphilus was a shepherd infected with the disease in the poem of Fracastorius (1530)) : a subacute to chronic infectious disease
Transmission :

Immunity to re-infection is incomplete.
Laboratory examinations

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