A world look at the venereal diseases: recrudescence of the venereal diseases.

Factors affecting the increased incidence of the venereal diseases syphilis and gonorrhea throughout the world since World War 2 are considered. Both diseases declined after the war to a minimum in about 1957, but they have since increased, particularly gonorrhea to even higher incidence in many countries. Late and congenital syphilis, however, have declined almost universally. Factors invoked to explain the recrudescence include decreased virulence of both organisms, perhaps aided by better nutrition and hygiene. An important trend is antibiotic resistance. Sulfonamide resistance was noted during World War 2. A relative penicillin resistence, threatening the convinient use of cheap single-dose treatment, is particularly frequent in the Far East. Other antibiotics and penicillin-probeneoid combinations are still available and have contributed to improved cure rates in some countries, e.g., Canada, United Kingdom, Denmark, Greenland and Norway. Environmental fa ctors suggested are more susceptible persons, greater population mobility, promiscuity, use of pills and IUDs instead of condoms, and changed sexual practices resulting in rectal and oral infections. Hopes for control in the future include formation of adequate case finding organizations in more places, health education, modification of behavior, discovery of a serologic test for gonnorrhea, and although unlikely, immunization. The author concluded that the problems of venereal disease will probably increase: even if syphilis and gonorrhea were controlled, the other sexually transmitted entities (spirochetes, bacteria, virus, protozoa, fungi, parasites and possible cervical carcinoma) will pose problems.