Condom use is the safest means of prevention
Professor, are we talking about cases in which infection occurred in the pre-AIDS period? Syphilis is a yardstick, and the number of cases is rapidly approaching the pre-AIDS era; the same applies to gonorrhea. Where there has been a truly exponential increase is in viral STDs, which include infections like condyloma and herpes. While in 1981 our hospital recorded 2,000 cases of condyloma and in the years 1991-93 we had reached very low levels (200-300 cases a year), in 2002, we had 2,400 patients. At the same time, in 2002, we had 880 patients with genital herpes as against 510 patients in 1982 and 85 in 1992. These figures are estimates. Some patients examined in the outpatients’ department refuse to give details, though legislation provides for confidentiality. Because they don’t need other tests or treatments, they take the prescription and go. In the last two months, the hospital, in cooperation with the Hellenic Center for Infectious Disease Control, has set up a special unit on STDs which records these cases, carries out epidemiologic research, and informs and advises patients. It’s a program staffed by special doctors and brings results; the patients are very satisfied. Private doctors What is the picture in the rest of Greece? There are many cases. Due to the nature of the disease, a large number of patients go to private doctors, more than those who come to our hospital. From our colleagues, we hear unofficially that there has been a huge rise in the provinces as well. But this is unofficial and they have not been counted. In the old days, treatment of STDs was a highly difficult, laborious and time-consuming task. Have things changed? Today, there is a wide range of treatments. Syphilis and gonorrhea are curable, and viral STDs can be treated with a considerable degree of success – on condition that the sufferer goes to the doctor when the first symptoms appear and follows directions faithfully. A word of advice: People shouldn’t think they can sleep easy, that STDs are a thing of the past. On the contrary, they are making a comeback and pose a threat to public health. Vigilance and defense against them mean the use of condoms and being selective in one’s sex life. Because when somebody has one STD, it is easier to catch another. For example, if you have herpes and come into contact with HIV, it is much easier to become infected with AIDS. Whatever the case, syphilis always rouses dread. Before 1950, when penicillin was added to the armory of treatments, it was a disease that was hard to cure. It might afflict people their entire lives. People are still imbued with this fear despite the fact that today, it is a disease that is easy to cure, much easier than a lot of others. Penicillin is still the drug of choice, since the spirochaetes bacterium that causes syphilis has fortunately not developed resistance to penicillin. This precious antibiotic continues to kill the microbe in 100 percent of cases. The only reason for not giving someone this particular treatment is penicillin allergy. But in the case of gonorrhea, some bacterial strains have developed a resistance to penicillin. There are, however, other options, and very powerful antibiotics. We are fortunate this has not happened with syphilis. Of course, the more we use an antibiotic, the more likely it is for it to develop resistance. Herpes and condyloma Are viral STDs more difficult to treat? Yes. For example, genital herpes is a disease that it is characterized by many relapses, which are an ordeal for the patients. Now, with the new anti-viral drugs and with persistent treatment, the number and seriousness of relapses can be reduced to a great extent. But one can’t talk about the eradication of the disease, only the suppression of the symptoms. The condyloma viruses can cause cervical cancer in women. Should we be turning more toward prevention? It’s true that a certain class of condylomas affecting women – the viral strains 16, 18, 31, 33 and 35 – have been linked to cervical cancer. These are five strains of the 80 that exist. Consequently, each case requires that the virus be identified and the requisite preventive measures be taken. Of course, prevention through the use of a condom, in all cases, is always the best approach.
