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Syphilis in the fens
  1. Adrian J Palfreeman1,
  2. Raouf A Moussa2
  1. 1Department of Genito-Urinary Medicine, Peterborough District Hospital, Thorpe Road, Peterborough PE 3DA, UK
  2. 2Department of Genitourinary Medicine, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK
  1. Dr A J Palfreeman adrian.palfreeman{at}

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At the beginning of 2000 several clinics in Cambridgeshire and Suffolk saw an increase in new cases of infectious syphilis. This cluster of cases was unusual in that unlike other clusters reported in the United Kingdom it involved transmission of syphilis locally by heterosexual sex among predominantly white middle aged individuals, some of whom had met their sexual contacts through internet chat rooms. This cluster of cases was reported initially in the Communicable Diseases Review1 and written up and presented at the MSSVD Spring meeting in Belfast.2 At least two other papers have been submitted for publication on this cluster (L Doherty, K Fenton, J Jones, et al Infectious syphilis in England—return of an old foe?; M Richardson, A Palfreeman, P B Nielsen, et al A case of congenital syphilis following negative antenatal screening; both submitted to the BMJ).

There are a number of lessons that can be learnt from our experience in Cambridgeshire.

(1) We should not drop our guard in screening for syphilis both in the blood transfusion service, the antenatal clinic, and in genitourinary medicine clinics. The index case had been …

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