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Molecular epidemiology of syphilis in Scotland
  1. M J Cole1,
  2. S A Chisholm1,
  3. H M Palmer2,
  4. L A Wallace3,
  5. C A Ison1
  1. 1
    Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, London, UK
  2. 2
    Scottish Bacterial Sexually Transmitted Infections Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3
    Health Protection Scotland, Glasgow, UK
  1. Correspondence to Ms M Cole, Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK; michelle.cole{at}


Objective: To examine the molecular epidemiology of syphilis in Scotland.

Methods: Ulcer specimens were collected from 85 patients with infectious syphilis. Typing of Treponema pallidum was performed using a method that examines variation in two loci; the number of 60-basepair repeats within the arp gene and sequence variation in the tpr genes.

Results: Patients were predominately white men who have sex with men (MSM). Treponemal DNA was detected in 75 specimens and a total of six subtypes were identified from 58 typeable specimens (77%). The most common subtypes were 14d (44/58, 76%), followed by 14e (7/58, 12%), 14j (3/58, 5%), 14b (2/58, 3%), 14p and 14k (1/58, 2%).

Conclusions: This study shows that subtype 14d is the predominant subtype circulating in Scotland and there is a surprising level of genetic diversity within the Scottish MSM community.

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  • Funding Financial support for this study was provided by the European Commission (DG SANCO), agreement no 2004210: ESSTI European Surveillance of Sexually Transmitted Infections.

  • Competing interests None.

  • Contributors MJC was the project microbiologist, performed the laboratory work, analysed the data and is the lead author for the paper. SAC contributed to the design of the study and assisted in the laboratory work and data analysis. HMP and LAW provided the specimens and epidemiological information and contributed to the design of the study. CAI contributed to the design of the study, supervised the project and was the project lead. All authors contributed to the write up and reviewed the final draft of the manuscript.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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