Medieval STI causing brain damage infects eyes of women who slept with same man

03 December 2023 , 08:00

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The five women all had the same sexual partner (Image: Getty Images/iStockphoto)

A worrying cluster of cases of a medieval STI detected in part of the US after a group of women contracted it from sleeping with the same man, has experts worried the disease may have evolved.

Five women in southwest Michigan presented with syphilis, the historic STI, but in their eyes. It's been reported that all five women contracted the infection after sleeping with the same man.

Experts are now concerned that these cases could mean a new strain of syphilis has evolved. The Centers for Disease Control and Prevention (CDC) published a report on November 24 looking into the cluster of ocular syphilis cases.

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Syphilis is a sexually transmitted infection that can cause serious health problems if it goes untreated. The infection develops in four stages - primary, secondary, latent and tertiary, with each stage having different symptoms.

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Despite being an STI, syphilis can also spread in other ways outside of sexual contact. Syphilis can spread from another with syphilis to her unborn baby. Despite common myths, syphilis cannot be transmitted through casual contact with objects such as toilet seats, swimming pools, hot tubs, sharing clothing or eating utensils.

You mainly get syphilis by coming into direct contact with a syphilis sore during vaginal, anal, or oral sex. While condoms can help prevent the spread of syphilis by preventing contact with a sore, sometimes sores will occur in areas not covered by a condom, and contact with these can still transmit syphilis.

Syphilis can have severe consequences if left untreated (Getty Images/iStockphoto)

The CDC said in the latest update on the five women in Michigan: "Untreated syphilis can lead to rare manifestations of ocular syphilis, otosyphilis, and neurosyphilis." While ocular syphilis impacts the eyes, otosyphilis impacts the ears and neurosyphilis impacts the brain and spinal cord.

The five cases found in Michigan worried experts, with the CDC saying it suggested "an unidentified Treponema pallidum strain might have been a risk factor for developing systemic manifestations of syphilis". During March to July last year, Michigan public health officials identified a "cluster of ocular syphilis cases".

On April 21, 2022, a local public health doctor alerted the Michigan Disease Surveillance System (MDSS) that two cases of ocular syphilis had been identified during the previous five weeks in two hospitalised women from the same geographic area. All five women were identified, with each living in a different county in southwest Michigan.

The first woman was referred by an ophthalmologist after they noted "blurred vision, fear of blindness, and no improvement in genital lesions" with medication they had been taking for "presumed recurrent herpes". When asked, the common male was identified as her only sexual partner in the last 12 months.

The man did not report any syphilis symptoms in his eyes (Getty Images)

The second woman was identified after being admitted to the hospital for neurosyphilis. The CDC said: "Before admission, she reported headache, mild hearing loss, and worsening blurry vision and double vision for four weeks".

After being treated with antibiotics, steroids and anti-inflammatory medications, she was referred to an emergency department by an ophthalmologist who "noted cranial nerve abnormalities". She then named the same recent sexual partner as the first woman and had also met him online.

The third woman was reported to a local health department in May after she presented with a full-body rash and peeling skin on the palms of her hands. She also reported "spots drifting through her field of vision (floaters) and photophobia (light sensitivity)." She was found to also have "cranial nerve abnormalities" and named the same man as the first two patients, whom she had also met online.

The fourth woman was diagnosed with ocular syphilis by an ophthalmologist in June 2022 after being referred to the hospital for worsening vision. The CDC said: "During the preceding months, [she] had experienced genital sores and a rash on her hands and abdomen".

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The fifth and final patient was evaluated at a hospital's ophthalmology clinic in May 2022 after reporting "visual floaters, seeing flashing lights, and worsening vision after cataract surgery three months earlier." In July, she was admitted to hospital with neurosyphilis and ocular syphilis. During February to April, she had sexual contact with the same male partner as the other four women.

All five women were diagnosed with ocular syphilis (Getty Images)

The case was investigated with all sexual partners notified and those with ocular syphilis had specimens and samples collected for further investigation. The women were aged 40 to 60 years and all had the same male sex partner.

The CDC said the women were identified with early-stage syphilis and all patients were "hospitalised and treated with intravenous penicillin". They added: "The common male sex partner was determined to have early latent syphilis and never developed ocular syphilis."

According to the CDC, the male was contacted multiple times by disease intervention specialists from March to May 2022. They said: "He provided limited information, stated that he had travelled out of Michigan, and did not attend a scheduled appointment for evaluation in April."

His health records were reviewed and it was discovered he had been to the emergency department in January 2022 with "ulcerative penile and anal lesions". He was treated and presumed to have herpes, despite a negative test, with no syphilis test ordered. Both the first and second women reported in follow-up interviews that they had noticed a sore on the man's penis in January 2022. However, he reported having no visual symptoms ay any point.

After he was treated, the CDC said "no additional transmission was identified". The CDC added; "A common heterosexual partner in an ocular syphilis cluster has not been previously documented and suggests that an unidentified strain of T. pallidum might have been associated with increased risk for systemic manifestations of syphilis."

Fiona Leishman