“Using Bioarchaeological Data to Inform Diagnostic Criteria for Acquired Syphilis in Clinical Care"

Due to a diverse set of limitations, less is known about how syphilis infection progresses within humans than most other common infectious diseases. One of the most clinically and epidemiologically important yet poorly understood issues that surround syphilis’ outcomes: which human host characteristics are associated with resolved early-stage infection, and which are associated with persistent infection, which involves substantial morbidity, mortality, and continued transmission (e.g., congenital syphilis)? To circumvent these limitations, we ask this question of data on host characteristics (e.g., chronic stress, co-infection) from human skeletal individuals representing patients with antemortem diagnoses of syphilis in 19th to early-20th US museum collections. By employing methods from public health and clinical medicine, which enable empirical translation of our findings into public health and medical indices, and collaborating with translational science experts, our aim is to translate our bioarchaeological findings into refined guidelines for screening and diagnosis of syphilis cases. Rapid increases in syphilis' global incidence, especially congenital syphilis, make this endeavor more critical; in this way, bio archaeological research fills a crucial knowledge gap in infectious disease ecology in ways that can benefit the living.