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Syphilis and Leprosy-Reply

Yehudi M. Felman, MD, MA, MPhil
JAMA. 1982;247(15):2097-2098. doi:10.1001/jama.1982.03320400017015.
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In Reply.—  Dr Murray's letter concerning simultaneous syphilis and HD poses some interesting questions. It is well known that from 10% to 40% of patients with lepromatous leprosy have false-positive reagin serological tests for syphilis.1 However, in these patients specific treponemal tests such as the FTA-ABS, TPI, and MHA-TP tests are generally negative.2Current incidence rates of syphilis in the United States do not approach the percentage of syphilis cases detected in Dr Murray's study population, indicating that patients with HD are at high risk. The highest incidence rate recorded in the United States from 1940 to 1979 for all stages of syphilis was in fiscal year 1943, at a rate of 447/100,000 population.3 Except for some occasional minor upward fluctuations, the rate for total syphilis in the United States has been steadily declining to a rate of 30.7/100,000 in 1979. Mathematically, 447/100,000 equals 0.447%. This figure


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