Five women got eye syphilis from the same man—raising questions

The cluster of rare cases suggests a new strain of syphilis may have spread.

See full article...

 

[Jim Salter]

Among the duties I had was to administer the treatment for the clap to the sailors who tested positive. It was 4.8 million unit of Y-Cillin K in each cheek (about 5 cc per shot). The needles looked like framing nails and were roughly five or six inches long. They were refrigerated and had the consistency of thick peanut butter. To soften them so that we could push in the medicine within a reasonable length of time (typically 1-2 minutes), we had them hold the syringes in their hands to warm them up for about 15 minutes.

Is that the same "peanut butter shot" from boot camp? We were told it was one of the gajillion vaccinations, but God damn if you didn't just describe it to a tee, INCLUDING the hand-warming.

 

[lazyrivr]

Here's a gripping conversation starter to bring up over your family's Thanksgiving feast this year

My family is having Thanksgiving dinner a night early due to work schedules tomorrow, so I look forward to testing out Beth's hypothesis from the first line of the article tonight!

 

[terrydactyl]

Well chosen image for an eye opening story.

 

[Bad Monkey!]

Is that the same "peanut butter shot" from boot camp? We were told it was one of the gajillion vaccinations, but God damn if you didn't just describe it to a tee, INCLUDING the hand-warming.

Benzathine benzylpenicillin.

 

[Nilt]

Thinking back to that case of the woman with TB recently - at what point should an infected person spreading disease move from 'health officials reached out' to 'judges issue commands'?

The point where someone clearly refuses to cooperate with public health officials. That doesn't appear to have happened here, at least not yet. Typically it takes quite a bit more than you'd think, especially since this is not as easily transmissible a disease as TB.

 

[jtwrenn]

Online sex hookups are dangerous. It's just true. I wish we could just bang away and screw whoever and whenever without dangers but those days...well they never existed. Don't have casual sex or you risk getting an STD. Also, you risk evolving std's into more virulent strains and propagating them. Your lifestyle is your lifestyle...until you breed super gonaherpasiphilaids and we are all screwed.

 

[enilc]

Is there some kind of HIPAA exception for this sort of thing

yes. This falls under permitted use.

https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html

 

[matheme]

This reminds me of what I used to do way back in the last century.

Back in my Navy days toward the end of my enlistment, I was rotated from the ER, where we used to be dispatched for calls, to the Navy base branch clinic where we'd work the clinic doing physicals and immunizations when we weren't out on medical emergencies.

Among the duties I had was to administer the treatment for the clap to the sailors who tested positive. It was 4.8 million unit of Y-Cillin K in each cheek (about 5 cc per shot). The needles looked like framing nails and were roughly five or six inches long. They were refrigerated and had the consistency of thick peanut butter. To soften them so that we could push in the medicine within a reasonable length of time (typically 1-2 minutes), we had them hold the syringes in their hands to warm them up for about 15 minutes.

So they'd sit there, holding a syringe in each hand, looking at them, forlornly contemplating their less than stellar life decisions for the full 15 minutes. I'd give them their shots, and they'd hobble out back into their lives.

That was before super-bugs were a thing. We definitely live in different times.

I wouldn't be surprised if the Y-Cillin K could also have been administered with a simple to swallow pill, but that they found that this route of administration was superior in preventing recurrence of the disease...

 

[lukipedia]

Beth, I'm worried about you. Not even "raising eyebrows"? I count on you to be ten-for-ten on the puns in these articles!

 

[Nexus]

I’m sure there’s a ‘stop or you’ll go blind“ gag in this somewhere…

I wanted to post something, but the first few comments beat me to it. I am not disappointed. Happy Turkey day ARSians.

 

[scooternva]

Thanks for putting this article up right during lunch!

Thanks for letting all of us know what your lunch routine is like.

 

[Random John Smith Guy]

This is actually very concerning:

Because HIV is no longer a death sentence -- actually, it's almost a "solved" problem, these days -- everyone's got real loosey-goosey with the "safer sex" things like condoms and dental dams.

Because, y'know, the clap just isn't all that scary to most people. It should be, though -- antibiotics aren't a panacea and there's surely some long term effects that aren't immediately evident.

Iirc dental dams don't really make any difference practically speaking, they were more a thing because lesbians felt left out than anything else.

 

[The Lurker Beneath]

I mean, that just isnt how this sort of sex works.

Sex for us is sex for certain bacteria and viruses too...

 

[Bad Monkey!]

I wouldn't be surprised if the Y-Cillin K could also have been administered with a simple to swallow pill, but that they found that this route of administration was superior in preventing recurrence of the disease...

Bioavailbility via oral administration is too low, and the "peanut butter shot" is expressly formulated to be a very large dose that's long acting so it can be a one and done for everyone who walks through the door (thus its memorable use during recruit processing), so the huge needle and large amount that gets injected is an unavoidable result.

 

[orwelldesign]

Iirc dental dams don't really make any difference practically speaking, they were more a thing because lesbians felt left out than anything else.

Oh, they're terrible and don't work and people don't use them. Condoms are an intervention that works and where it's not that hard to get people to understand and use.

Condoms for blowjobs are just terrible, though. Yuck. I mean, they're necessary, if you're doing promiscuity. But still, yuck.

Myself, the only reason I didn't catch 'em all like STDs were Pokemon is sheer dumb luck.

(And now, healthy monogamy with a partner I trust -- and a vasectomy for birth control.)

 

[hutsell]

"... I promise."

 

[Properjob70]

And I get responses like I've just asked someone to give up eating meat. It's just mind-boggling.

Ya see, the "give up eating meat" in this case might just be a misunderstanding of what you're trying to convey

 

[blankit]

My juvenile side thought "you seem to be doing it wrong."

But really, shouldn't people who have this dangerous attitude be charged with criminal assault for this kind of thing.

It might seem extreme, but maybe? Just because it seems to be the only way to get certain people to take things like this seriously.

Your comment brought to mind something Dorothea Tanning said about rape: that it would nearly vanish overnight if suddenly there were a 50/50 chance of either person getting pregnant from it.

Edit: typo

 

[Thegs]

This reminds me of what I used to do way back in the last century.

Back in my Navy days toward the end of my enlistment, I was rotated from the ER, where we used to be dispatched for calls, to the Navy base branch clinic where we'd work the clinic doing physicals and immunizations when we weren't out on medical emergencies.

Among the duties I had was to administer the treatment for the clap to the sailors who tested positive. It was 4.8 million unit of Y-Cillin K in each cheek (about 5 cc per shot). The needles looked like framing nails and were roughly five or six inches long. They were refrigerated and had the consistency of thick peanut butter. To soften them so that we could push in the medicine within a reasonable length of time (typically 1-2 minutes), we had them hold the syringes in their hands to warm them up for about 15 minutes.

So they'd sit there, holding a syringe in each hand, looking at them, forlornly contemplating their less than stellar life decisions for the full 15 minutes. I'd give them their shots, and they'd hobble out back into their lives.

That was before super-bugs were a thing. We definitely live in different times.

As someone who has gotten two separate peanut butter shots in my brief time on this world (so far) you paint a beautiful picture of the experience, but from the other side of the table. Thankfully I never had to warm my own shots up myself, I was spared that particular detail...

 

[jbjhillbilly]

This is actually very concerning:

Because HIV is no longer a death sentence -- actually, it's almost a "solved" problem, these days -- everyone's got real loosey-goosey with the "safer sex" things like condoms and dental dams.

Because, y'know, the clap just isn't all that scary to most people. It should be, though -- antibiotics aren't a panacea and there's surely some long term effects that aren't immediately evident.

I've had this conversation with my friends in the gay community. Because most everyone is on PREP, it's being used as a prophylactic. This means the use of condoms has plummeted, and the rest of the STI army has started to run amok. Remember when MPox blew thru? Not hard to figure out why. (for the record, I'm not victim blaming, but the use of condoms would have made that outbreak a lot slower).

 

[honkafied]

... Scott Baio?

 

[Cpt_Beefheart]

Who knew butterfly kisses could be so dangerous.?

 

[Maestro4k]

Everyone in the article was treated. Guy's still a massive douche, but end of the day everyone in the article appears to be fine.

I don't think that's entirely fair to him. Looking at the whole article when contacted the first time he was probably thinking "I went to the ER and was treated for herpes, so I couldn't have been the source." Once found and contacted with five cases, he made an appointment and kept it. He also accepted treatment. He did refuse to name all his sex partners, but so did at least one of the women.

The important thing is that once it was clear he was the source, he did the right thing and accepted treatment. Compare that to the woman with TB who blatantly flaunted the rules and had to be jailed before she'd properly accept treatment. She was even riding the fucking bus with TB so advanced doctors thought she had cancer from looking at her lung x-rays. While there may have been some communication issues, she knew she was sick at that point and still endangered other people so she could go to a casino.

 

[kragg]

I think the simpler and probably more accurate observation is that this is a result of his particular sexual kink. Earache my eye.

 

[Galatian]

The point where someone clearly refuses to cooperate with public health officials. That doesn't appear to have happened here, at least not yet. Typically it takes quite a bit more than you'd think, especially since this is not as easily transmissible a disease as TB.

Uh…don’t want to be pedantic but TB is not easily transmitted at all. It takes you hours spent together with a TB+ patient to catch the bacteria . Source: been around a lot of active TB patients in the emergency room. Been through several tests already. Never turned positive and this is what the hygiene experts always tell me.

The problem with TB is: most people don't realize they are infected and they can transmit the disease and the treatment is a strict regime for half a year.

Back to topic. Since everybody was making jokes and it wasn’t clear in the article: did anybody ask the patient if they got semen or the like in eye? I know my fellow doctors often skimp over the sex question because they feel uncomfortable. I guess it would be even harder for you prude Americans? For me, that’s the more likely explanation than some freak mutation.

 

[RhinestoneEyes]

raising questions​

Questions like, “haha, what the fuck?” and “why am I looking at this when I could be playing with the new Procreate animation app?”

 

[rochefort]

...in January of 2022 he had gone to a hospital emergency department for ulcerative genital and anal lesions. At the time, he was treated for a presumed herpes infection—but his herpes test was negative and he was not tested for syphilis.

I assume the chart was signed by Dr. Nick Riviera?

 

[Nilt]

Uh…don’t want to be pedantic but TB is not easily transmitted at all. It takes you hours spent together with a TB+ patient to catch the bacteria . Source: been around a lot of active TB patients in the emergency room. Been through several tests already. Never turned positive and this is what the hygiene experts always tell me.

That's all well and good but the specific patient I'm talking about had a particularly transmissible version of TB. The relative lack of transmissibility is also due to most cases not being all that advanced yet. It's highly transmissible in enclosed spaces where advanced cases are present. This is why it's such a major issue in prisons and jails, for example.

 

[Secondfloor]

From the CDC article:

In follow-up interviews, both patient A and patient B stated that the male sex partner had a sore on his penis in January 2022.

i’m not one to victim blame, but that would be a “no” from me.

 

[Rival Vector Plot]

One question not likely to be asked is, "How did this transfer happen?"

OK, I know half of the crowd will downvote this, but yes, how the hell did it happen? Did it involve some kind of biological projectile transfer of bodily fluids?

 

[1bit]

One question not likely to be asked is, "How did this transfer happen?"

EDIT: Ocular syphilis is considered secondary or tertiary syphilis and generally from systemic spread and treated as neurosyphilis. The article is pointing out that usually other health symptoms will be present by the time the eyes are involved and the question is whether this is a variant that predominantly affects the ocular and nervous system. Worth investigating and the case report so doctors keep their eyes out for more cases.

 

[Mothringer]

I had to read that several times before it finally sunk in that you weren't sticking a 5 inch needle into their faces. I could not figure out why you needed a needle that long when most people's cheeks are only ~0.25-0.5 inch thick. I would definitely be pondering my life's choices if you needed to stick something that big into each side of my face!

Pretty sure you’re thinking of the wrong cheeks. The medication described is normally a deep intramuscular depot shot, so they likely meant buttcheeks.

 

[loginnombre]

Eye wouldn't.

More seriously, this is what happens when Syphilis spreads inside and throughout the body from the original infection. The, uh, originating act doesn't have to have anything to do with eyeballs.
FORTUNATELY these cases were all caught relatively early and treated.


...

I'm glad the specialists decided not to keep a lid on this.

That’s not really the point of the article though. Syphilis is not uncommon as an std, the point of interest is the cluster of eyeball syphilis is a warning, if only one data point. It Could serve as a canary in the coal mine for public health officials to look for more widely

 

[.劉煒]

Pretty sure you’re thinking of the wrong cheeks. The medication described is normally a deep intramuscular depot shot, so they likely meant buttcheeks.

Heh. I remember back in training where we got a pretty thorough look at some of the results of various STDs and biologicals.

 

[Grey Bird]

I wonder if these people had sex education classes in school. They were a regular part of the required Health class when I went, but many if not all schools in my area have since cancelled sex education from public schools. It was more than a decade ago that I saw a local politician from a nearby city on a Sunday morning news program bragging on how they'd removed sex education from their school system.

 

[Oldmanalex]

Is that the same "peanut butter shot" from boot camp? We were told it was one of the gajillion vaccinations, but God damn if you didn't just describe it to a tee, INCLUDING the hand-warming.

I knew a guy who was a Navy Medic, who ended up in a port VD clinic. He said as you saw the same people multiple times the shot went in colder and faster, but most were back in a month or two.

 

[Rad9umber]

I would also have told him that if he didn't provide contact info for all of his partners the health department was going to public advertise that people who had had sex with him should come to see them for testing and treatment. Most guys I think at that point would name names, rather than being outed as "Syphilis Sidney".

Well sure but this is also a great way to cost your org a ton of money and possibly open yourself up to litigation, too.

 

[Xenobio]

Yes it's possible that this is a new strain of syphilis that has an extraordinarily high rate of dissemination to other body parts, but direct transmission to that anatomical site should be considered too. Remember way back when Michael Douglas announced that he got throat cancer from oral and the lay public thought he was crazy?

(I mean it was obviously known by biologists but back then there was less awareness of HPV and the average person still thought it was only the "cervical cancer virus" especially since the vaccine was only offered to girls.)

 

[trynberg]

Five women in the span of a few months (that we know of) and none of them used safer sex practices? Good golly miss molly

 

[DovePig]

I mean, that just isnt how this sort of sex works.

Hmm. I feel like I might be getting old (though not really, compared to the age of the people in the article given as "40‑60"), but when I still used to go clubbing with some of the associated (consensual) ONSs, having and using a condom was pretty much expected by both parties. Up to the point that I might have asked the partner if she had one, when I totally forgot to have one on hand a few times, and if she didn't, we'd just snuggle or pleasure each other in a non‑penetrating way. Guess the times have changed...

ETA: And those cases in TFA weren't just some people who might have gotten totally wasted at some party having a probably mostly non‑consensual quickie in dirty toilet booth while nearly passing out (PSA: FFS, don't ever do that and don't ever be that fucking guy, as totally wasted people can't give consent!), as TFA noted they all met pretty consensually through online dating apps. Which makes it even weirder – is unprotected sex getting more prevalent among random hookups? I remember that plenty of sexually active people used to be not on the birth control pill because of its other associated health and hormonal issues, so it was mostly protection all the way. Which was good. Even here where the after‑pill is just a pharmacy away and not illegal.

Well, even if clubbing use pro and still get regularly tested. Anonymous testing exists. STDs are no joke.