Syphilis, the sexually transmitted disease that was once the best argument for fidelity, is making a comeback, and too few doctors are familiar with it.

A decade ago it was virtually wiped out in the developed world but now cases are on the rise again, according to a review in The Lancet Infectious Diseases.

Kevin Fenton, from the Centres for Disease Control and Prevention, in Atlanta, Georgia, said: “In many high-income countries successes in syphilis prevention and control were accelerated during the early and mid-1990s, with many countries approaching or achieving elimination of endemic disease transmission.

“However, since the beginning of the 21st century, syphilis incidence has started to rise in high-income settings, in part driven by increases in cases among men who have sex with men, although more recent increases among heterosexual people have also been reported.”

In 1996 137 people had the disease diagnosed in England and Wales. By 2005 the number had risen to almost 3,000.

Most cases of syphilis are acquired through direct sexual contact. It can also be passed on by women to their unborn children. Symptoms include fever, headache, rash on the palms and feet and lesions. Untreated, syphilis can result in insanity and death, but it can be effectively treated with antibiotics.

Dr Fenton added: “In developed countries the low incidence of syphilis over the past two decades and the interactions of the disease with HIV infection have resulted in clinicians who are unfamiliar with the disease’s many manifestations.”

The first well-recorded outbreak of the disease was in 1494 in Naples.

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