Syphilis test

The invention: 



The first simple test for detecting the presence of

the venereal disease syphilis led to better syphilis control and

other advances in immunology.



The people behind the invention:



Reuben Leon Kahn (1887-1974), a Soviet-born American

serologist and immunologist



August von Wassermann (1866-1925), a German physician and

bacteriologist









Columbus’s Discoveries



Syphilis is one of the chief venereal diseases, a group of diseases

whose name derives from Venus, the Roman goddess of love. The

term “venereal” arose from the idea that the diseases were transmitted

solely by sexual contact with an infected individual. Although

syphilis is almost always passed from one person to another in this

way, it occasionally arises after contact with objects used by infected

people in highly unclean surroundings, particularly in the underdeveloped

countries of the world.

It is believed by many that syphilis was introduced to Europe by

the members of Spanish explorer Christopher Columbus’s crew—

supposedly after they were infected by sexual contact withWest Indian

women—during their voyages of exploration. Columbus is reported

to have died of heart and brain problems very similar to

symptoms produced by advanced syphilis. At that time, according

to many historians, syphilis spread rapidly over sixteenth century

Europe. The name “syphilis” was coined by the Italian physician

Girolamo Fracastoro in 1530 in an epic poem he wrote.

Modern syphilis is much milder than the original disease and relatively

uncommon. Yet, if it is not identified and treated appropriately,

syphilis can be devastating and even fatal. It can also be passed from

pregnant mothers to their unborn children. In these cases, the afflicted

children will develop serious health problems that can include

paralysis, insanity, and heart disease. Therefore, the understanding,

detection, and cure of syphilis are important worldwide.

Syphilis is caused by a spiral-shaped germ called a “spirochete.”

Spirochetes enter the body through breaks in the skin or through the

mucous membranes, regardless of how they are transmitted. Once

spirochetes enter the body, they spread rapidly. During the first four

to six weeks after infection, syphilis—said to be in its primary

phase—is very contagious. During this time, it is identified by the

appearance of a sore, or chancre, at the entry site of the infecting spirochetes.

The chancre disappears quickly, and within six to twenty-four

weeks, the disease shows itself as a skin rash, feelings of malaise,

and other flulike symptoms (secondary-phase syphilis). These problems

also disappear quickly in most cases, and here is where the real

trouble—latent syphilis—begins. In latent syphilis, now totally without

symptoms, spirochetes that have spread through the body may

lodge in the brain or the heart. When this happens, paralysis, mental

incapacitation, and death may follow.





Testing Before Marriage







Because of the danger to unborn children, Americans wishing to

marry must be certified as being free of the disease before a marriage

license is issued. The cure for syphilis is easily accomplished

through the use of penicillin or other types of antibiotics, though no

vaccine is yet available to prevent the disease. It is for this reason

that syphilis detection is particularly important.

The first viable test for syphilis was originated by August von

Wassermann in 1906. In this test, blood samples are taken and

treated in a medical laboratory. The treatment of the samples is

based on the fact that the blood of infected persons has formed antibodies

to fight the syphilis spirochete, and that these antibodies will

react with certain body chemicals to cause the blood sample to clot.

This indicates the person has the disease. After the syphilis has been

cured, the antibodies disappear, as does the clotting.

Although the Wassermann test was effective in 95 percent of all

infected persons, it was very time-consuming (requiring a two-day

incubation period) and complex. In 1923, Reuben Leon Kahn developed

a modified syphilis test, “the standard Kahn test,” that was

simpler and faster: The test was complete after only a few minutes.

By 1925, Kahn’s test had become the standard syphilis test of the

United States Navy and later became a worldwide test for the detection

of the disease.

Kahn soon realized that his test was not perfect and that in some

cases, the results were incorrect. This led him to a broader study of

the immune reactions at the center of the Kahn test. He investigated

the role of various tissues in immunity, as compared to the role of

white blood antibodies and white blood cells. Kahn showed, for example,

that different tissues of immunized or nonimmunized animals

possessed differing immunologic capabilities. Furthermore,

the immunologic capabilities of test animals varied with their

age, being very limited in newborns and increasing as they matured.

This effort led, by 1951, to Kahn’s “universal serological reaction,”

a precipitation reaction in which blood serum was tested

against a reagent composed of tissue lipids. Kahn viewed it as a potentially

helpful chemical indicator of how healthy or ill an individual

was. This effort is viewed as an important landmark in the development

of the science of immunology.



Impact



At the time that Kahn developed his standard Kahn test for syphilis,

theWassermann test was used all over the world for the diagnosis

of syphilis. As has been noted, one of the great advantages of the

standard Kahn test was its speed, minutes versus days. For example,

in October, 1923, Kahn is reported to have tested forty serum

samples in fifteen minutes.

Kahn’s efforts have been important to immunology and to medicine.

Among the consequences of his endeavors was the stimulation

of other developments in the field, including the VDRL test (originated

by the Venereal Disease Research Laboratory), which has replaced

the Kahn test as one of the most often used screening tests for

syphilis. Even more specific syphilis tests developed later include a

fluorescent antibody test to detect the presence of the antibody to

the syphilis spirochete.





See also: Abortion pill;Antibacterial drugs; Birth control pill;

Mammography; Pap test; Penicillin;







Further Reading :