Thanks Columbus! The true story of how syphilis spread to Europe

Thanks a lot, Columbus.
Thanks a lot, Columbus.
Image: AP Photo/Ramon Espinosa
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Christopher Columbus and his men brought a lot of things back to Europe after his voyage to the New World: corn, potatoes, and—according to general scholarly consensus—syphilis. But the provenance of the disease has emerged as a source of heated debate over the past few decades, with some scholars arguing that European explorers actually brought the ironically named “Cupid’s disease” to the Americas.

The question of where syphilis originated carries a lot of psychological weight. As is the case with many infectious diseases, countries impacted by syphilis were historically eager to assign blame to entire populations for the illness—a phenomenon that both sparks and reinforces xenophobia.

But when we ask where syphilis—or any other disease—originally came from, our goal should be not to engage in nationalistic finger-pointing but to better understand how to combat infections in the future. Understanding the evolution of the syphilis and the group of diseases to which it belongs, the treponemal diseases, could help scientists better predict the spread of pathogens today.

The earliest reports of syphilis date back to the late 1400s, coinciding with the return of Christopher Columbus and his men from their voyage to the Americas. The descriptions are not for the weak of stomach.

“In the yere of Chryst 1493 or there about, this most foule and most grevous disease beganne to sprede amongst the people,” German scholar and poet Ulrich von Hutten wrote in his work on syphilis, “On the Wood called Guaiacum.” The symptoms were horrible: genital sores, abscesses and ulcers covering the body, severe muscle and joint pain. The ulcers could eat all the way into bone and cartilage, and could even be deadly.

For the most part, it was New World inhabitants who were felled by diseases as a result of Columbus’s exploration. Indigenous Americans had never encountered deadly microbes such as smallpox, measles, typhus, and malaria, so they had no immunity. Their deaths numbered in the hundreds of millions.

But though the microbial exchange was almost unidirectional, syphilis appears to be the exception. The first cases of the disease in the Old World were described in 1493. The first large outbreak occurred in 1495, following the march of Charles VIII to Naples with 50,000 soldiers and their subsequent return to France, likely spreading the bacterium into Naples and all along the route.

The bacterium spread further into Europe as his soldiers returned to their homes with Treponema spirochetes in their blood. By the turn of the century, syphilis had been spread from London to Moscow, with each country blaming it on another. It was alternatively referred to as “the French disease,” “the disease of Naples,” “the Bordeaux disease,” “the Spanish disease,” “the German disease,” and “the Polish disease.” As it spread beyond Europe, people in the Middle East called it “the European pustules,” and so on.

We still see echoes of this kind of blame and stigma surrounding infectious diseases in contemporary history. During the early days of AIDS, Haitians in the US were blamed for the disease. And as recently as last year’s Ebola epidemic, Africans (including those from countries thousands of miles from the outbreak) were held responsible and stigmatized.

People tend to engage in this kind of stigmatization not because it is useful but because it makes us feel better to believe that our homes are essentially safe, clean, and disease-free, and that only outside forces can expose us to threats to our health. Yet it is a mistake to make the question of a disease’s origins a matter of social shaming—despite historian Alfred Crosby’s comments that the spread of syphilis from Europe to India and China in a mere decade is “at once a tribute to man’s nautical genius and social idiocy” in his book, The Columbian Exchange.

It was not until Fracastoro’s poem Syphilis was published in the 1530s that the name “syphilis” came into use. By the mid-1500s, the infection’s virulence appeared to decline. And by the 17th century, a picture of syphilis that is quite similar to the modern disease appeared—a more mild, chronic disease, rather than the severe and acute infection that appeared at the turn of the 16th century.

Today, we know that syphilis is caused by the bacterium Treponema pallidum, subspecies pallidum. The disease occurs over several stages, which can be separated by weeks to years.

The infection typically begins with a chancre (primary syphilis): a painless sore that can form on the genitals or mouth. The sore heals in four to eight weeks, and is then followed by a rash over most of the body (secondary syphilis). Months to years later, tertiary syphilis can manifest in a variety of ways. It can cause mental changes including insanity; cardiac disease; and soft gummas—tumor-like growths that can appear in many of the body’s tissues.

But despite all we know about syphilis, there’s still some mystery surrounding its origins. In recent decades, some scholars have begun to challenge the idea that syphilis is a New World export.

A number of papers have been published over the past 20 years examining Old World skeletons with lesions suggestive of syphilis infections. While skeletal remains in the Americas have documented extensive evidence of syphilis (including in up to 14% of skeletons from the Dominican Republic, dating back to over 4,500 years ago), skeletal evidence of infection in the Old World is sparse.

However, a publication released just last month claims to add another pre-Columbian syphilis victim from Austria. The publication examined a single specimen, a child around 6 years old. The study’s authors claim the child suffered from congenital syphilis—syphilis transmitted from an infected mother to her child. This paper, like many before it claiming Old World syphilis cases, looks at skeletal evidence from a single individual to make their case of pre-Columbian syphilis.

But Molly Zuckerman, an assistant professor of anthropology at Mississippi State, remains unconvinced. She tells Quartz that all reports of syphilis in the Old World to date have either shown lesions on bones that are not specific to syphilis (meaning they can happen in syphilis patients, but also in people with other diseases), or that the dating is very close to Columbus’s voyage in 1492. This would mean the skeletons bearing signs of syphilis might not actually be pre-Columbian. Zuckerman noted that in a 2011 paper she coauthored, “We found that in all the cases that had any high certainty of actually being treponemal disease cluster on that date [1492]—and we don’t think that’s chance.”

In the case of the paper that claimed to find a pre-Colombian syphilis victim in Austria, Zuckerman notes that the study did not measure for the presence of carbon-13 or nitrogen-13 isotopes. These isotopes indicate presence of marine animals in the diet. They can also throw off the accuracy of dating considerably, so scientists need to test for them and adjust their estimates accordingly. Zuckerman noted that even a small amount of marine contribution (“a smidge”) in their diet could dramatically alter the established date by decades to hundreds of years—putting the pre-Columbian claims of most papers in doubt.

Bruce Rothschild, another researcher who has studied historical syphilis, was even more blunt in an interview with the Daily Mail. “Syphilis is clearly a New World product,” he told the paper. “Despite many efforts to suggest otherwise, there is no Old World evidence of syphilis prior to 1492.”

In the end, the ultimate origin of syphilis will be difficult to definitively prove. While the bulk of the evidence right now points to a New World birthplace, this will naturally be contested as new skeletons are unearthed.

Meanwhile, the story of syphilis is far from dead and buried. While the disease is now treatable with antibiotics, the number of U.S. cases of syphilis increased by 15% between 2013 and 2014, after hitting an all-time low just over a decade ago. Some health authorities suggest the rising popularity of dating apps like Tindr may be fueling its comeback. Whatever the cause for the disease’s new resurgence, it’s clear that syphilis remains a serious problem—and as relevant now as it was 500 years ago.