Punishment in Hell After Death !

America's 10 Unhealthiest Presidents !

Presidential fitness hasn't always been characteristic of the nation's commander-in-chief. Here, a retrospective of some of the least healthy presidents in American history.

President Barack Obama knows a thing or two about fitness. His well-documented gym habits and disciplined diet, has the media heralding Obama as the new face of presidential health. Of course, he isn't perfect -- the guy has been a longtime smoker (although he has resolved to quit, and has often been seen chewing Nicorette), and occasionally chows down on cheeseburgers. Still, his longtime physician issued a statement in 2008 that Obama is in "excellent health," citing his lean body mass, and normal cholesterol, blood pressure, and EKG levels.

But not all American presidents have been model specimens of health. Some of them far from it, in fact. Disease, injury, and destructive habits have run rampant in the 43 commanders-in-chief -- but while we can't totally fault George Washington for contracting malaria or smallpox (it was the 1700s, after all), we also can't really condone John Adams' habit of having bread and beer for breakfast at age 15.

Here, the 10 least healthy presidents in American history.

By Jocelyn Voo

10. James Monroe

Fifth President (1817-1825)

Bullet wound: Before becoming elected president, James Monroe dropped out of college and enlisted as a cadet in the Third Virginia Infantry in 1776. During this time, he fought in the Battle of Trenton, during which he was wounded by a bullet hitting his left shoulder and injuring the axillary artery, the major bloodway to his arm. It's suspected that Monroe would've died if a doctor hadn't stuck his index finger into the wound to stop him from bleeding out. Surgeons were unable to locate the bullet for removal, so though Monroe recovered fully, the bullet remained in his shoulder for the rest of his life.

Malaria: In 1785, the president contracted malaria while visiting a swampy area of the Mississippi River, and he suffered from sporadic feverish flare-ups for years down the line.

Seizure: In August 1825, Monroe suffered a severe seizure that almost killed him. Though the cause was never pinpointed, it's speculated that it could've been triggered by mushroom poisoning, a stroke, or cerebral malaria.

Tuberculosis: In 1830, Monroe developed a chronic lung illness that plagued him for several months, leaving him with labored breathing, fever, night sweats, and a nagging cough that sometimes had him spitting up blood. Though not officially diagnosed as such, his symptoms suggest pulmonary tuberculosis.

9. Theodore Roosevelt

26th President (1901-1909)

Blindness: A frail and sickly child, Roosevelt was encouraged to do lots of physical activity in hopes of alleviating his asthma and other ailments. Boxing became one of Roosevelt's hobbies through adulthood. However, after being elected to the presidency, he suffered one major injury when a blow to the left eye detached his retina, leaving him blind in that side.

Deafness: Suffering from a throat infection, Roosevelt developed otitis media, an inflammation of the middle ear. The subsequent operation left him deaf in his left ear.

Bullet wound: On the campaign trail in 1912, Roosevelt was shot by a deranged saloonkeeper. The gun was originally pointed at the president's head, but a bystander saw the weapon and jolted the gunman's arm, causing the bullet to hit Roosevelt in the chest. Luckily, both a 50-page speech and a steel glasses case, held in his breast pocket, absorbed some of the impact and deflected the shot, saving Roosevelt's life. Deeming surgery too risky, he carried the bullet in his chest for the rest of his life.

Malaria: On an expedition into the Amazon rainforest in 1913, Roosevelt contracted malaria, made worse by an infected leg wound. These injuries resulted in chest pains, a high fever, and delirium. Though Roosevelt didn't die, he returned to America in a decrepit state, and for many years was often unable to leave his bed.

8. Ronald Reagan

40th President (1981-1989)

Nearsighted: Ronald Reagan's poor eyesight not only disqualified him from serving in combat during World War II, but as a college football player he could only clearly see within a yard's radius, causing him to sometimes be hit in the head with the ball. Later, when he got glasses, he remarked in surprise that trees had leaves -- something he'd never known had existed before.

Smoker: Reagan was once a smoker, but stopped, reportedly after his brother developed throat cancer.

Prostate stones: In 1966, after experiencing multiple urinary tract infections, Reagan underwent surgery to remove prostate stones.

Bullet wound: In 1981 while riding in his limousine, the president was shot in the chest by would-be assassin John Hinckley Jr. Suffering from blood loss and a collapsed lung, Reagan successfully underwent emergency surgery to remove the bullet, which missed his heart by an inch. But despite the seriousness of his injury, the president's spirits were still buoyed: When his wife Nancy arrived at the hospital to see him after surgery, Reagan joked to her, "Honey, I forgot to duck."

Hearing loss: Reagan used a hearing aid in his right ear early in his term, but later also started wearing one in his left ear. It's been speculated that his hearing was damaged during his early years as a Hollywood actor, when he was exposed to loud gunshot noises during the filming of Western movies.

Colon cancer: After two benign polyps were discovered in his colon, Reagan had a colonoscopy that revealed another tumor that required surgical removal. As a result, about two feet of his colon was removed.

Skin cancers: In the late 1980s, small basal cell carcinoma was discovered on Reagan's nose, and the cancer was removed. In 1995, another patch of skin cancer was discovered and removed from his neck.

Alzheimer's disease: Though he was famous for having a near-photographic memory during his prime, Reagan's memory deteriorated when he hit his 70s, and he would forget the names of key staffers and visiting dignitaries. A formal diagnosis of Alzheimer's occurred in 1994.

7. Woodrow Wilson

28th President (1913-1921)

Hypertension, headaches, double-vision: Wilson suffered from multiple strokes throughout adulthood. Symptoms foreshadowing these episodes were hypertension, massive headaches, and double-vision.

Multiple strokes: The first of a series of strokes occurred in 1896, which hindered the fingers in his right hand and left him unable to write normally for a year.

Blindness: His third stroke, in 1906, left him blind in his left eye.

Paralysis: Finally, in 1919, the president suffered a massive stroke that paralyzed his left side and confined him to a wheelchair. Wilson decided to keep his condition a secret from the public, which essentially meant isolating himself. It's thought that during his last three years in the White House, his wife Edith made all presidential decisions.

Eventually, the truth of Wilson's illness became public, spurring the ratification of the 25th Amendment, which states that the vice president shall become the executive power in the event of the president's death, resignation, or disability.

6. Andrew Jackson

Seventh President (1829-1837)

Smallpox: During the American Revolution, Andrew Jackson, only 13 years old at the time, became a courier in South Carolina's mounted militia with his brother. During this period, both boys were imprisoned by the British, and contracted smallpox while in jail. Though Jackson's mother was able to gain the boys' release, she could only take one of them on horseback to their home for treatment. Jackson, delirious with fever, had to walk the 45 miles without shoes or a jacket. Jackson's brother died two days later; Jackson recovered after several months.

Bullet wounds: Jackson was known for his hot temper, particularly over slanderous comments about his wife. These often landed him in gun feuds with his attackers, despite Jackson's poor aim. In 1813, Jackson was seriously wounded after being shot twice in the shoulder and once in the arm during an altercation with politician Thomas Hart Benton and his brother Jesse Benton. His left shoulder was shattered, with shrapnel lodged against his left humerus. Since he was losing massive amounts of blood, almost every doctor recommended amputation, which Jackson refused. He was bedridden for three weeks, but ultimately healed.

Jackson was also injured during an 1806 duel with famous marksman Charles Dickinson, during which Dickinson shot the future president in the chest. The bullet missed Jackson's heart but shattered two of his ribs, which never healed properly, leaving him with pains for the rest of his life. (To his credit, even after taking the bullet, he righted himself and fired a fatal shot at Dickinson.)

Dysentery, malaria: During his military campaigns, Jackson suffered from both dysentery and malaria.

Addiction to coffee, alcohol, and tobacco: Jackson refused to give up these three vices, despite doctor's orders and the fact that they gave him migraines. He was such a fan of chewing tobacco that brass spittoons were installed in the White House.

Lead and mercury poisoning: Despite enduring intense pain from bone infection, Jackson didn't have the bullet from the Benton scuffle removed until 1832, 19 years after the fact. The chief of the Navy's Bureau of Medicine arrived at the White House to perform the operation sans anesthesia. The extraction proved successful, and Jackson's health improved tremendously immediately afterward, suggesting the bullets may have contributed to slow lead poisoning.

Furthermore, Jackson also had a habit of self-medicating with calomel (mercurous chloride -- often used as a diuretic and purgative in the mid 19th century), as well as ingesting sugar of lead (lead acetate -- used as a food sweetener). Both these compounds are toxic, leading to mercury and lead poisoning. Indeed, a 1999 evaluation of Jackson's century-old hair samples revealed significantly elevated levels of both metals, which surely contributed to his severe health decline.

Edema: In 1845, during his last two months of life, Jackson began experiencing edema, an abnormal accumulation of fluid beneath his skin and in certain cavities. With his feet, legs, hands, abdomen, and face all swollen, his bloated body was bedridden until he died on June 8.

5. Warren Harding

29th President (1921-1923)

Hypertension, diabetes: Even before he became president, Harding had high blood pressure and signs of diabetes.

Heavy tobacco user: Not only did Harding smoke two cigars a day and chew tobacco, but he also indulged in the occasional pipe and cigarette. He was so fanatical about the aroma of his cigars that he brought his cigar humidor from his Ohio home to the White House.

Overweight: Harding tipped the scales at over 200 pounds in 1918.

Heart disease: Harding's physical health was in rapid decline in the late 1910s through the early 1920s. Combined with his weight problem and shortness of breath, Harding also became easily tired and had occasional chest pains. In 1923, Harding died of a sudden heart attack.

4. Dwight Eisenhower

34th President (1953-1961)

Heavy smoker: As in four-packs-a-day heavy smoker. Eisenhower's physician recommended that he cut down to one pack a day, but after limiting his intake for a few days, the president decided to quit cold turkey. Asked how he did it, Eisenhower said that he just didn't think about it, and that it helped to develop a scornful attitude towards those who couldn't kick the habit.

Crohn's disease: In 1956, six months before the election, Eisenhower was diagnosed with Crohn's disease (an inflammatory disease that affects the digestive system, generally causing abdominal pain, diarrhea, vomiting, or weight loss). That June, the president successfully underwent emergency surgery to alleviate his inflamed small intestine.

Gallstones: Eisenhower had his gallbladder (containing 16 gallstones) removed in 1966.

Heart attacks: In 1955 Eisenhower suffered a heart attack so severe that his primary cardiologist advised the president not to run for a second term. Eisenhower did not take his advice, and was reelected. Later, he would endure more heart trouble. During a five-month span alone in 1968, he suffered four heart attacks and 14 cardiac arrests. These attacks weakened him to the point where he could only be out of bed for 45 minutes a day, and he died soon after the next year.

3. John F. Kennedy

35th President (1961-1963)

Scarlet fever, measles, whooping cough: Kennedy's childhood was riddled with health issues. At 2 years old, he contracted measles, whooping cough, and chickenpox. He also contracted scarlet fever, which almost killed him. Later in his childhood, he frequently had upper respiratory infections and bronchitis, as well as allergies, frequent colds, asthma, and a weak stomach that made him keep a bland diet for most of his life.

Jaundice, pneumonia, appendicitis: During his teen years, Kennedy had his appendix removed, suffered a severe case of pneumonia, had his tonsils removed, and was hit with jaundice twice, which sent him to the hospital for two months and forced him to withdraw from Princeton University.

Urethritis: Once Kennedy recovered from jaundice, he resumed his college education at Harvard University. During this time, he contracted urethritis, an inflammation of the urethra that results in painful urination. Kennedy didn't seek immediate treatment, so this became a chronic problem for many years, despite his taking drugs to suppress symptoms. Considering Kennedy's notorious libido, some have speculated that his urethritis was a sexually transmitted disease.

Addison's disease: After years of suffering back pains, Kennedy was diagnosed in 1947 with Addison's disease, a rare endocrine disorder that generally results in fatigue, muscle weakness, nausea, and bronzing of the skin. Kennedy was so ill that he was given the last rites of the Roman Catholic Church, with physicians speculating that he would die within the year. However, cortisone therapy and medicinal implants kept Kennedy alive. Still, the president underwent two failed back operations to rid him of his aches, and took chronic pain medication from 1955 until his death.

Cigar smoker: Kennedy loved a fine cigar -- so much, in fact, that he once called his press secretary into his office and asked him to buy 1,000 Cuban cigars by the next morning. The press secretary obliged, and walked into the Oval Office the next morning with the requested goods. Smiling, Kennedy pulled a long paper out of his desk drawer and signed it. It was the embargo ending trade with Cuba.

Drug cocktail: Kennedy suffered from a host of maladies throughout his lifetime, causing him to take a cocktail of drugs at the beginning of his presidency -- many of which can affect one's thinking processes. Among those taken were injected cortisone, phenobarbital, Tuinal, Lomotil, and amphetamines.

2. William Taft

27th President (1909-1913)

Obesity: Though Taft generally didn't drink (he became a teetotaler in 1906), he had an extreme appetite. At 5'11", he ballooned to over 300 pounds during his presidency, making him the fattest president in history. However, through aggressive dieting, he lost almost 100 pounds, which he continually gained and lost over his lifetime.

Sleep apnea: Due to his morbid obesity, Taft suffered from severe sleep apnea (a sleep disorder marked by pauses in breathing during sleep) throughout his life. He slept through meetings with the president when he was serving as secretary of war, nodded off during conversations with the speaker of the House and with the chief justice of the Supreme Court, fell asleep in the middle of signing documents and while eating, and also once slept through a typhoon in the Philippines.

Cardiac arrhythmia: Also due to his weight, Taft suffered from an abnormal heartbeat, which he monitored by taking three pills a day. High blood pressure and an irregular heart rate plagued him throughout his life.

Smoker: Taft was a cigar smoker when he started his term, but quit while in office.

Gout: Both of Taft's feet were attacked by gout (a disease created by a buildup of uric acid, which causes swelling, stiffness, and burning pain in joints).

Gallstones: Because of the gout, Taft had 30 or so stones removed from his gallbladder.

1. Grover Cleveland

22nd President (1885-1889), 24th President (1893-1897)

Obesity: Since childhood, Grover Cleveland was a bit tubbier than average, and his weight problem stuck with him into adult age. At 5'11" and weighing over 250 pounds, Cleveland, the second-heaviest president to date, was nicknamed "Big Steve," and some of his nieces and nephews called him "Uncle Jumbo."

Penchant for food and alcohol: Likely contributing to his obesity was Cleveland's love for rich food and beer. At one point during his 1870 campaign for district attorney of Erie County, New York, Cleveland and his friendly opponent agreed to drink only four glasses of beer per day -- only to later decide it was too restrictive an amount.

Cigar smoker: In 1893, Cleveland, a longtime cigar smoker, complained of an ulcer on the roof of his mouth, which later proved to be a carcinoma. Fearing repercussions if word got out, the president arranged for a secret surgery. Doctors removed parts of his upper left jaw and hard palate and considered the operation to be a success, although it left Cleveland's mouth disfigured.

Gout: Cleveland was hampered by gout for many years, possibly as early as 1885 when he was seen limping at former President Ulysses S. Grant's funeral. Cleveland's condition was likely exacerbated by his heavy drinking, which increases serum uric acid concentrations.

http://features.fitnessmagazine.com/americas-10-unhealthiest-presidents.html

Prostitusi Anak Di Batam ( Pantesan Orang Singapore Suka Kesana ! )

On the Indonesian island of Batam, trafficking is a booming business. The commodity - young girls sold into prostitution. Matthew Moore reports.

Picture: PETER MORRIS
A 14-year-old prostitute working in a karaoke bar in Batam.

Barely 14, Dewi is the girl her "momma" sends round when men in Batam ask for a young one. Tall enough to be an adult, Dewi has a child's body and a mind still struggling to comprehend life's violent summersault that came when a neighbour sold her into prostitution.

That was about a year ago, when Dewi (not her real name) was living in poverty in a small town east of Jakarta. Some of what happened she remembers well, but the trauma and her immaturity have combine to blur many of the details. Still, she remembers her neighbour Trisno convincing her grandmother he could get her a job in Jakarta.

"He said, you can work in a restaurant or as a maid. My grandmother believed him and so he took me," Dewi tells The Age in a hotel in Batam.

Trisno took her to a place called SG, where he left her. Her new life began soon after. "I can still remember his face. He's old with glasses, he's strong, he's Chinese . . ." she recalls.

"I was afraid, I was shaking. I told him I want to go home, but he took me to a discotheque. He asked me, 'do you want to sing', and he took me to a karaoke place and I told him I want to go home. And then he took me home to the hotel.

"He said open your dress.

"I said 'I don't want to'. I cried."

The man told her he would not take her out again if she did not open her dress. "He said tomorrow we can go to Ancol and Taman Mini (entertainment parks). And so I did it. So I lost my virginity."

Dewi didn't understand she'd been sold when she fled back to her grandmother, who was furious she'd lost her virginity and reported Trisno to the police.

Selling girls into prostitution might technically be illegal in Indonesia, but it is not considered a serious crime and Trisno had no trouble negotiating his way to freedom.

Another "friend" then convinced Dewi to go with her to Batam, a booming island near Singapore where thousands of Indonesians head in search of jobs.

She promised they would stay with relatives; instead she took her to a karaoke bar where she left her.

"She cheated me," Dewi says.

Only 13, Dewi had been sold for a second time. Now she lives above one of Batam's numerous prostitution bars with two dozen other girls, sleeping by day, sent to hotel rooms by night.

She's contracted venereal disease, which she says her "momma" treats with a herbal health tonic. She also owes the club for the clothes she has to buy and, only recently, she got her period.

She'd like to go home, but she knows it won't happen.

"That's what I want, but how could I do that?"

In Batam, you can tell the places where girls like Dewi live by the ropes. On balconies overlooking backstreets, captive prostitutes have them draped over the railings or hanging down to the streets below.

Restricted from leaving their dormitory quarters, the ropes are the easiest way to get food and drinks - they lower money to street vendors below who use the ropes to send supplies back up.

It's a convenient way of sidestepping one clause in the harsh contracts that rule the lives and the movements of thousands of women and girls who work in Batam's ballooning sex industry.

Many Australians might never know they've been within sight of it. Look north from Batam's beaches, Singapore's gleaming towers loom large on the horizon. Only half an hour away by ferry, Batam last year was Indonesia's busiest international port after Denpasar.

Singaporeans make up 80 per cent of the foreign visitors, most of them looking for a quick and cheap weekend away. Most of the visitors are men and, if you believe the girls on the balconies, they all come for one thing.

Sex, it seems, is for sale everywhere in Batam. Massage parlours, brothels and karaoke bars are dotted throughout the town and taxi drivers scratch their heads if asked to name a hotel where sex is not on offer. Authorities estimate there are more than 9000 prostitutes in Batam, an island with a population of just over half a million.

Surging demand for commercial sex in recent years has seen Batam develop into a major centre for trafficking women and girls like Dewi, some of whom end up overseas.

Febrina Yaswir, from the Indonesian Family Planning Association, has spent three years working with prostitutes in Batam and in the neighbouring islands Karimun and Bintan, which also support vigorous sex industries.

Although there are no reliable figures on how many Batam prostitutes have been trafficked or sold into their jobs, Yaswir believes the numbers are overwhelming.

"As many as 90 per cent of the prostitutes we see have been trafficked," she says.

They come from all over Indonesia, especially from villages in Java and Sumatra. They are young, naive and poor, and their stories are all similar. Usually a family acquaintance will promise parents they will find their daughter a job in Batam, working in a restaurant, or as a maid.

The family friend, perhaps with the help of an agent or another middleman, will instead take the girl to a brothel in Batam and receive a substantial fee, often about 3 million rupiah, or $600.

With little education, no understanding of their rights, and no money, these girls have no ability to protest and little practical option but to work for the "mommas" who run the brothels. After all, once the brothel owners have paid for a girl, they won't readily let her go before they've turned a profit on their investment.

Gangs of thugs outside the clubs discourage the girls from attempting to flee. And if they do leave, the girls know they'll be followed home and punished.

From the moment of arrival, the girls are told they are in debt for three or four months for the cost of transporting them to the brothel, for their keep and for the payments made to their agents who delivered them. If they want to leave, it will cost them.

"If we want to go before the 120 days are up we have to pay 100,000 rupiah ($20) per day," says Tini, 20, from one of Batam's karaoke clubs.

As with almost all the contracts, her's requires her to sleep in the dormitory located above the club when she's not out on a job.

"About 30 of us live there on the third floor and sleep in bunk beds. Usually there are two to a bed, but sometimes there are three of us. We are allowed out from 5pm to 6.30pm but it's impossible to go out before 5.30 because the 'momma' will be very angry. She will know."

Down at the Lucy's Oar House - as the sign says "Batam's Best Collection of Oars" - most of the business is going on in the Banana Bar upstairs, not at the Rock Hard Caf down below.

The 15 Banana Bar prostitutes are also required to sleep in the dormitory upstairs when they are not booked for the night by the bar's clients. The Australian owner of Lucy's and the Banana Bar, Evan Jones, defends the arrangement.

"They do have to sleep there because if they don't, they will go to the disco and get f----d up on drugs, they'll get health problems,'' Jones says. "That's the deal, that's pretty standard."

Jones says all the women who work in his brothel are there voluntarily and were not trafficked, although he agrees others were elsewhere in Batam.

"I think some of it is true," he says. "The girls are cheated. Someone offers them a job in a restaurant and when they get up here they get sold off to a karaoke bar. If you ask the girls in a karaoke bar they'll often tell you that."

One of the women working for Jones told The Age they must work three months before they get paid. If they want to leave their jobs earlier, the flat fee is 3 million rupiah. Jones agrees he requires the women to work a minimum of three months before they were paid, but denies they have to pay 3 million rupiah if they leave early. He refuses to explain his contracts.

"That's none of your business, actually," he says.

Outside the back door at Queens massage parlour in downtown Batam, a police car pulls up at about 8pm on a quiet Wednesday night. A uniformed policeman gets out, pushes open the parlour door and goes straight to the counter. He shows little interest in the fishbowl room to his right, where 40 young women with numbers pinned to their tops sit watching television behind one-way glass as their next customers survey them. He's only come for the money, and he doesn't have to wait long before it is handed over.

Judging from the BMW and Volvo cars at the Batam police station, other officers have trodden a similarly profitable route.

The head of the women's desk at the police station, Uri Nartanti, readily concedes that Batam police take bribes from the massage parlours and karaoke bars; that they have little interest in the offence of trafficking despite her efforts.

The lack of concern among police is generally reflected in the Indonesian government, where officials often find it easier to take bribes and ignore the trafficking industry, which is not considered a problem.

This week, a fresh attempt to make it more of an issue is being made in Bali, where delegates from 40 countries across the region and beyond are discussing trafficking strategies at a conference organised by the Australian and Indonesian governments on transnational crime.

In a speech to Batam's Government recently, Jakarta-based AIDS expert, Dr Irwanto, revealed that Karimun Island has the second highest rate of HIV infections among prostitutes in Indonesia, after Papua.

He feared an "explosion in AIDS" in Batam and neighbouring islands will soon erupt because so many clients refuse to use condoms and the young prostitutes are so ignorant about reproductive health.

Trying to teach the prostitutes the importance of condoms is difficult, partly because so many are so young.

"Batam is one very unique place. Whenever I come here I'm surprised so many of the girls are children." yit/btm

Prostitusi Di Negeri Tirai Bambu !

Syphilis, virtually eradicated after the founding New China in 1949, has become a viciously-growing epidemic there, driven by prostitution, internal migration and poor health controls, a new study warns.

In 1993, the reported rate of syphilis in China was a mere 0.2 cases per 100,000.

A Chinese prostitute is caught in bed with two men at a brothel in Guangzhou. Syphilis has become a viciously-growing epidemic there, driven by prostitution, internal migration and poor health controls, a new study warns.

In 2005, it had surged to 5.7 cases per 100,000, a figure that may well be a serious under-estimate, according to the paper by Chinese epidemiologists.

In addition, the number of babies born with syphilis has shot up. Congenital syphilis occurred among just 0.01 per 100,000 live births in 1991; in 2005 it was 19.68 -- an annual rise of nearly 72 percent over that time.

"Surveillance data and focussed reports from throughout China provide compelling evidence of a substantial and worsening syphilis epidemic in individuals at high risk and in the general population," the research says.

"The spread of syphilis in China has been insidious and has only recently attracted the attention it deserves."

The paper, written by experts from China's National Centre for STD (Sexually Transmitted Diseases) Control, appears in Saturday's issue of the British health journal The Lancet.

Syphilis is a sexually transmitted disease caused by a bacterium, Treponema pallidum, that can be treated by antibiotics. If untreated, it can cause genital ulcers, damage the cardiovascular and nervous systems and brain, affect fertility and foetal health.

By the time New China was founded in 1949, China had one of the biggest syphilis epidemics in history: one person in 20 in some large cities had the disease, and the rate was two to three percent among dwellers in the countryside.

In 1952, the Chinese government launched an unprecedented campaign, instituting mass screening for the T. pallidum germ, providing free treatment to infected individuals and closing brothels. By the 1960s, the initiative virtually eradicated syphilis in China.

The Lancet paper says that this success ironically worsened the danger for the Chinese population when the country opened up its economy in the 1990s, unleashing the social earthquake that continues to this day.

As syphilis had been virtually absent for 20 years, the general population of young, sexually active individuals had become "completely susceptible" to infection, it says.

The driver for the epidemic has mainly been sex work, which has risen with the expansion of China's vast, shifting population of migrant workers.

There have also been changes in sexual habits, including a move towards sexual intercourse at an earlier age, with more partners and before marriage but also with poor use of condoms.

Syphilis prevalence is highest in the big-growth regions of coastal China, led by Shanghai (55.3 cases per 100,000), Zhejiang (35.9) and Fujian (26.8).

This was followed by Beijing (24.9 cases per 100,000) and the Zhujiang river delta, comprising Guangxi, Guangdong and Hainan provinces, with rates of 14-21 per 100,000 individuals.

Other countries have likewise reported a resurgence of syphilis in high-risk groups recent years. The United States reported a 2.7 per cent nfection rate in 2004.

The paper, lead-authored by Chen Xiangsheng, admits that the picture could be even worse, as the data is based on 26 nationwide "sentinel sites" which receive details of patient admissions from government STD clinics.

Many people, though, may get treated at family planning centres, gynaecological clinics and other facilities or by pharmacists or private practitioners, and these cases go largely unreported.

In addition, the increasing privatisation of health care in China has left many people without the resources to get screened or treated for syphilis.

(China Daily )