One child was born with syphilis every hour in China in 2008, researchers said Thursday, as new money from the country's growing economy fuels the world's fastest-growing epidemic of the disease.
Syphilis was almost wiped out in China 50 years ago, but it is now the most commonly reported sexually transmitted disease in Shanghai, according to an article in the New England Journal of Medicine (NEJM).
Female sex workers and homosexual men are driving the infection rate, the researchers said, and there is evidence that social pressures are discouraging people from seeking treatment at official clinics.
"After China's economy became increasingly market-based in the 1980s, the growing numbers of Chinese businessmen with money and young women without money translated into expanded demand and supply for the country's commercial sex industry," the article said.
Syphilis is a bacterial infection which can easily be tackled with antibiotics if diagnosed early, but if left untreated can lead to paralysis, blindness and death.
No other country has seen such a rapid rise in syphilis cases since the discovery of penicillin, the researchers said.
Social stigma discourages the groups worst affected by the Chinese epidemic - prostitutes and gay and bisexual men - from seeking proper care, the article said.
In China, at least a third of men who have sex with other men are also married and the transmission of syphilis to their wives and children is an important issue, the article said.
"The limited data that are available suggest that fear of being identified as a 'social deviant' may steer members of marginalised groups away from official ... clinics where licensed physicians use national guidelines and have standardised laboratory facilities," the researchers said.
"Although the stigma associated with syphilis and other STIs (sexually transmitted infections) is present the world over, its burden can be particularly severe in a social structure such as China's, which highly values dignity or 'face' and social relationships."
Quick syphilis tests using finger-prick blood samples have allowed screening for the disease to be expanded outside clinics, to saunas, brothels and other entertainment venues, the researchers said.
Government programmes to help this expansion have laid the foundations to tackle the epidemic, the article said, but more funding and greater recognition of the disease as a public health issue were needed to bring syphilis under control.