HACKETT C J
Bull World Health Organ. 1963;29(1):7-41.
A close relationship between the four human treponematoses is suggested by their clinical and epidemiological characteristics and by such limited knowledge of the treponemes as there is at present. No treponeme of this group (except for that of the rabbit) is known other than in man, but the human treponemes probably arose long ago from an animal infection. The long period of infectiousness of pinta suggests that it may have been the earliest human treponematosis. It may have been spread throughout the world by about 15 000 B.C., being subsequently isolated in the Americas when the Bering Strait was flooded. About 10 000 B.C. in the Afro-Asian land mass environmental conditions might have favoured treponeme mutants leading to yaws; from these, about 7000 B.C., endemic syphilis perhaps developed, to give rise to venereal syphilis about 3000 B.C. in south-west Asia as big cities developed there. Towards the end of the fifteenth century A.D. a further mutation may have resulted in a more severe venereal syphilis in Europe which, with European exploration and geographical expansion, was subsequently carried throughout the then treponemally uncommitted world. These suggestions find some tentative support in climatic changes which might have influenced the selection of those treponemes which still survive in humid or arid climates. Venereal transmission would presumably remove the treponeme from the direct influence of climate. The author makes a plea for further investigation of many aspects of this subject while this is still possible.
四种人类密螺旋体病之间存在密切关系,这一点从它们的临床和流行病学特征以及目前对密螺旋体的有限了解中可以看出。除了兔子的密螺旋体之外,该类群(除兔子外)的密螺旋体仅在人类中发现,但人类密螺旋体可能早在很久以前就源于动物感染。品他病的长期传染性表明它可能是最早的人类密螺旋体病。它可能在公元前15000年左右传播到世界各地,随后在白令海峡被淹没时在美洲被隔离。公元前10000年左右,在亚非大陆,环境条件可能有利于密螺旋体突变体导致雅司病;从这些突变体中,大约在公元前7000年,可能发展出地方性梅毒,随着西南亚大城市的发展,在公元前3000年左右产生了性病性梅毒。在公元15世纪末,进一步的突变可能导致欧洲出现更严重的性病性梅毒,随着欧洲的探索和地理扩张,这种梅毒随后传播到当时尚未感染密螺旋体的世界各地。这些推测在气候变化中得到了一些初步支持,气候变化可能影响了对那些仍在潮湿或干旱气候中存活的密螺旋体的选择。性传播可能会使密螺旋体不受气候的直接影响。作者呼吁趁现在还有可能,对该主题的许多方面进行进一步研究。