Caroline Cameron is often asked about her job at a University of Victoria lab, the only one in Canada working on a syphilis vaccine. Even at dinner parties, shocked hosts remark - mistakenly - that they thought the sexually transmitted scourge was a thing of the past.
"Syphilis has a mystique," said Dr. Cameron, 41, a microbiology professor who holds a Canada research chair in molecular pathogenesis. "This disease has been around so long, it's incredible."
Once known as the great mimicker for its ability to mirror other diseases and make diagnosis difficult, syphilis is experiencing a comeback in B.C. and parts of the rest of Canada. Other countries have also been affected, with China in the midst of a huge syphilis epidemic.
B.C. thought it had syphilis beaten in the early 1990s, but in 1997, 50 cases were diagnosed. By 2001, there were 177. By 2006, there were 333 cases (210 of those in Vancouver), representing eight out of 100,000 people, according to a B.C. Centre for Disease Control report for 2007.
Nationally, there were about four cases per 100,000 Canadians in 2006.
Syphilis's rise in B.C. is due to two epidemics, said Michael Rekart, the centre's director of sexually transmitted disease control.
Sex workers and their customers represented the first wave that surfaced in 1997. The second spike was around 2000, when syphilis was found in gay males, concentrated in the 30-59 age group.
But while the disease snakes around the world at the rate of about 12 million new cases annually, there are the fewest-ever number of labs working on a syphilis vaccine, said Dr. Cameron, whose lab's annual costs - about $560,000 - are funded by two Canadian and one U.S. health institution.
In addition to her seven-person lab team, four U.S. university labs are trying to determine how the syphilis-causing Treponema pallidum bacteria survives in the human body.
Rabbits are the only other species that contract syphilis.
Dr. Cameron admits she's obsessed about her challenging research to the point of dreaming about it and putting in 20-hour days when normally slow results show sudden promise.
"There are no other bacteria that are that fragile," she said. "It's one of the few bacteria that can't be cultured in a test tube, you can't use conventional methods."
When she buffers (or washes) the bacteria, they break apart. In the centrifuge, they disintegrate.
If T. pallidum were a person, it would be long, thin and slinky, tenacious yet delicate. It was discovered in 1905 by German bacteriologist Fritz Schaudinn, and its Latin name means "pale turning thread."
"It's one of the most invasive organisms," Dr. Cameron said.
Once it enters the body, via breaks in the skin or mucous membranes, T. pallidum floods the circulatory system and, with great flexibility, wends it way between human cells throughout the body.
The body's immune system kills some of the bacteria. But in a testament to T. pallidum's devious nature, others - if untreated with antibiotics - escape and stay hidden in the body for years. That is why 10 to 20 years after the initial infection, syphilis inflicts its late-stage blows, which include paralysis, dementia and blindness.
Despite long debate in scientific circles, it is not definitively known whether Spanish sailors introduced syphilis to the New World in the late-1400s, or if the travellers brought it back to Europe, Dr. Cameron said.
"It doesn't matter where it started, I just want to stop it," said Dr. Cameron, who calls it the stealth pathogen.
Her research has focused on the bacteria's key components and how they stubbornly affix to and disseminate throughout the body.
"She's the only person I know of figuring out how the bacterium attaches to the host," said Sheila Lukehart, professor of medicine and infectious diseases at the University of Washington in Seattle.
In 2002, Dr. Cameron began her research in Seattle, working with Dr. Lukehart, whose lab is one of the five seeking a syphilis vaccine. Well known for mentoring female scientists, Dr. Lukehart said Dr. Cameron is one of the best young researchers she's encountered.
"Caroline is very creative, a very thorough scientist," she said.
Both women believe a vaccine can be found, but they can't predict when. "I'm pretty excited by recent results," said Dr. Cameron, who returned to take her faculty position at UVic in 2006.
Bringing urgency to the need for a preventative vaccine is that, when someone is infected with syphilis, their chances of acquiring HIV increase about sevenfold, Dr. Cameron said. The other problem is that only 30 to 40 per cent of people with early-stage syphilis are diagnosed worldwide.
Famous people who had syphilis include Florence Nightingale, Al Capone, Paul Gauguin, Oscar Wilde, Ivan the Terrible, Catherine the Great, Napoleon and Beethoven, whose deafness was caused by the disease.
"It's the disease that shaped history," Dr. Cameron said.
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