U.S. Apologizes for Unethical Studies on Sexually Transmitted Disease
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(This is a revised version with more information on the diseases added)
U.S. officials apologized on Friday for unethical medical studies that a federal doctor conducted 64 years ago among prisoners, soldiers and mental patients in Guatemala. The studies were conducted without the consent of the “participants.”
The studies, performed between 1946 and 1948, were meant to determine if use of penicillin right after sex would be effective in preventing sexually transmitted diseases such as the potentially deadly disease syphilis.
The gonorrhea studies involved 772 people, the chancroid experiments 142, and the syphilis experiments affected 497 people. In the syphilis studies, 427 subjects were infected and 332 treated, but only 85 were documented to have received full treatment; 71 people died during the studies.
For the studies, the U.S. physician, Dr. John C. Cutler, along with his colleagues in Guatemala, intentionally let prostitutes, who were allowed to visit prisons legally in the country at the time, to spread sexually transmitted diseases to prisoners. The prostitutes either carried sexually transmitted diseases or had infectious agents placed on their cervixes if they had no sexually transmitted disease.
As very few people became infected, the researchers furthered their studies by inoculating infectious bacteria directly into soldiers and mental patients without telling them the risk they were going to face.
The researchers eventually discontinued the studies because such experiments did not yield much information. Dr. Cutler later went on to conduct another infamous experiment - the Tuskegee syphilis study in Alabama in which hundreds of African American men with late-stage syphilis were left untreated between 1932 and 1972.
These unethical studies were sponsored by the Public Health Service, the National Institutes of Health and the Pan American Health Sanitary Bureau and the Guatemalan government, according to Washington Post. Some high-ranking U.S. officials including Thomas Parran, jr, the U.S. surgeon general at the time, were aware of the studies.
Susan M. Reverby, professor at Wellesley College in Massachusetts accidentally discovered these unethical studies when she read papers in the University of Pittsburgh's Archives from Dr. Cutler. At the time she was investigating the Tuskegee study for a book.
Last spring, Professor Reverby revealed what she found to David Sencer, retired director of the Centers for Disease Control and Prevention, who then notified current CDC officials, leading to the official disclosure of these studies on Friday. A 29-age paper describing these tests is reportedly scheduled to appear in the journal of Policy History.
Secretary of State Hillary Rodham Clinton and Health and Human Services Secretary Kathleen Sebelius were quoted as saying in a joint statement "We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices."
After learning about these tests, President Barack Obama called Guatemalan President Alvaro Colom to "personally express that apology", according to the Washington Post.
Officials are now worried that the disclosure of these unethical studies supported by the U.S government may become a reason for people not to participate in clinical trials at best, or even refuse to receive medical treatment at worst.
The Tuskegee study was said to have already been blamed over the years for the ever-increasing reluctance of the public to participate in medical research. For this and other reasons, pharmaceutical companies have conducted more and more trials in disadvantaged countries.
In response to the disclosure, NIH director Dr. Francis S. Collins condemned the experiments, and said strict rules are now in place to prevent anything similar from happening again.
"This case of unethical, human subject research represents an appalling example from a dark chapter in the history of medicine," Collins was quoted as telling reporters during a telephone briefing on Friday.
Gonorrhea - What you need to know
Disease: Gonorrhea is a sexually transmitted disease caused by Neisseria gonorrhoeae - a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract including the cervix, uterus, and fallopian tubes in women and in the urethra in both women and men. The bacterium can also grow in the mouth, throat, eyes and anus.
Incidence: Gonorrhea infects an estimated 700,000 people in the U.S each year. Half of the infections are reported to the Centers for Disease Control and Prevention. In 2006, 120.9 per 100,000 persons were reported to have gonorrheal infections.
Transmission: Gonorrhea spreads through contact with the penis, vagina, mouth, or anus. Transmission does not require ejaculation. The bacterium can also spread from mother to baby during delivery. People who have had the infection and received treatment may be infected again if they have sexual contact with a person infected with gonorrhea.
Who's at risk: Anyone who is sexually active is at risk of gonorrhea, but in the U.S., sexually active teenagers, young adults and African Americans are at higher risk.
Symptoms: Symptoms of the infection may take 5 to 30 days to show up in some men, but not every man will definitively experience any symptoms at all. The typical symptoms found in men include a burning sensation when urinating or a white, yellow or green discharge from the penis. Sometimes men with gonorrhea may have painful or swollen testicles.
In women, symptoms are mild often, and most women don't have any symptoms at all. Initial signs or symptoms in women may include a painful or burning sensation when urinating, increased vaginal discharge or vaginal bleeding between periods.
Complications: Left untreated, men and women with gonorrhea may develop serious and permanent health problems.
In women, gonorrhea can cause pelvic inflammatory disease or PID, which can damage the fallopian tubes leading to infertility or an increased risk of ectopic pregnancy. PID can also cause internal abscesses and long-lasting, chronic pelvic pain.
In men, gonorrhea can lead to epididymitis, causing pain in the ducts attached to the testicles. With this condition, men can be infertile if left untreated. When gonorrhea spreads to the blood or joints, the condition can be life-threatening. With gonorrhea, people are more likely than the population at large to acquire HIV.
Syphilis - What you need to know
Disease: syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum.
Incidence: In the U.S., an estimated 36,000 cases of syphilis including about 10,000 cases of primary and secondary syphilis were reported in 2006. Primary and secondary syphilis is more commonly found in men 20 to 24 and men 35 to 39 years of age.
Transmission: Syphilis spreads when a person has direct contact with a syphilis sore in another person. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores may also occur on the lips and in the mouth. So the infection can occur during vaginal, anal, or oral sex. Pregnant women with syphilis may pass the infection to the babies they are carrying.
Symptoms: Syphilis may not cause any symptoms for years after initially infecting a person.
When a person gets infected with syphilis, a single sore or multiple sores may appear at the primary stage. This may take 10 to 90 days with an average 21 days. The sore or chancre lasts 3 to 6 weeks and then heals itself without treatment.
But left untreated, the infection may progress to the secondary stage. When that happens, skin rash and mucous membrane lesions may occur, but that does not cause itching. Rashes can appear several weeks after the chancre has healed. In addition to rashes, symptoms at this stage include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. All of the symptoms can disappear without treatment, but without treatment, syphilis can progress to the latent or late stages of the disease.
The latent or late stage can last for years without symptom; however, the disease can damage internal organs including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Symptoms of the late stage include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness and dementia. In severe cases, the disease causes death.
By Jimmy Downs and editing by Rachel Stockton
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