PL07 (Re-)emerging STIs, a challenge for public health

In the early eighties HIV/aids emerged among men who have sex with men (MSM), this new virus was originally transmitted from chimpanzees in Central Africa to humans about 100 years ago. In the beginning no one foresaw that HIV/aids would spread all over the world through sexual transmission. In the past decades hundreds of infectious diseases (re-)emerged including other sexually transmitted infections (STIs). Among MSM outbreaks occurred of enteric pathogens through oro-anal transmission like Hepatitis A virus, Shigella, Campylobacter and Entamoeba histolytica. Also among MSM, clusters of invasive meningococcal disease were seen while the same pathogen, the N meningitidis, a colonizer of the nasopharynx, was found to cause urethritis in heterosexual men. Other examples of (re-)emerging STIs among MSM are lymphogranuloma venereum (LGV) and Hepatitis C among HIV-positive MSM and HIV-negative MSM using PReP. In 2015 Zikavirus, a flavivirus transmitted through the mosquito Aedes Egypti, broke out in South America and unexpectedly was found to be sexually transmitted especially from men to women. During the Ebola outbreak in West-Africa in 2013–2016, reports strongly suggested sexual transmission of this filovirus from men to women. In 2021 Ebola Virus re-emerged in Guinea and genomic analysis made it likely that this outbreak started through sexual transmission of the virus by a survivor of the West African epidemic 5 years earlier. In the future new and re-emerging STIs will surface and cause limited outbreaks, epidemics and possibly even a pandemic, a major challenge for public health.