Endemic syphilis in Europe.

Nonvenereal syphilis (endemic syphilis) has existed in Europe since the 16th century. Main characteristics of the disease are its presence for a longer time in a specific territory and its transmission regardless of age and sex, mainly extragenitally in unsanitary living conditions. Nonvenereal syphilis was described under different names in almost all regions of Europe. The primary genital chancre was absent, and lesions were most frequently found in the mouth and affected mostly children. The disease spread in rural areas with poor economic and hygienic conditions. The disease was eradicated in Europe in the 20th century, but it is still present in some rural regions of the Arabian Peninsula, Southwest Asia, and North Africa.