Syphilis
By: Trever Jones 2006.03.05
What is Syphilis?
Syphilis is a complex sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It has often been called "the great imitator" because so many of the signs and symptoms are indistinguishable from those of other diseases.
In the United States, health officials reported over 32,000 cases of syphilis in 2002, including 6,862 cases of primary and secondary (P&S) syphilis. In 2002, half of all P&S syphilis cases were reported from 16 counties and 1 city; and most P&S syphilis cases occurred in persons 20 to 39 years of age. The incidence of infectious syphilis was highest in women 20 to 24 years of age and in men 35 to 39 years of age. Reported cases of congenital syphilis in newborns decreased from 2001 to 2002, with 492 new cases reported in 2001 compared to 412 cases in 2002.
Between 2001 and 2002, the number of reported P & S syphilis cases increased 12.4 percent. Rates in women continued to decrease, and overall, the rate in men was 3.5 times that in women. This, in conjunction with reports of syphilis outbreaks in men who have sex with men (MSM), suggests that rates of syphilis in MSM are increasing.
Transmission
- Passed from person to person through direct contact with a syphilis sore.
- Sores occur mainly on the external genitals, vagina, anus, or in the rectum.
- Sores also can occur on the lips and in the mouth.
- Vaginal, oral, or anal sex.
- Infected mother to her newborn during vaginal childbirth.
- Syphilis cannot be spread by toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils.
Signs & Symptoms
Symptoms, usually appear within 21 days, but can range from 10-90 days.
Primary Stage:
- Usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores.
- The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body.
- The chancre lasts 3-6 weeks, and it will heal on its own.
- If adequate treatment is not administered, the infection progresses to the secondary stage.
Secondary Stage:
- The second stage starts when one or more areas of the skin break into a rash that usually does not itch.
- Rashes can appear as the chancre is fading or can be delayed for weeks.
- The rash often appears as rough, red or reddish brown spots both on the palms of the hands and on the bottoms of the feet. The rash also may appear on other parts of the body with different characteristics, some of which resemble other diseases. Sometimes the rashes are so faint that they are not noticed. Even without treatment, rashes clear up on their own.
- Second-stage symptoms can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and tiredness.
- A person can easily pass the disease to sex partners when primary or secondary stage signs or symptoms are present.
Late Stage:
- The latent (hidden) stage of syphilis begins when the secondary symptoms disappear. The infected person still has syphilis even though there are no signs or symptoms.
- It remains in the body, and it may begin to damage the internal organs, including the brain, nerves, eyes, heart, blood, vessels, liver, bones, and joints. This internal damage may show up many years later in the late to tertiary stage of syphilis.
- Late stage signs and symptoms include not being able to coordinate muscle movements, paralysis, numbness, gradual blindness and dementia.
- This damage may be serious enough to cause death.
Diagnosis
- A health care provider can diagnose syphilis by using dark field microscopy to examine material from infectious sores. If syphilis bacteria are present in the sore, they will show up with a characteristic appearance.
- A blood test is another way to determine whether someone has syphilis. Shortly after infection occurs, the body produces syphilis antibodies that can be detected by an accurate, safe and inexpensive blood test. A low level of antibodies will stay in the blood for months or years even after the disease has been successfully treated. Because untreated syphilis in a pregnant woman should have a blood test for syphilis.
Treatment
- A single dose of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year.
- Larger doses are needed to cure someone who has had it for longer than a year.
- For people who are allergic to penicillin, other antibiotics are available to treat syphilis.
- Penicillin treatment will kill the syphilis bacterium and prevent further damage, but it will not repair any damage already done.
Prevention
- Use latex or polyurethane condoms correctly every time you have sex.
- Condoms do not provide complete protection from all STDs. Sores and lesions of other STDs in infected men and women may be present in areas not covered by the condom, resulting in transmission of infection to another person.
- Limit the number of sex partners.
- Practice sexual abstinence, or limit sexual contact to one uninfected partner.