Syphilis – Still a Relevant Disease?

Syphilis is a sexually transmitted disease (STD) that, if left untreated, can lead to major consequences, but it is easy to cure with the appropriate medication.

Treponema pallidum is the pathogen that causes it. According to the Centres for Disease Control and Prevention (CDC), more than 88,000 cases of syphilis were reported in the United States in 2016.

In the United States, the rate of syphilis infection among women has been dropping, while the rate among men has been rising, particularly among men who have sex with men.

There are several stages of syphilis which are primary, secondary, latent, and tertiary. Each stage is characterized by its own set of signs and symptoms.

Prior to the discovery of antibiotics, syphilis was thought to be a serious disease with long-term, life-threatening implications that may even harm the brain and nerves.

Thankfully, modern medicine is now well equipped to diagnose, treat, and cure syphilis well before difficulties arise, thanks to the invention of penicillin antibiotics and lab tests to detect syphilis infection early.

What Does It Look Like When You Have Syphilis?

There are four phases to syphilis:

  • Primary
  • Secondary
  • Latent
  • Tertiary

The first two phases of syphilis are the most contagious. When syphilis is in the hidden or latent stage, it is still active but has no symptoms. The most dangerous form of syphilis is tertiary syphilis.

Primary syphilis

The primary stage starts about three to four weeks after an individual contract with the Treponema pallidum bacteria. It starts with a chancre; a tiny, circular sore. A chancre is not painful, but it is extremely contagious.

This sore can form on or within the mouth, the genitals, or the rectum, depending on where the bacteria entered the body.

The sore usually appears three weeks after infection, but it can take anywhere from ten to ninety days. It takes two to six weeks for the chancre to heal. It’s important to remember that chancres heal on their own, and just because the chancre is gone doesn’t indicate the infection is gone.

Direct contact with a sore transmits syphilis. This is most common during sexual activities, including oral sex.

Secondary syphilis

During the second stage of syphilis, which happen months or more after the initial infection, skin rashes and a painful throat are common. The rash is non-itchy and appears on the palms and soles of the feet, but it can actually appear anywhere on the body. Some people may fail to acknowledge the presence of this rash until after it subsides.

The typical appearance of a syphilitic rash may range from very faint brownish to obvious reddish patches. Other secondary syphilis symptoms include:

  • Snail track ulcers: formation of raw, red ulcers in the mouth and genital area
  • Condylama lata: raised patches that occur in areas that are usually moist in the body like the groin and armpit. The patches are usually grey in colour
  • Non-specific symptoms like headaches, fatigue, fever, weight loss, joint aches, swollen lymph nodes and hair loss

Whether or not you receive treatment, these symptoms will go away. However, syphilis infection will persist in the absence of treatment. Secondary syphilis is frequently misdiagnosed as something else.

Latent syphilis

The latent, or concealed, stage of syphilis is the third stage. The primary and secondary symptoms fade away, and there are no visible symptoms left at this point.

The bacteria, on the other hand, remain in the body. Before developing to tertiary syphilis, this stage could linger for years.

Tertiary syphilis

Most cases of tertiary syphilis are now recognised and treated before they develop to this stage. Symptoms manifested are depending on the target organ that is affected by the bacteria.

According to the Mayo Clinic, 15 to 30 percent of those who do not undergo syphilis treatment will progress to this stage. This stage can occur years or decades after the initial infection. Tertiary syphilis has the potential to cause severe medical problem and may be fatal.

For example, syphilis has the potential to harm the eyes and nerves. Vision impairments, bizarre bodily movements, and even early dementia or memory problems can all be indicators of tertiary syphilis.

How Can I Get Syphilis?

Direct contact with a syphilis sore during vaginal, anal, or oral sex can transmit syphilis. Sores can appear on or around the penis, vagina, or anus, as well as in the rectum, lips, or mouth. Syphilis can be passed down from a mother to her unborn child as well.

Am I At Risk To Get Syphilis Infection If I Am Sexually Active?

Syphilis can be contracted via unprotected vaginal, anal, or oral sex by any sexually active individual. You should ask your health care provider if you should be tested for syphilis or other STDs once you get involve with sexual activities.

Certain conditions or sexual behaviours are recommended to be tested for syphilis on a regular basis. These include:

  • men who has sex with men (MSM)
  • previously diagnosed with HIV
  • have partner(s) who have tested positive for syphilis or other STDs

All pregnant women are also warranted to be tested for syphilis during their first prenatal or antenatal visit.

How Can I Lower My Chances of Contracting Syphilis?

The only way to avoid contracting STDs is to abstain from engaging in vaginal, anal, or oral intercourse.

If you are sexually active, you can reduce your risk of contracting syphilis by doing the following:

  • Being in a long-term monogamous relationship with a partner who has been tested for syphilis and is negative
  • Every time you have sex, use latex condoms properly. Condoms protect against syphilis transmission by preventing direct contact with a sore. Do not that sores can develop in areas that aren’t covered by a condom and syphilis can still be transmitted by contact with these lesions.

I’m Expecting A Child. What Is The Impact of Syphilis On My Child?

If you have syphilis and are pregnant, you risk infecting your unborn child. Syphilis can cause a baby to be born with a low birth weight. It can also increase your chances of having a premature or stillborn baby (a baby born dead). You should be checked for syphilis at least once during your pregnancy to protect your baby.

If you test positive, you should seek treatment right away.

It’s possible that an infected infant will be delivered with no signs or symptoms of infection. If not addressed right away, the baby could suffer significant problems in a matter of weeks. Babies who are not treated may develop health problems such as cataracts, deafness, convulsions, and may as well lead to death.

How Can You Be Diagnosed With Syphilis?

If you suspect you have syphilis, make an appointment with your doctor as soon as possible. They’ll obtain a blood sample and perform a full physical examination in order to look for signs of syphilis.

If you have a sore, your doctor may take a sample from it to see if the bacterium that causes syphilis is present.

If your doctor suspects tertiary syphilis is causing nervous system issues, you may need a lumbar puncture, often known as a spinal tap. Spinal fluid is obtained during this procedure so that your doctor can screen for syphilis.

What Are The Treatment Options For Syphilis?

Penicillin is used to treat syphilis infections, and it is given as an injection. The dosage or quantity of injections necessary is determined by the infection’s stage.

If the infection does not clear up after initial therapy (a condition known as treatment failure), further antibiotics may be needed for a longer period of time.

Regular blood tests at intervals of a few months may be required to evaluate if therapy is effective and to monitor for return of the syphilis infection.

To reduce the danger of spreading syphilis to others, it is preferable to avoid sexual activity until the illness has been cleared.

An important key message is to know that treatment, on the other hand, may not be able to reverse any damage that the infection has already done.

I Was Diagnosed With Syphilis and Had My Treatment. Is It Possible For Me To Contract Syphilis Again?

If you’ve had syphilis before, it doesn’t mean you won’t get it again. You can get infected again even after you’ve been effectively treated. Only lab testing can determine whether or not you have syphilis. Your health care practitioner should conduct follow-up tests to ensure that your treatment was successful.

It may not be obvious that your sexual partner had syphilis especially if the lesion is concealed for example inside the vagina, under the foreskin of the penis, or in the mouth. Is this is the case, you may be at risk of contracting syphilis again unless you know that your sex partner(s) has been tested and treated.

If you are experiencing any symptoms or keen for a screening, contact your doctor today.

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