Syphilis: General Information
Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. Syphilis is transmitted from person to person by making direct contact with a sore known as a chancre (see photo). Chancres can occur on the vagina, anus, rectum, mouth, or genitals. The transmission of syphilis may occur during vaginal, anal, oral sex, or through pregnant women transmitting it to their unborn child.
Syphilis is known as “The Great Pretender” due to its symptoms being similar to those of other diseases. It typically follows a progression of stages that can last from a few weeks to even years. The primary stage includes the appearance of a single or multiple chancres. These chancres are usually painless and round in shape. It will appear at the part of the body in which the syphilis entered the body. The chancre lasts about 3 to 6 weeks and will heal whether or not the infected individual has been treated or not. The secondary stage is marked by skin rashes and mucous membrane lesions. The rash does not typically cause itching. The rash may appear as rough, red, or reddish brown spots on the palms of the hands and the bottom of the feet. The mucous lesions are gray or white that develop in warm, moist areas such as the mouth or underarms. The latent stage is composed of no visible symptoms of syphilis. However, without treatment, the infected person will continue to have syphilis in their body. Finally, the tertiary stage is rare and may appear 10-30 years after the infection was first obtained. At this stage, it may affect multiple organs in the body and the symptoms vary depending on which organ is being affected. Diagnosis of syphilis is most commonly done by blood tests. The two types of blood tests available for syphilis are nontreponemal tests and treponemal tests. Nontreponemal tests are not specific for syphilis, can produce false-positive results, and by themselves, are not significant enough for a diagnosis. Meanwhile, treponemal tests detect antibodies that are specific for syphilis. The most effective treatment for syphilis is a Benzathine penicillin G injection that should be administered intramuscularly in a single dose. |
The common look of a chancre sore
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Syphilis: Historical/Modern Rise
In 2016, the total case count of reported syphilis was the highest recorded number since 1993. The total number of cases increased from 74,707 to 88,042 from 2015 to 2016 (a 17.8% increase). During this time, the rate increased by 14.7% among men and 35.7% among women. The syphilis rates increased in every age group from 15 years or older and in every race/ethnic group. Though drug resistance has not become a common problem with syphilis, the penicillin injection used to treat it is often times in short supply in less developed countries where the burdens of syphilis are greater.
Syphilis: Prevention Education
The greatest forms of prevention of syphilis are correct usage of condoms and sexual partner notification. The correct usage of a latex condom can reduce the risk of syphilis when the infected area is protected. However, a sore outside the covered area can still allow for transmission. Also, notifying your sexual partner is a critical component to preventing the spread of syphilis.
References
1.Center for Disease Control. Syphilis- CDC Fact Sheet. Updated February 13, 2017. https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm.
2. Center for Disease Control. Syphilis- Sexually Transmitted Diseases Surveillance. Updated September 26, 2017. https://www.cdc.gov/std/stats16/syphilis.htm.
3. Hartl, Gregory. Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted diseases. World Health Organization. 2016. http://www.who.int/mediacentre/news/releases/2016/antibiotics-sexual-infections/en/.
2. Center for Disease Control. Syphilis- Sexually Transmitted Diseases Surveillance. Updated September 26, 2017. https://www.cdc.gov/std/stats16/syphilis.htm.
3. Hartl, Gregory. Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted diseases. World Health Organization. 2016. http://www.who.int/mediacentre/news/releases/2016/antibiotics-sexual-infections/en/.