Syphilis

Syphilis is a bacterial infection usually transmitted by sexual contact. The disease affects your genitals, skin and mucous membranes, but it may also involve many other parts of your body, including your brain and your heart.

The "pox," as syphilis was once known, first appeared in Europe in the 1490s, triggering an epidemic that inspired such fear and misunderstanding that people with the disease were commonly banned, even from many hospitals. Before effective treatment was found nearly 500 years later, many of those with syphilis suffered severe boils, pain, wasting, madness and death, often in shame and social seclusion. However, lack of education and unsafe sex triggered a new rise in syphilis incidence and this is disease has again been on the rise since 2001.

Signs and Symptoms

The signs and symptoms of syphilis occur in three stages — primary, secondary and tertiary

Primary:- These signs may occur from 10 days to three months after exposure:-

• A small, painless sore (chancre, a painless ulcer) on the part of your body where the infection was transmitted, usually your genitals, rectum, tongue or lips. A single chance is typical, but there may be multiple sores.
• Enlarged lymph nodes in your groin.

Primary syphilis typically disappears without treatment, but the underlying disease remains and may reappear in the secondary or third (tertiary) stage.

Secondary:- syphilis may begin three to six weeks after the chancre appears, and may include: -

• Rash marked by red or reddish-brown, penny-sized sores over any area of your body, including your palms and soles
• Fever
• Fatigue and a vague feeling of discomfort
• Soreness and aching in your bones or joints

These signs and symptoms may disappear and reappear for up to two years. In some people, periods called latent syphilis — in which no symptoms are present and the disease is not contagious — may follow the secondary stage. Signs and symptoms may never return, or the disease may progress to the tertiary stage.

Tertiary:- without treatment, syphilis bacteria may spread, leading years later to serious internal organ damage and death, some of the signs and symptoms of tertiary syphilis include: -

• Neurological problems: - These may include stroke; infection and inflammation of the membranes and fluid surrounding your brain and spinal cord (meningitis); poor muscle coordination; numbness; paralysis; deafness or visual problems; personality changes; and dementia.
• Cardiovascular problems: - These may include bulging (an aneurysm) and inflammation of the aorta — your body's major artery — and of other blood vessels.

Causes, Risk factors and Complications

Syphilis is contagious during its primary and secondary stages. The bacterial organism that causes syphilis, Treponema pallidum, enters your body through minor cuts or abrasions in your skin or mucous membranes. The most common route of transmission is through contact with an infected person's sore during sexual activity. Other routes are through transfusion of infected blood, through direct unprotected close contact with an active lesion (such as during kissing), and from an infected mother to her unborn child during pregnancy.

Treponema pallidum is extremely sensitive to light, air and changes in temperature. It can live only within the human body.

High-risk sexual activity puts you at risk of syphilis and other sexually transmitted diseases (STDs). Who have unprotected sex are at special risk. Syphilis incidence since 2000 has increased only among men, and about half the men recently diagnosed with syphilis are also infected with the human immunodeficiency virus (HIV).

Anyone who has unprotected sex is at risk of contracting syphilis. Even if you've had syphilis and been treated for it previously, you can contract it again.

If you're pregnant, it is possible for you to pass syphilis to your unborn child. Blood containing the bacteria reaches the fetus through the placenta. More than half of women who are pregnant and who have active, untreated syphilis may pass the disease to their unborn babies, and about one-fourth to one-half of these pregnancies will end in miscarriage. If your baby is born infected with syphilis, signs of the disease may be evident at birth or may develop when your baby is between 2 weeks and 3 months old.

Babies born with syphilis who aren't treated early may experience serious complications, including: -

• Bone abnormalities and pain
• Depressed nose bridge (saddle nose)
• Swollen joints
• Vision and hearing problems
• Disfigured, screwdriver-shaped teeth (Hutchinson's teeth)
• Scarring at the site of early sores
• Death

People with syphilis also have an estimated two- to fivefold increased risk of contracting HIV. A syphilis sore can provide an easy way for HIV to enter your bloodstream during sexual intercourse.

Prevention

To reduce your risk of syphilis and other sexually transmitted diseases, practice safe sex.

Avoid sex, or limit sexual relations to a single, uninfected partner.

If you don't know the STD status of your partner, use a latex condom during each sexual contact.

Avoid excessive use of alcohol or other drugs, which can cloud judgment and lead to unsafe sexual practices.

When to seek medical advice

If you have painless sores in your genital area and enlarged lymph nodes in your groin area, see the doctor. These may be signs of syphilis.

Treatment in the early stages of syphilis can prevent serious, long-term illness and spread of the disease.