Syphilis, an Old Disease Remains a Health Issue


Syphilis is an old disease that continues to be a public health problem. Syphilis is caused by the Treponema pallidum bacterium. It is a sexually transmitted infection (STI). Like all STIs it can be transmitted by genital, oral, and anal sex.

In the United States, the number of reported cases increased 11.8% between 2005 and 2006. In 2006, health officials reported over 36,000 cases of syphilis. The incidence was highest in women 20 to 24 years of age and in men 35 to 39 years of age.

Primary syphilis

* 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 to 6 weeks, and it heals without treatment.
* If not treated, the infection progresses to the secondary stage.

Secondary Stage of Syphilis

* Skin rash and mucous membrane (ie inside the mouth) lesions characterize the secondary stage.
* The characteristic rash of secondary syphilis may appear as rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet. However, rashes with a different appearance may occur on other parts of the body, sometimes resembling rashes caused by other diseases.
* Other symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue.
* The signs and symptoms of secondary syphilis will resolve with or without treatment. Untreated the infection will progress to the latent and possibly late stages of disease (or Tertiary Syphilis).

Late and Latent Stages (or Tertiary Syphilis)


* Without treatment in the first or second stage, the infected person will continue to have syphilis even though there are no signs or symptoms. The infection remains in the body.
* The late stages of syphilis can develop in about 15% of people who have not been treated for syphilis, and can appear 10 – 20 years after infection was first acquired.
* The disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

Congenital Syphilis

Syphilis transmitted by an infected pregnant woman to her fetus. It causes serious illness and, in some cases, fetal death.

Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin will cure a person who has had syphilis for less than a year. Other antibiotics are used for those allergic to penicillin. There are no home remedies or over-the-counter drugs that will cure syphilis. See your physician early if you suspect you may have an STI.

Having syphilis once does not protect a person from getting it again. You can get syphilis a second or third or fourth time. It is important to protect yourself from unsafe sex practices and partners.

The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Correct and consistent use of latex condoms can reduce the risk of syphilis, as well as genital herpes and chancroid, only when the infected area or site of potential exposure is protected.

Any unusual discharge, sore, or rash, particularly in the groin area, should be a signal to refrain from having sex and to see a doctor immediately.

Center for Disease Control and Prevention
JAMA (for pictures of the rashes and lesions)


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