| Fact Sheet: Syphilis
Before the advent of
penicillin, syphilis was an incurable infection that affected many
people including well known historical figures such as Henry VIII.
Syphilis was frequently passed from mother to child, and congenital
syphilis was the terrible secret underlying the action of Ibsen’s
play, Ghosts. Syphilis is now easily treatable in its early stages.
Infection rates are high in some parts of the country, and there is currently a local increase of syphilis among men
who have sex with men.
WHAT IS IT?
Syphilis is caused by a
bacteria (Treponema pallidum) that is curable with antibiotics. If not
treated early, however, syphilis can cause serious problems.
TRANSMISSION
Syphilis is spread during
sexual exposure to an infected person. It can also be transmitted from
an infected mother to her child during pregnancy (congenital syphilis).
Syphilis is a disease having different "stages" and because
the symptoms that occur soon after infection go away without treatment,
people may mistakenly think they are cured or have recovered when, in
fact, they are infected and can pass the infection to their sexual
partners.
SYMPTOMS
The first stage of
infection is known as primary syphilis. The first symptom of infection
is an often painless sore (chancre) that appears 10 – 90 days (average
3 weeks) after contact with an infected person. Most often the chancre
appears on the genitals, but may appear in the anorectal area, the
mouth, or other parts of the body if that is the site of infection.
These sores look painful, but often they aren’t and go away on their
own in 1-5 weeks. Because they are painless, they may go unnoticed if
they occur inside the vagina or rectum.
The next stage, secondary
syphilis, may begin immediately following the primary stage or up to 10
weeks later. Secondary syphilis is most often characterized by a rash on
the palms of the hands and soles of the feet or on the chest or back.
Some people may have genital lesions, flu-like symptoms or may have loss
of hair during this stage of syphilis. Like primary syphilis, the
symptoms of secondary syphilis go away without treatment, but the
infection continues to progress.
If syphilis is not
diagnosed and treated during the primary or secondary stage, the disease
enters an extended period with no symptoms (latent infection). During
this period the infection continues to cause damage to the body. Up to
one third of untreated persons will develop complications due to
syphilis at the end of this latent period (tertiary syphilis.).
Complications may include damage to the arteries and/or dementia or
blindness. If left untreated syphilis can result in death. The
likelihood of transmission decreases during these later stages, but some
risk remains.
PREGNANCY
A pregnant woman can pass
the infection to her child. A fetus can become infected as early as the
4th month of pregnancy, resulting in stillborn or premature
delivery and neo-natal death in 20% of infected infants. Other symptoms
and complications of congenital syphilis may include nasal discharge in
the first weeks of life, jaundice, anemia, and bone disease. Pregnant
women infected with syphilis can be effectively treated with penicillin,
usually resulting in a cure for the infant as well. Even so, the infant
should be evaluated and given further treatment if necessary.
DIAGNOSIS
Only a health care
provider can diagnose syphilis. Diagnostic tests for primary and
secondary syphilis include blood tests and tests performed on fluid
recovered from open chancres. For some infected persons, e.g. those with
latent or late disease, examination of spinal fluid may be performed to
determine central nervous system involvement.
TREATMENT
Penicillin is very
effective at treating primary and secondary syphilis infection. Latent
or tertiary syphilis requires more intensive treatment, but can be
cured. Nonetheless, any damage done by the disease is permanent. Sexual
contacts of individuals diagnosed with syphilis should be notified,
tested and treated as necessary. People can become reinfected with
syphilis and must continue to take precautions to prevent repeat
infections.
PREVENTION
- Abstinence from sexual
activity is the surest way to avoid acquiring or transmitting
syphilis.
- The next surest way is
to limit sexual contact to one uninfected partner who only has sex
with you.
- For those choosing to
be sexually active, condoms should be used correctly and
consistently to minimize transmission.
- Avoid sexual contact
if suspicious symptoms are present. If you suspect that you have
syphilis (or any sexually transmitted disease), seek immediate care
at a local STD clinic, hospital, or medical practitioner.
- Before having sex,
talk with your partner(s) about syphilis and other sexually
transmitted diseases. Negotiate a risk reduction strategy with them
that feels comfortable to both of you. If the STD status for you or
your partner is unknown, go together to get screened at a local STD
clinic, hospital, or medical practitioner.
- If you have syphilis
(or any sexually transmitted disease), notify all sex partners so
that they can also seek and obtain treatment.
In the
News: Health
experts - Syphilis rates rising (CNN)
Information courtesy of
Seattle and King County Public Health
at (http://www.metrokc.gov/health/)
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