Syphilis is a bacterial sexually transmitted infection that affects both men and women. It can be acquired, where it is contracted during life and most often through sexual intercourse, or congenital, where it is present from birth. Syphilis has been decreasing throughout most of the last quarter of the twentieth century. However, these has been an increase since 2000, particularly in homosexual men. It nevertheless remains one of the common sexually transmitted diseases, alongside gonorrhea and genital herpes.
Causes of Syphilis
Syphilis is caused by the Treponema pallidum bacterium. The infection can be acquired through any break in the skin and mucous membranes. The most common route of transmission is through sexual contact, however, it is possible to contract syphilis through kissing and blood transfusions. Between mother and child, the infection can be transmitted across the placenta. Syphilis leads to the formation of sores, which may be found on the lips, in the mouth, on the genitals and the rectum. Direct contact with these sores, known as chancres, can lead to the transmission of syphilis. Therefore risk factors for contracting syphilis includes unprotected sex, intercourse with multiple partners and even intravenous drug use. Health care workers may also be at risk.
Stages of Syphilis
There are different stages of syphilis – primary, secondary, latent and late. The incubation period is between 10 to 90 days with a mean time of 14 to 28 days. This means that there are no signs or symptoms for this period of time.
Signs and Symptoms
In primary syphilis, there is usually the single sore (chancre) although there can be multiple chancres. These small, round sores are painless and arises at the site where the bacteria entered. It lasts for up to 6 weeks before resolving spontaneously. In the secondary stage, there is a skin rash which is not itchy. It often, but not always, arises as the chancre is disappearing. The rash is red to reddish brown spots on the palms of the hand and soles of the soles of the feet. It can also occur at other sites, particularly the trunk and limbs but a rash on the palms and soles following a chancre is a good indication of syphilis. At this point other symptoms are also present including fever, swollen lymph nodes and fatigue. Some patients may also experience a sore throat, patches of hair loss, muscle aches and headaches. Sometimes the symptoms of the secondary stage resolve only to return a short while later. Eventually, however, the disease will progress to the latent stage if is not treated. This may occur within 3 to 4 months of the onset of secondary symptoms.
The latent stage follows when the symptoms of the primary and secondary stages disappear. It is referred to as latent because there are no signs and symptoms during this period but the infection is still present. In the first 2 years or so, a period known as early latency, a person can still transmit syphilis to a partner during sexual intercourse. However, in late latency, the person is not sexually infectious. Women with syphilis can still transmit the infection to their unborn child for up to several years after infection. The late stage does not occur in every person with syphilis. In fact it only arises in a minority of syphilis patients who do are left untreated. When it does occur, however, it is very severe and sometimes even fatal. Many different organs and systems in the body are affected and some of the symptoms may include blindness, muscle weakness or paralysis, numbness and difficulty in coordinating muscle movements.
Tests and Treatment of Syphilis
A thorough medical history and the findings of a clinical examination may prompt the need for further tests to confirm syphilis. Blood, cerebrospinal fluid (lumbar puncture) and fluid from the sores may all be utilized to confirm the diagnosis. Syphilis patients should also be tested for HIV as unprotected sex, risky sexual behavior and/or exposure of the sores are also risk factors for HIV. Treatment for syphilis is quick, inexpensive and very effective. It can be cured although it is a possible for a person to be reinfected at a later stage. Just a single dose of penicillin is sufficient in most cases, although additional doses may be necessary for those patients who had the infection for long periods. A person who is sensitive to penicillin first has to undergo desensitization and then the penicillin is administered.