What is syphilis and how do you know whether you have it? We discuss these and other things you may want to know about the infection in this article.
Syphilis – What is it?
Syphilis is a contagious – very contagious – sexually transmitted infection (STI). People mostly get it through sexual contact and may not even be aware of its presence when they have it.
It is not exactly clear where syphilis came from, but it has been around for hundreds of years.
The first recorded outbreak was in Europe toward the end of the 15th century. This was after an invasion of Naples by French troops during the Italian War of 1494 to 1498. It was then called the “French disease” by the locals, who thought the occupying troops brought it along with them.
The term “syphilis” is credited to Italian physician Girolamo Fracastoro, who first used it in 1530.
Prior to 1943, there were no clinically confirmed treatments for the STI. Most deaths and unpleasant complications occurred before that year.
There are now efficacious therapies available for the disease. The treatments help the most when there is early detection.
Incidence and Deaths
Following the introduction of penicillin, cases of syphilis infection dropped considerably. Widespread antibiotics use caused the incidence to plunge especially in developed countries of the world.
However, a resurgence in cases of infection has been observed in the United States, Canada, Europe, and Australia since 2000. The spike is more noticeable among gay men.
According to the Centers for Disease Control and Prevention (CDC), there are more than 55,000 new diagnoses every year in America. The majority of these infections are in the advanced stages.
Fatality is a possibility if an infection goes untreated for too long.
There has been a considerable decline in syphilis-related deaths since 1990. Yet, roughly 107,000 people died as a result of the disease in 2015.
Causes and Risk Factors
Syphilis results when the bacterium Treponema pallidum gets into the body. This pallidum subspecies features Gram-negative organisms that are spiral-shaped and very mobile. These cannot survive beyond a few days outside the body of a host.
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The bacteria find their way into the body of a host via a cut or through the mucous membranes. Hence, most people get them mostly through sexual contact – vaginal, anal, or even oral.
An infection can develop when you kiss an area near a lesion of an affected person. Also, a pregnant mother can transmit the bacteria to her unborn child.
A person is more likely to contract the infection in cases of:
- unprotected sex
- multiple sexual partners
- a man having sex with another man
- human immunodeficiency virus (HIV) infection
With the screening of blood for transfusion these days, the risk of transmission by blood products is lower. There is also limited evidence that the STI can spread through needle sharing.
Experts say it is highly unlikely for you to become infected by sharing toilet seats, clothing, or eating utensils with an infected person. The bacteria die rapidly when outside the body.
What are the Symptoms of Syphilis?
When talking about the signs you would likely see if you have this disease, the state of its development determines them. Most experts agree that there are three stages of symptoms, while some sources add a fourth. These are:
- Primary stage
- Secondary stage
- Latent stage
- Tertiary stage
Also known as early-stage, refers to a period of about 10 days to three months, or an average of three weeks, from the time of first exposure. Chancre, or painless sore, often appears on the point of contact, such as the penis or vulva. It can also show up on the anus, rectum or around the mouth.
These non-itchy ulcers may heal in as little as two weeks and a maximum of six weeks, even without any treatment. But, if you failed to treat it, the infection enters the next stage.
There are numerous symptoms you may notice when syphilis progresses to this stage, which is about four to 10 weeks after the initial infection to six months after exposure. These signs have to do with the skin, lymph nodes, and mucous membranes in most cases.
Among the possible symptoms are rosy, non-itchy rash on the palms or soles of the feet, white patches inside the mouth, and lesions that look like warts on mucous membranes. Swollen lymph glands, sore throat, weight loss, fever, and hair loss are some other likely signs.
As in the case of the primary stage, secondary stage symptoms will also resolve even without any treatment. This typically happens in about three to six weeks after when you first saw the signs.
You may think of this as the “quiet” stage. Untreated syphilis is still present in the body, but there is no clear sign that it is. It is only by testing that you will know of the infection.
The latent stage can go on for many months or even years.
Tertiary or Late-Stage
You could find yourself in this stage about three years after the primary infection. It might also take decades before syphilis gets to this point. Significant damage to the body system could have taken place by this time, and this is not reversible.
Dementia, blindness, tumors, and paralysis are among pointers to tertiary syphilis.
Testing for Syphilis
You may never really know you have this infection, particularly at the early stages, until you get tested.
Your doctor might try to diagnose it through physical examination. He/ she may inspect your genital region, anus, mouth, and throat for signs such as chancres, rashes, or growths.
Analysis of blood, another body fluid, or tissue is a crucial part of testing. The investigation is usually a two-step process – first done to identify the infection and again to confirm the bacteria. Blood tests check for antibodies linked to the disease while fluid and tissue tests detect the bacteria.
Two popular blood tests are the venereal disease research laboratory (VDRL) test and the rapid plasma reagin (RPR) test. These are called nontreponemal tests, which are followed up with treponemal tests for confirmation.
Examples of treponemal tests are treponemal pallidum particle agglutination (TP-PA) and fluorescent treponemal antibody absorption (FTA-Abs) test.
These days, it is not hard or embarrassing to get tested for an STI, such as syphilis. STDCheck makes it more convenient and discreet to access testing. The service, which combines the RPR test with the confirmatory treponemal pallidum assay (TPA), has more than 4,500 centers spread across the U.S. You should be able to find a location close to you.
This infection can be quite easy to cure. The key thing is early detection.
If you are able to detect syphilis early enough, you might not need more than a round of antibiotics to get rid of it. A single dose of benzathine benzylpenicillin injected into the muscle can eliminate early infections.
Ceftriaxone is another effective alternative to penicillin-based treatment. People who are allergic to penicillin may also be placed on tetracycline and doxycycline.
High doses of intravenous penicillin are usually given to patients with late-stage infections. Patients receive the treatment for a duration of at least 10 days.
You should note that treatment doesn’t reverse any damage already done by late-stage or tertiary syphilis. It only inhibits further progression.
What Happens When Syphilis is not Treated?
This STI can do damage to different areas of your body when you fail to deal with it on time. Whatever harm it does might be permanent.
The parts of the body the infection could damage include:
- The brain
- Blood vessels
- Bones, including teeth
Essentially, internal organs are at significant risk with untreated syphilis, which also greatly increases the risk of having HIV.
A pregnant mother with an untreated infection may also pass it on to her baby. This could result in a miscarriage, stillbirth, or birth defects.
How to Prevent Syphilis
Since sexual contact is responsible for the vast majority of syphilis cases, the best way to prevent an infection is through abstinence.
A condom or dental dam can help to reduce the likelihood of becoming infected. This is considered the best option for people who are sexually active, although it may not totally prevent an infection.
Use a new condom or dental dam whenever you want to have sex. Make sure that this covers any sores or rashes that might be present.
Having only a single, faithful partner will also help for prevention.
We should mention that pre-exposure prophylaxis (PrEP) pills do not protect against syphilis. You may want to speak with your doctor for proper guidance.