Syphilis

WHAT IS SYPHILIS?
Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. Many of the signs and symptoms of syphilis are identical to other diseases so it is often called “the great imitator.”

HOW COMMON IS SYPHILIS?
In 2002, health officials reported over 32,000 cases of syphilis in the United States, including 6,862 cases of primary and secondary (P&S) syphilis. In the United States, P&S syphilis declined by almost 90 percent from 1990 to 2000, however, the number of cases rose from 5,979 in 2000 to 7,352 in 2004. Most P&S syphilis cases occurred in persons 20 to 39 years of age with the highest incidence of infectious syphilis was in women 20 to 24 years of age and in men 35 to 39 years of age.

WHAT ARE THE SYMPTOMS OF SYPHILIS?
Many people infected with syphilis do not have any symptoms for years, but they remain at risk for complications if the infection is not treated. Transmission occurs from sores present in persons who are in the primary or secondary stage, but these sores may not be apparent. Most transmission is from persons who are unaware of the infection.

Primary Stage
The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The chancre can appear 10 to 90 days after contact with the infection, with an average of 21 days. The chancre is usually firm, round, small, and painless and appears at the location where syphilis entered the body. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to a secondary stage.

Secondary Stage
A skin rash and mucous membrane lesions characterize the second stage of syphilis. This stage typically starts with the development of a rash, which does not usually cause itching, on one or more areas of the body. The rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. The 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 rashes associated with secondary syphilis are so faint that they go unnoticed. Additional 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 heal with or without treatment, but without treatment, the infection will progress to the latent and late stages of disease.

Late Stage
Once the secondary symptoms disappear, the latent (hidden) stage of syphilis begins. Without treatment, the infection remains in the body and the infected person will still have syphilis even though there are no symptoms, meaning that the infection can still be passed to partners. In the late stages of syphilis, damage may be caused to the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This internal damage may show up many years later. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. Damage in the late stage of syphilis is irreversible and may be serious enough to cause death.

HOW IS SYPHILIS DIAGNOSED?
There are two ways to diagnose syphilis. One way is to have a health care provider examine material from a chancre (infectious sore) using a dark-field microscope. If syphilis bacteria are present in the sore, they will show up when observed through the microscope. The second way is to have a blood test. Once infection occurs, the body produces syphilis antibodies that can be detected by a blood test.

You should visit your health care provider if you have a lesion in your genital area or a widespread rash. Also if you engage in sexual behaviors that may put you at risk for STIs or have been treated for other STIs; such as gonorrhea or HIV infection, it is important to get tested for syphilis.

HOW IS SYPHILIS TREATED?
Syphilis is easy to cure in its early stages. The antibiotic, penicillin, will cure a person who has syphilis. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There are no home remedies or over-the-counter drugs that will cure syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

It is important for people who receive syphilis treatment to abstain from sexual contact until the chancres are completely healed. Persons with syphilis should notify their sex partners so that they can also have effective treatment if necessary.

McKinley Health Center can test and treat persons infected with syphilis.

HOW DO YOU PREVENT SYPHILIS?
The surest way to avoid STIs, including syphilis, is to abstain from sexual contact. Correct and consistent use of condoms will greatly lower the risk of contracting the infection if the infected area is covered; this includes condom or latex barrier use during oral sex. Avoiding alcohol and drugs can also prevent the transmission of syphilis because these activities may increase the chances for risky behaviors. Washing genitals or douching after intercourse will not prevent transmission of the infection. If you have been diagnosed and treated, you are still susceptible to contracting the infection again. If you or your partner have any signs of discharge, lesions, or rashes refrain from sexual activity and see a doctor.

References
Centers for Disease Control (CDC) and Prevention, Division of Sexually Transmitted Diseases Prevention Web site; search for syphilis
National Institute of Allergy and Infectious Diseases Web site; search for syphilis

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