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Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. Although new cases of syphilis in United States decreased by nearly 90 percent from 1990 to 2000, case reports increased significantly each year from 2001 through 2009, according to the Centers for Disease Control and Prevention. Syphilis is a curable disease if diagnosed and treated in the early. Late stage syphilis, however, is a potentially life-threatening illness.
TRANSMISSION
Syphilis spreads primarily via direct skin contact with an infectious sore, usually during sexual intercourse or oral sex. Syphilis also spreads through blood and body fluids, similar to HIV. Therefore, you can get syphilis by sharing needles with someone who has the illness. Pregnant women with syphilis can pass the infection to their unborn baby, which may lead to stillbirth, birth defects or complications after birth. CDC reports that the highest incidence of syphilis occurs among those age 20 to 29, although you can contract syphilis at any age.
PRIMARY AND SECONDARY STAGES
Untreated syphilis progresses through a series of stages after contracting the infection. The primary stage occurs roughly three weeks after contracting the bacteria and is characterized by the development of one or more painless sores called chancres. Men typically develop chancres on the penis or scrotum. In women, chancres usually occur in the vagina or on the cervix. Because the sores are usually internal and painless, most women are not aware of the presence of chancres, which heal spontaneously in approximately three to six weeks.
Secondary stage syphilis develops one to two months after the initial infection. Possible symptoms include a rash, fever, headaches, achy muscles, fatigue, swollen glands, sore throat and patchy loss of hair. These symptoms eventually disappear but may recur, especially during the first year if the infection is left untreated.
LATENT AND LATE STAGES
After the symptoms of secondary syphilis disappear, the infection goes into a latent stage. No symptoms occur but the syphilis bacteria remain in the body. Latent syphilis may progress to late or tertiary syphilis, which involves organ damage caused by the infection. The liver, bones, brain, spinal cord and cardiovascular system are often affected. Nervous system involvement may lead to blindness, partial paralysis, memory loss or dementia. Tertiary syphilis can occur as late as 20 years after the initial infection and may be fatal.
TESTING
Syphilis is usually detected by an inexpensive blood test, which may be offered free-of charge at your local clinic. If you have a chancre, diagnosis can be made by examining material from the sore under a special microscope. When a diagnosis of syphilis is made, all sexual partners should also be tested.
TREATMENT
Syphilis can be treated and cured with antibiotics. Penicillin is the treatment of choice, but other antibiotics can be used if you have a penicillin allergy. A single injection is usually curative for syphilis infections that have been present for less than a year. A longer course of treatment is needed for later stages of the illness.
PREVENTION
Consistent and correct use of condoms may reduce your risk of contracting syphilis. However, chancres may be in areas not covered by a condom. Thus, syphilis transmission may occur even with condom use. Abstinence is the only way to completely avoid the risk of syphilis and other sexually transmitted diseases. If you are sexually active, you and your partner should be tested to be sure you are uninfected.
References
- Centers for Disease Control and Prevention; Syphilis - CDC Fact Sheet; September 2010
- "Journal of the American Medical Association"; Syphilis; Carolyn J. Hildreth, M.D., et al.; February 2009
- UC San Diego; Needle Sharing May Play A Major Role in Transmission of Syphilis; Debra Kain; April 2010
- Centers for Disease Control and Prevention; 2009 Sexually Transmitted Diseases Surveillance, Syphilis; November 2010
