SYPHILIS

What is Syphilis?

In 1999, approximately 6,657 cases of syphilis occurred in the United States with 2, 796 cases among women. Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum ( 9 ).

How does one contract syphilis and how is it diagnosed?

Syphilis is passed from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. Transmission of the organism occurs during vaginal, anal, or oral sex. Pregnant women with the disease can pass it to the babies they are carrying. Syphilis cannot be spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils ( 9 ).

A blood test is another way to determine whether someone has syphilis. A low level of antibodies will stay in the blood for months or years even after the disease has been successfully treated. Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis ( 10 ).

What are the signs and symptoms?

The first symptom of primary syphilis is a sore called a chancre ("shan-ker"). This can appear within ten days to three months after exposure. The chancre is painless and sometimes occurs in the body, it may go unnoticed.

Secondary syphilis is marked by a skin rash that appears anywhere from three to six weeks after the chancre appears. Active bacteria are present in the sores and any physical contact with the broken skin may spread the infection.

If left untreated, syphilis then continues into a latent stage in which the disease is no longer contagious and no symptoms are present. However, approximately one-third of those infected go on and develop damage to the heart, eyes, brain, nervous system, bones, and joints. This stage can last for years and can lead to mental illness, blindness, heart disease, and death ( 10 ).

What are the complications and how will it affect pregnancy?

The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth (a baby born dead) or of giving birth to a baby who dies shortly after birth. An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may become developmentally delayed, have seizures, or die ( 9 ).

What are the treatments and prevention methods against syphilis?

Syphilis is usually treated with penicillin, an antibiotic, by injection. Other antibiotics can be used for patients allergic to penicillin. A person can no longer transmit syphilis 24 hours after beginning therapy. There are no home remedies or over-the counter medication to treat syphilis. Treatment will kill the syphilis bacterium. However, it will not repair the damage caused by the infection ( 11 ).

The best way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact. Also, being in a long-term monogamous relationship, that is, only have sex with one person who only has sex with you.

Latex male condoms, when used correctly, can reduce the risk of transmission of syphilis. Syphilis screening is recommended annually for all sexually active women 25 years of age and younger. An annual screening test also is recommended for older women with risk factors for syphilis (a new sex partner or multiple sex partners). All pregnant women should have a screening test for syphilis ( 2 ).

Any genital symptoms such as discharge or burning during urination or unusual sore or rash should be a signal to stop having sex and to consult a health care provider immediately. If a person has been treated for syphilis (or any other STI), he or she should notify all recent sex partners so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from syphilis and will also reduce the person's risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for syphilis ( 8 ).