SYPHILIS:
THE “GREAT IMITATOR”
yphilis,
which is caused by a bacterium called Treponema pallidum, is one
of the oldest known sexually transmitted diseases (STDs). It is
often referred to as the “great imitator” because its
symptoms are similar to those of other diseases. Syphilis can be
treated easily with antibiotics yet the early symptoms can be mild
and may go unnoticed. If syphilis remains untreated, it can damage
the brain and other organs and become life threatening. Until recently,
the average number of syphilis cases in the United States was 70,000
per year. In 1992, however, approximately 134,000 cases, occurring
mainly in heterosexuals, were reported to the U.S. Public Health
Service. The resurgence of syphilis among heterosexuals has been
attributed to the exchange of sex for drugs.
contact with an infected individual, with the exception of congenital
syphilis which is spread from mother to fetus. The bacteria that
cause syphilis remain in skin lesions of an infected person. Transmission
by sexual contact requires exposure to moist lesions which are usually
in the genital area, although they can occur in the mouth or on
other parts of the body.
Symptoms
antibiotics, it will progress through four characteristic stages:
primary, secondary, latency and tertiary.
syphilis is a painless sore or ulcer, known as a chancre. The chancre
will generally appear within two to six weeks after exposure and will
heal without antibiotic treatment. If the disease is not treated during
the primary stage, it may progress through the other three stages.
a skin rash that appears anywhere from three to six weeks after the
chancre appears. The rash may cover the whole body or just a few areas
such as the hands and feet. Since active bacteria are present in these
sores, any physical contact (sexual or nonsexual) with the broken
skin of an infected person can spread the disease at this stage. The
rash usually heals within several weeks or months, even without antibiotic
treatment. Other symptoms of secondary syphilis include a mild fever,
fatigue, a sore throat, headaches, hair loss and swollen lymph nodes.
The signs of secondary syphilis can return over the next one to two
years, although they may be mild.
it will lapse into the latent stage (absence of symptoms) which can
persist for months or years. The disease is no longer contagious and,
for many individuals, the symptoms may never return. However, approximately
one-third will develop complications from late or tertiary syphilis.
last for years or decades and can be quite debilitating. In the last
stage of syphilis, the bacteria can damage the heart, eyes, brain,
nervous system, bones, joints, lining of the spinal cords and other
parts of the body.
Treatment
penicillin which is administered by injection. Other antibiotics can
be used for those who are allergic to penicillin. Typically, an infected
person can no longer transmit syphilis 24 hours after beginning antibiotic
treatments. It is important that people being treated for syphilis
see their health care provider for periodic blood tests to be sure
that the bacteria have been completely destroyed.
Syphilis
and pregnant women
syphilis pass the infection to their unborn children. Approximately
25 percent of these pregnancies result in stillbirth or neonatal death,
and between 40 and 70 percent of syphilitic mothers will yield syphilitic
infants. While some infants with congenital syphilis have symptoms
at birth, most develop symptoms two weeks to three months later. The
symptoms include lesions on the skin, rashes, fever, weakened cries,
swollen liver and spleen, jaundice, anemia and various deformities.
Often the symptoms go undetected in infants and, as older children
and teens, they may develop the symptoms of tertiary syphilis.
Syphilis
and HIV
the highest rate of syphilis also have the fastest growing HIV infection
rates in childbearing women because the lesions in the genital areas
make the transmission of HIV easier. Also, for those who acquired
HIV through sexual contact, it is possible to be infected with other
STDs, including syphilis.
may have unusual symptoms, progress more rapidly and may be more difficult
to diagnose and treat. However, most cases of syphilis in HIV-infected
people are managed in the same way as in people without HIV.
Prevention
infected with syphilis and have no other sex partners besides each
other cannot contract syphilis. When a person has sex with a person
whose syphilis status is unknown, a latex condom put on before beginning
sex and worn until the penis is withdrawn is a good defense against
infection. Only lab tests can confirm someone has syphilis. Because
syphilis sores can be hidden in the vagina, rectum, or mouth, it is
not obvious by looking whether a partner has syphilis. Washing the
genitals, urinating, or douching after sex does not prevent STDs.
Any unusual discharge, sore, or rash, especially in the groin area,
should be a signal to stop having sex and to see a doctor immediately.
For more information about syphilis and other sexually
transmitted diseases, see the National Center for HIV, STD and Tuberculosis
Prevention’s (NCHSTP) home page at http://www.cdc.gov/nchstp/od/nchstp.html
or call the Center for Disease Control and Prevention’s STD Hotline
at (800) 227-8922.