Syphilis is a disease caused by the bacterium Treponema pallidium.
When the infection is transmitted through sexual contact, it is called venereal syphilis while that transmitted from mother to baby during childbirth is called congenital syphilis.
How is Syphilis spread?
Syphilis is spread from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. It can also occur on the lips and in the mouth. Transmission of the organism occurs during vaginal, anal, or oral sex.
If a women with the disease becomes pregnant, she can pass it to her unborn child. Syphilis cannot be spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils
Symptoms of Syphilis
The symptoms of early syphilis is usually mild and difficult to recognise. In faction, it was called “the great imitator” as many of the symptoms of infection is not distinguishable from other diseases.
After exposure, symptoms can take as long as 3 months to appear. The course of the disease is long and is divided into 3 different stages of infection.
In this initial stage of the disease, painless ulcers (also called chancres) appear on the genitalia. In general, it takes about 21 days after sexual contact with an infected person for this to appear.
Unfortunately, chancres are highly infectious and not very noticeable and may be concealed, e.g. in the vagina/cervix or on the penis. It could also appear in the anus or the mouth for individuals who practice anal or oral sex.
These lesions take about 2 to 6 weeks to heal even without treatment and if the infection is not picked up at this point, it progresses to secondary syphilis.
About 3 to 6 weeks after the chancres appear, the disease enters the second stage. During this time, the patient suffers from a series of non-specific symptoms which include:
- A flu-like illness, a feeling of malaise with loss of appetite, accompanied by swollen lymph nodes lasting for weeks or months.
- A rash that is not itchy covering the entire body or certain areas.
- Flat wart like growth in the cervix or anus.
- White patches in the oral cavity.
- Patchy hair loss
During this stage, the patient is still very infectious and can spread the infection to their sexual partners.
Latent and Tertiary Syphilis
If the infection is still not picked up and treatment instituted, it progresses into the latent stage. The infection no longer causes much symptoms but can still be detected with a blood test. After about 10 years or more, the infection starts to affect the nervous system, the heart and other organs of the body. This is called tertiary syphilis.
At this stage, the infection is rather serious and can include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.
Syphilis and Pregnancy
If a women with syphilis becomes pregnant, she may have a high risk of having a stillbirth (a baby born dead). Babies born are also at a high risk of dying soon 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.
Diagnosis of Syphilis
Syphilis can be easily diagnosed by taking a blood test or taking a sample from the chancre and sending it for examination in a laboratory. For women, an internal exam may be needed.Click here for more Info on When and How to Test for Syphilis
Treatment of Syphilis
Syphilis is easily treated if diagnosed early. Generally it involves one or several injections of penicillin or oral antibiotics. However, patients usually need to return for testing to ensure that the disease is completely eradicated before they can be discharged.
Patients will also be asked about their sexual contacts so that contact screening can be done.
While on treatment, patients should also refrain from sexual activity to avoid further spread of the disease.
One complication however, is that even after treatment, any future blood tests (e.g. for immigration reasons) will still be positive because the body retains antibodies against the bacteria. Doctors can give the person a certificate explaining that they have been treated and no longer have syphilis.
Having syphilis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
Prevention of Syphilis
Barrier contraception can reduce the chances of contracting syphilis. However, it is not completely protective and infected people can still spread to their partners even if they use condoms. The only way is to check for sexually transmitted diseases regularly and treat if infected.
Syphilis also increases the likelihood of spread of other sexually transmitted diseases particularly HIV. There is an estimated 2- to 5-fold increased risk of acquiring HIV if syphilis is present.
Syphilis belongs to the group of sexually transmitted diseases that causes ulcers and sores and these lesions disrupt the barrier that provide protection against infections. The genital ulcers caused by syphilis bleed easily and when they come into contact with oral and rectal mucosa during sex, increase the infectiousness of and susceptibility to HIV. Infection with sexually transmitted diseases like syphilis is an important predictor for becoming HIV infected.
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.