How Could I Get Syphilis?

Syphilis is a sexually transmitted bacterial disease that is caused by Treponema pallidum. Syphilis spread from an infected person to a healthy contact via direct physical contact. The source of infection in most cases is a syphilitic sore (also known as chancre), usually present on the genitals of the affected person (such as vagina, penis, rectum etc.) In addition, syphilitic sore may appear on the mucus membranes of oral cavity such as lips or oral mucosa.

According to latest estimates, more than 63,450 new cases of syphilis were reported in the year 2014 (1).

Who Is At Risk Of Contracting Syphilis?

Syphilis is transmitted via body secretions and direct physical/ sexual contact. Here are two primary modes of transmission:

1. Babies born to Syphilitic Mothers (Congenital Syphilis):

The syphilis infection is passed from the infected mother to unborn baby during pregnancy. Congenital syphilis is a growing concern in United States. In 2014 alone, approximately 458 cases of this disease were reported (1).

Based on latest statistics, risk of this disease is approximately 10-times higher in babies born to Black parents. Congenital syphilis is also fairly common in Hispanics (3.3-times higher when compared to general population). The prevalence of syphilis in blacks is 39 cases per 100,000 as opposed to 3.7 cases per 100,000 in whites.

Here is how the risk of transmitting congenital syphilis can be reduced:

• It is highly recommended to get yourself tested at regular intervals if you have a risky lifestyle.
• Healthcare providers should test all expecting mothers for sexually transmitted infections and repeat screening test of syphilis during the third trimester of pregnancy at 28 to 32 weeks) in high risk group.

If left poorly managed, exposure to syphilis during early intrauterine life can lead to stillbirths (demise of a viable fetus shortly after birth). According to a new study, maternal syphilis can aggravate the risk of intrauterine death or still birth in 40% of the cases.

2. Heterosexual and Homosexual Contact with an Affected Individual:

It is sexually transmitted and can spread via oral, anal or vaginal intercourse. The bacterium gains access into the blood stream via intimate sexual contact and divides rapidly to produce symptoms within a period of 10 to 90 days (average of 21 days). Homosexual individuals are at much higher risk of contracting syphilis via sexual contact. According to latest estimates, 83% cases of syphilis in 2014, were reported in homosexual males.

Classic symptoms of this disease are:

• Primary Stage: Appearance of a painless, firm bump (also known as chancre) at the site of primary infection. In some cases, multiple chancre may appear on the genitals. The chancre or sore heals within 6 – 8 weeks (with or without any treatment). Since the chancre is painless and usually at concealed places, the primary infection may go unnoticed. In the absence of any treatment, the infection progresses into a secondary stage.
• Secondary Stage: Symptoms of secondary stage are marked by; appearance of reddish or grey rash and sores on the oral cavity, lips and other moist areas of the body (such as groin and under-arms). The rash is non-itchy and patchy in appearance; also known as condyloma lata. Other symptoms of secondary syphilis include; patchy headaches, fever, weight loss, hair loss, muscle aches, sore throat, swollen lymph glands, and fatigue
• Latent and Late stage: The symptoms of latent and late stage can occur months or years after early infection. Long standing serious infections can lead to a wide variety of complications including nervous symptoms due to neurosyphilis.

Besides sexual contact, body to body contact with an infected person or his secretions (such as touching the sore or kissing) can also help in the transmission of syphilis bacterium. It is imperative to mention that it can’t be transmitted via contact with non-living objects (such as articles or clothes used by an infected person).

How Can I Treat Or Manage Syphilis?

It is imperative to mention that home remedies or over-the counter medications cannot treat it. In other words, you should complete the antibiotic course in order to get rid of the infection. In untreated cases, it can lead to long term complications such as; damage to internal organs (like brain, blood vessels, bones, joints, liver, nerves, eyes, heart), gradual blindness, paralysis, numbness, difficulty coordinating muscle movements, dementia and other symptoms of Huntington’s disease and Parkinson’s disease.

Some viable treatment options include:

• Benzathine penicillin G: Single intramuscular injection in a dose of 2.4 million units can cure it regardless of clinical stage. In late latent stages, total of 3 intramuscular injections are advised (at one-week interval).
• Individuals who are allergic to Penicillin can get benefitted from other antibiotics such as tetracycline, doxycycline and ceftriaxone.

References

1. Centers for Disease Control and Prevention (CDC. (2013). Notes from the field: repeat syphilis infection and HIV coinfection among men who have sex with men--Baltimore, Maryland, 2010-2011. MMWR. Morbidity and mortality weekly report, 62(32), 649.

2. Patton, M. E., Su, J. R., Nelson, R., Weinstock, H., & Centers for Disease Control and Prevention (CDC). (2014). Primary and secondary syphilis—United States, 2005–2013. MMWR Morb Mortal Wkly Rep, 63(18), 402-6.

3. Tuddenham, S., & Ghanem, K. G. (2015). Emerging trends and persistent challenges in the management of adult syphilis. BMC infectious diseases, 15(1), 1.