Am I vulnerable to Syphilis? Gambella Medical Journal

Rochester, MN, May 08, 2015 (GMN) - It seems like these days everyone can learn just about anything via social media but how important is to learn about the disease and organs that affected the most. Of course there is nothing better than knowing being healthy. There are many ways people can protect themselves from uncertainly diseases; especially Sexually Transmitted Infection (STIs). But how much does one know the transmission of STIs? Do not be surprised to know how syphilis is transmitted.

In fact, Syphilis is a sexually transmitted infection. It is caused by a type of bacteria known as Treponema pallidum, Centers for Disease Control and Prevention (CDC, 2014). More than 36,000 cases of syphilis were reported in the United States. The first sign of syphilis is a small, painless sore. It can appear on sexual organs, rectum, and inside the mouth. This sore is called a chancre and most often people fail to notice it right away. Syphilis can be tricky to diagnose and an infected person can go years without showing any symptoms. However, the earlier person discovers the infection, the better outcome. Syphilis that remains untreated for a long period of time can cause major damage to important organs, like the heart and brain. It is only spread through intimate contact and cannot be transmitted by sharing a toilet with another person, sharing clothes, and using eating utensils (CDC, 2006). Stages: Syphilis has four stages, such as primary, secondary, latent, and tertiary. It is most infectious in the first two stages and when is in the hidden stage (latent), person can experience symptoms, but it will not be infectious others. Tertiary syphilis is most dangerous to the health of the person (Mayo Clinic, 2014). 

Primary Syphilis: The primary stage of syphilis occurs shortly after person infected with the bacteria. It begins with a small and painless, but highly infectious, round sore called a chancre (Mayo Clinic, 2014).  This sore may appear on or inside the person’s mouth or genitals, wherever the bacteria entered in the body. On average, the sore shows up around three weeks after infection, but it can take between 10 and 90 days and the sore can remains for anywhere between two and six weeks. It is transmitted by direct contact with a sore and usually occurs during sexual activity (Mayo Clinic, 2014)

Secondary Syphilis: During the second stage of syphilis, one may experience skin rashes and a sore throat. The rash will not itch and is usually found on the palms and soles and some people do not notice the rash before it goes away. CDC Dec. 16, 2014 indicated that other symptoms of secondary syphilis may include:

* headaches

* swollen lymph glands

* fatigue

* fever

* weight loss

* hair loss

* aching joints

These symptoms will go away whether or not the person receives treatment; however, without treatment person will still be infected and usually secondary syphilis is often mistaken for another condition. 

Latent Syphilis: The third stage of syphilis is the latent or hidden stage. Person may not have any noticeable symptoms in this stage; however, person will still be infected with syphilis (Oregon Public Health Division, 2011). The secondary symptoms could reappear and also remain in this stage for years before progressing to tertiary syphilis. 

Tertiary Syphilis: The last stage of infection is tertiary syphilis in which one-third of people who do not receive treatment for syphilis will enter this stage. Tertiary syphilis can occur years or decades after person is infected and it is very serious (Oregon Public Health Division, 2011).

Some potential outcomes of tertiary syphilis include: 

* blindness

* deafness

* mental illness

* memory loss

* destruction of soft tissue and bone

* neurological disorders (e.g., stroke and meningitis) 

* heart disease

* neurosyphilis (brain or spinal cord infection)

* death

Diagnosis: According to CDC Dec. 16, 2014; if individual think that he/she might have syphilis, just seek medical attention or check with the doctor as soon as possible. The doctor will take a blood or urine sample to run the tests. If a sore is present, the doctor will take a sample from the sore to determine the present of the bacteria. If a doctor suspects that the patient is having nervous system problems because of tertiary syphilis, the patient may need a spinal tap. During this procedure, the spinal fluid would collect it so that the doctor can test for bacteria. Since the bacteria can be in the body without knowing it, the doctors will often screen pregnant women for syphilis to prevent the fetus from being infected with congenital syphilis. Congenital syphilis can cause severe damage in a newborn and it can even be fatal as indicated by the World Health Organization (WHO, 2014). 

Treatment: Primary and secondary syphilis are easy to treat with a penicillin injection. Penicillin is one of the most widely used antibiotics. It is usually effective in treating syphilis. People who are allergic to penicillin will be treated with a different oral antibiotic, such as tetracycline. Those who are suffered from Neurosyphilis will get daily doses of IV administered penicillin. This will often require a brief hospital stay. Unfortunately, the damage caused by late syphilis cannot be reversed. The bacteria can be killed, but treatments will most likely focus on easing pain and discomfort.During the treatment, the patient needs to avoid all sexual contact until all sores on the body are healed. If patient is sexually active, the partner should be treated as well and should not resume sexual activity until both partner’s treatment are complete it (Mayo Clinic, 2014).  

Prevention: The best way to prevent syphilis is to practice safe sex period. Using condoms during any type of sexual activity is a good idea. In addition, it is helpful to:

* avoid having sex with multiple partners

* use a dental dam (square piece of latex) or condoms during oral sex

* avoid sharing sex toys 

* get screened for sexually transmitted infections and talk to your partners about their results 

Syphilis can also be transmitted through shared needles. Avoid sharing needles if someone is using drugs. Drinking too much or doing recreational drugs can cause person to make unsafe sexual decisions. 

Complications

Pregnant Mothers and Newborns: According to CDC, 2014, Mothers infected with syphilis are at risk for miscarriages and premature births. There is also risk that an infected mother will pass the disease on to her fetus. This is known as congenital syphilis and babies born with congenital syphilis can suffer from the following:

* death

* deformities

* developmental delays

* seizures

* rash

* fever

* swollen liver/spleen

* anemia

* jaundice

* infectious sores

If congenital syphilis goes undetected, then a baby could develop late stage syphilis. This could lead to major damage in their bones, teeth, eyes, ears, and brains. World Health Organization (WHO, 2014) indicated that people with syphilis have a significantly increased chance of getting HIV/AIDS. Because of sore area, the virus will have opportunity to gain entrance to the human body through sores. It is also important to note that those with HIV may experience different syphilis symptoms than those who do not have HIV. If person has HIV, talk to the doctor about how to recognize syphilis symptoms.

Screening Testing: The first stage of syphilis can easily go undetected, and the second stage symptoms are common to other illnesses. This means that if symptom falls into any of the following categories, one should probably be tested for syphilis. It does not matter if person have ever had any symptoms. 

Person must test if:

* had unprotected sex with someone that might have had syphilis

* are pregnant

* are a sex worker

* have exchanged sex for drugs

* are in prison

* have had unprotected sex with multiple people, or have a partner who has done so 

If person’s test comes back positive, it is important to complete full treatment to avoid antibiotic resistant. The person has to finish all antibiotics as it prescribed by the doctor even though the symptom is disappeared. Avoiding all sexual activity until the doctor tells the patient that it’s ok to do so. One might also consider being tested for HIV;  most often people who have tested positive for syphilis should notify to all of their recent sexual partners so that they can also get tested and receive treatment. According to Epidemiologic studies demonstrate that sexually transmitted diseases (STDs) including syphilis, and particularly genital ulcers associated with primary syphilis, are associated with an increased risk of HIV acquisition (Christopher & Gail June 2006).  Latex male condoms, should use consistently in a correctly ways because it can reduce the risk of getting or giving syphilis. This is the best way to avoid syphilis or being in a long-term mutually monogamous relationship with a partner who has been tested and known to be uninfected.

References

Centers for Disease Control and Prevention. (Dec. 16, 2014). Sexually transmitted disease surveillance, 2013. Atlanta, GA: U.S. Department of Health and Human Services.

Centers for Disease Control and Prevention.(CDC). (2006). Primary and Secondary Syphilis – United States, 2003—2004. MMWR;55(269-272).

Christopher S. H & Gail Bolan. (June, 2006). Genital ulceration as a risk factor for human immunodeficiency virus infection.AIDS.2(1):47-50. University of California San Francisco and the California Department of Health Services STD Control Branch.

Mayo Clince. (2014). Retrieval by http://www.mayoclinic.org/diseases-conditions/syphilis/basics/symptoms/con-20021862.

Oregon Public Health Division. (2011). Syphilis in Oregon and stages statewide

mandatoryreporting of caseshttp://public.health.oregon.gov

World Health Organization. (WHO). (2014). Global guidance on criteria and processes for validation: Elimination of Mother-to-Child Transmission of HIV and Syphilis

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