SYPHILIS.
When studies are released, there are some numbers
that you want to see increase. The latest number on the rise of syphilis cases
does not fall under that category. The Centers for Disease Control recently reported
a nearly 10 percent increase in the number of reported cases of syphilis in the
United States. The increase in the cases has been specifically noted in males
and is attributed to males having sexual relations with other males, but females
may also become infected. This increase is especially shocking because of all
of the education that has come on the heels of the AIDS epidemic. At a time when
the knowledge and talk of safe sex is at an all-time high, why are sexually transmitted
diseases also at an all-time high?
What is syphilis? Syphilis is a sexually transmitted disease
caused by bacteria
called Treponema pallidum. It has been called "the great imitator" over
the years because of its nonspecific symptoms, which can be indistinguishable
from other disease processes.
How does it occur? The bacteria are transmitted from
person to person by direct contact and may enter the body through the mouth,
rectum, vagina or a break in
the skin. The bacteria are released from an infected individual directed to another
person, thereby infecting that person.
It is important to understand that it is not through contact with toilet seats,
doorknobs, dinnerware, swimming pools, hot tubs or the sharing of clothing that
one may become infected. Women may pass the infection to unborn children through
the birth process. This is very serious, as the child may develop serious mental
and physical problems or even die.
What are the symptoms? Syphilis presents in three
stages and the primary stage occurs after 10 days of infection, lasting up to
three months. The initial complaint
may involve the development of a painless, soft, reddened sore called a chancre
(pronounced "shanker"). There may be one sore or multiple sores, but
the first sore is where the syphilis has entered the body. There may be some
other symptoms such as fever, body aches, swollen lymph nodes and loss of appetite.
If untreated, the chancre will disappear.
The second stage of the untreated disease is called the latent phase and many
of the physical signs and symptoms disappear; yet the disease can still be transmitted.
Some patients may develop a rash on the palms and feet, which can mimic several
other diseases. In addition, a person may continue to have nonspecific complaints
of fever, body aches and muscle pains. This stage may last for several months
to several years.
The final stage, which is called late, or tertiary syphilis is very serious and
results in permanent complications. These complications may include brain damage,
blindness, deterioration of the nerves and blood vessels, bone and joint damage,
as well as death. This may take several years to occur after the first infection,
which is usually undiagnosed.
How is it diagnosed? In the first stage, a health
care provider must be suspicious of the sore and perform a scraping to look for
the bacteria under a microscope.
There is also a blood test that can be performed. Unfortunately, the blood test
is not very sensitive in the early stages of the disease. It is really important
for the health care provider to obtain a comprehensive history with regard to
the exposure including sexual activity with possibly infected patients. Close
observation must occur if the health care provider is suspicious.
How is it treated? It may be unfortunate, but the
early stages of syphilis may be so mild that treatment may not be sought. Syphilis
is sensitive to penicillin
and is effectively treated with oral doses or shots. The ability to transmit
the disease stops within 24 hours of treatment, as the penicillin is very effective
in stopping the progression of the infection. Treatment is necessary for several
days.
Ongoing testing and reassessment is necessary in order to be sure that the disease
has been cured. Early treatment is necessary in order to prevent late complications.
Unfortunately, if syphilis is left untreated and organ damage occurs, there is
no reversing these permanent effects with penicillin.
What should I do? Prevention is the key, as with so
many illnesses. Safe sexual activity is important in order to prevent this infection
and other sexually transmitted
diseases. In the event that you are suspicious of a sore and have participated
in high-risk sexual activity, your health care provider must see you. You may
prevent life-long health complications.
