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Sexually Transmitted Diseases (STDs): Syphilis
FACT SHEET
What is syphilis?
Syphilis is a curable sexually transmitted disease (STD). It is caused by Treponema pallidum, a type of bacteria called a spirochete. The spirochete first causes a sore called a cancre and then spreads throughout the body. Syphilis progresses through four stages: primary, secondary, latent, and tertiary (late).
How many people get syphilis?
The rate of syphilis in the United States has been relatively low for many years with about 33,000 new cases annually. In Connecticut, the number of new cases has been rising steadily from 29 cases in 2003 to 64 cases in 2006.
How is syphilis transmitted?
Syphilis is passed from person to person through direct contact with a syphilis sore during oral, vaginal or anal sex. Because syphilis sores can be hidden in the vagina, rectum or mouth, it may not be obvious that a sex partner has syphilis. Transmission does not occur after the secondary stage of syphilis. A pregnant woman can also transmit syphilis to her unborn baby (congenital syphilis).
What are the symptoms of syphilis?
The first symptom of syphilis is a sore called a chancre, which can appear within 10 days to three months after exposure but generally within three weeks. Because the chancre is ordinarily painless and sometimes occurs inside the body, it may go unnoticed. It is usually found on the part of the body exposed to the bacteria, such as the penis, the vagina or the rectum. A chancre also can develop on the cervix, tongue, lips or other parts of the body. The chancre disappears within a few weeks regardless of whether treatment is obtained.
Secondary syphilis is marked by a skin rash that appears up to 10 weeks after the chancre heals. The rash may cover the whole body or appear only in a few areas, such as on the palms of the hands or soles of the feet. The rash usually heals within several weeks or months. Other symptoms — mild fever, fatigue, headache, sore throat, patchy hair loss and swollen lymph glands throughout the body — also may occur. These symptoms may be very mild and, like the chancre of primary syphilis, will disappear without treatment. The signs of secondary syphilis may come and go over the next one to two years.
The chancre (primary stage) and genital secondary rashes increase the risk of acquiring HIV, the virus that causes AIDS, by providing an accessible point of entry for HIV.
If untreated, syphilis then lapses into a latent stage during which the disease is no longer contagious and no symptoms are present. Many people who are not treated will suffer no further consequences of the disease. However, approximately one-third of those infected go on to develop the complications of late, or tertiary, syphilis in which the bacteria damage the heart, eyes, brain, nervous system, bones, joints or almost any other part of the body. This stage can last for years, or even decades. Late syphilis can result in mental illness, blindness, other neurological problems, heart disease and death.
How is syphilis diagnosed?
Syphilis has sometimes been called "the great imitator" because its early symptoms are similar to those of many other diseases. People who have more than one sex partner should consult a physician about any suspicious rash or sore in the genital area. Those who have been treated for another STD, such as gonorrhea, should be tested to be sure they have not also acquired syphilis.
There are three ways to diagnose syphilis: a physician's recognition of its signs and symptoms, microscopic identification of syphilis bacteria, and blood tests. Usually, these approaches are used together to detect syphilis and identify the stage of infection.
While blood tests can provide evidence of infection, they may give false negative results (not show signs of infection despite its presence) for up to three months after infection. In addition, blood tests for syphilis can sometimes be positive even though a person is not infected with the disease. Interpretation of blood tests for syphilis can be difficult and repeated tests are sometimes necessary to confirm the diagnosis.
What is the treatment for syphilis?
One to three injections of a special long-acting penicillin is the recommended treatment and the dose depends on how long a person has been infected with syphilis. Infants of untreated mothers are treated with a special kind of penicillin in IV form for 7 to 10 days in the hospital.
What are the complications of untreated syphilis?
Blindness, deafness, insanity, heart disease, partial paralysis (when you can't move) and numbness of the feet and hands. Personality changes, psychosis (serious mental illness), impotence (inability to have an erection), tumors of the bones and organs, all can result from untreated syphilis. These usually happen later in the disease, although they can occur early in the infection, especially for people who have an impaired immune system. Stillbirths are common among untreated mothers. Congenital syphilis (syphilis that a baby is born with) includes skin lesions and rashes, mucous patches, bone deformities, anemia (weak blood), jaundice (yellow skin caused by liver damage), inflammation of the lymph nodes, and brain damage.
Can syphilis be prevented?
Not having sex is the best protection against acquiring syphilis and other STDs. Having sex with only one uninfected partner who only has sex with you is also safe.
The open sores associated with syphilis may be visible and are infectious during the active stages of the disease. Any contact with these infectious sores must be avoided to prevent the spread of the disease. Latex condoms, when used consistently and correctly, can reduce the risk of syphilis and other STDs but only when the infected areas are covered or protected by the condom.
Testing and treatment early in pregnancy is the best way to prevent syphilis in infants and should be a routine part of prenatal care.
Where can I get more information?
Stamford Health Department offers a STD clinic on Mondays from 2 pm to 5 pm, Wednesdays and Fridays from 10:30 am to 11:45 am. It is a confidential clinic and no appointment is necessary. It is located at 141 Franklin St in Stamford. Please call Pauline Pochette at (203) 977-5933 for more information. For more information on STDs, visit the Centers for Disease Control and Prevention (CDC) website, http://www.cdc.gov.
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