Syphilis

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidium. The infection is usually sexually transmitted, in which case it is called venereal syphilis. It may also be passed from an infected mother to her unborn child, in which case it is known as congenital syphilis. Syphilis has been uncommon since penicillin become widely available in the 1950s, although global syphilis statistics show that an estimated 10 million new infections still occur each year. An electron photomicrograph of two spiral-shaped Treponema pallidum bacteria.

Syphilis symptoms
The symptoms of syphilis are the same in men and women. They can be mild and difficult to recognise or distinguish from other STDs. Symptoms may take up to 3 months to appear after initial infection. Syphilis is a slowly progressing disease that has several stages. The primary and secondary stages of syphilis are very infectious.

Primary stage of syphilis

One or more painless ulcers (know as chancres) appear at the place where the syphilis bacteria entered the body. On average, this will be 21 days after sexual contact with an infected person. Chancres may be difficult to notice and are highly infectious. The usual locations for chancres are:

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On the vulva (outside the vagina) or on the cervix (neck of the womb) in women. On the penis in men. Around the anus and mouth (both sexes). Without treatment, the ulcers take between 2 and 6 weeks to heal.
The above image displays a chancre, and ulcer of primary syphilis on male and female genital.

If the infection is not treated at this point then it will progress to the secondary stage.

Secondary stage of syphilis

If the infection has not been treated, the secondary stage of syphilis will usually occur from 3 to 6 weeks after the appearance of chancres. The symptoms often include:

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A flu-like illness, a feeling of tiredness and loss of appetite, accompanied by swollen glands (this can last for weeks or months). A non-itchy rash covering the whole body or appearing in patches. Flat, warty-looking growths on the vulva in women and around the anus in both sexes. White patches on the tongue or roof of the mouth. Patchy hair loss. The Image shows Granulomatous reaction often found in During this stage syphilis is very infectious and may be sexually transmitted to a partner. These symptoms will usually clear up within a few weeks, but may re-occur for years.
secondary syphilis.

Treatment at any time during the first two stages of syphilis will cure the infection.

Latent and tertiary stages of syphilis

If a person infected with syphilis has not received treatment during the first two stages of the disease then it will progress to the latent stage. The person will no longer experien ce any symptoms of the earlier stages, but their infection can still be diagnosed with a blood test.

If left untreated, the infection may develop into symptomatic late syphilis, also known as the tertiary stage. This usually develops after more than 10 years and is often very serious. It is at this sta ge that syphilis can affect the heart and possibly the nervous system.

The upper right shows Tertiary syphilis on the tongue of adult male patient. The upper left shows Aortic aneurysms associated with tertiary syphilis occur almost always in the thoracic aorta and more often, in the ascending portion.

If treatment for syphilis is given during the latent stage the infection can be cured. However, any heart or nervoussystem damage that occurred before the start of treatment may be irreversible.

Congenital syphilis
Untreated syphilis during pregnancy can lead to stillbirth, neonatal death, or infant disorders such as deafness, neurologic impairment, and bone deformities

Cutaneous lesion of congenital syphilis; Syphilis Hutchinson's teeth, a late manifestation of congenital syphilis.; the last image shows the face of a patient with congenital syphilis.

How syphilis is passed on

Syphilis can be transmitted through direct contact with a syphilis sore. The methods of transmission are:

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By having vaginal, anal or oral sex with someone who has the infection. From a mother to her unborn baby. Syphilis cannot be passed on by sharing baths, toilets, towels or eating utensils. The sexual behaviors that spread syphilis also spread other STDs, like HIV.

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Syphilis is easy to cure in its early stages. Signs and symptoms of syphilis include a firm, round, small, and painless sore on the genitals, anus, or mouth, or a rash on the body, especially on the palms of the hands or the soles of the feet. In 2008, 63% of the reported primary and secondary (P&S) syphilis cases were among men who have sex with men (MSM). uring 20042008, rates of P&S syphilis increased the most among 1524 year-old men and women.

Where to go for help

If you have any symptoms or you are worried you may have been infected with syphilis, you should discuss your worries with a doctor. They may be able to run tests or offer you treatment themselves, or else will refer you to someone who can. Some countries also have specific sexual health clinics that can help you directly.

The diagnosis of syphilis

To find out if someone has syphilis, a doctor will usually carry out the following examinations and tests:

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A blood sample is taken and sent to an STD testing laboratory. A specimen of fluid is taken from all sores using a cotton swab and examined under a microscope. The genital area is examined for any primary signs of syphilis. The rest of the body is also checked. Women are given an internal examination to check for sores. A sample of urine is taken. None of the examinations should be painful, but they may be slightly uncomfortable. The blood samples taken by the doctor are examined in a laboratory under a microscope to confirm a diagnosis. Various tests can be used on the blood sample. The most common and least expensive looks for antibodies. The examinations and tests can be done as soon as a person thinks they might have become infected with syphilis. If the result is negative then it is usually recommended that the person retests at a later time, as it can take up to 3 months for the immune system to produce the antibodies that are detected by the test.

Treatment for syphilis

Treatment for syphilis usually consists of a two-week course of intramuscular penicillin injections or, in some cases, antibiotic tablets or capsules. If the patient has had syphilis for less than a year then fewer doses will be needed. If the patient is allergic to any antibiotics, or if there is any possibility that they may be pregnant, then the doctor should be informed so that alternative medication can be prescribed. It is important that the full course of treatment is completed. If treatment is interrupted then it may be necessary to start again from the beginning. The patient will be asked about their sexual partners as it is important they are informed and tested as soon as possible. It is strongly advised to avoid any oral, vaginal or anal sex whilst having treatment, especially if the patient is in the early infectious stages of syphilis. Contact with any sores or rashes carries a risk of syphilis transmission. After the treatment is completed the patient will be asked to attend the clinic at regular intervals for blood tests to check that the syphilis has gone. Once a person has been treated and confirmed cleared of syphilis, 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. Treatment is only capable of killing the syphilis bacteria and preventing further damage. It cannot repair damage already done to organs, or prevent re-infection if the person is exposed to the bacteria again.

Prevention
Although using a condom reduces the chances of becoming infected with syphilis, it is not entirely effective. A condom may not cover all of the sores or rashes in the affected areas, and direct skin contact may result in transmission. If a person has sex regularly with multiple partners, then it is advisable for them to get frequent STD check-ups. A person can become re-infected with syphilis even if they have had effective treatment for a previous infection: past infection with syphilis does not make a person immune.

Interesting Facts
Famous people
Ivan the Terrible (1530-1584) is likely to have had syphilis. Typical lesions of syphilis were found in his bones when the Soviets exhumed his body. Infection would help explain his descent into madness that led him to kill thousands of people, including his son and heir. Lord Randolph Churchill, Winston Churchills father, was admitted to an insane asylum after he displayed symptoms of late-stage syphilis. Some researchers have suggested that Lenin (1870-1924), the Soviet founder of the Bolshevik political party, showed symptoms of syphilis.

Issue of Dr. Jose Rizal s life that is rarely discuss in school! (Dr. Jose Rizal had syphilis with Josephine Bracken)
Marie Josephine Leopoldine Bracken (August 9, 1876 March 15, 1902) was the common-law wife of Philippine national hero Jose Rizal. Before she met Rizal, Josephine Bracken was adapted by George Taufer and treated as a sex-slave. About 1893 Taufer lose his sight and desperately he came to Rizal. Within a short period Rizal concluded that Taufers condition could not to be cured and later it was found out that it was SYPHILIS.