Syphilis: Symptoms, Risks, and Effective Prevention Tips

Syphilis is a sexually transmitted infection (STI) caused by a bacterium called Treponema pallidum. It starts with the appearance of painless ulceration in the penis, vagina, or anus. If left untreated, syphilis can cause serious health problems, affecting the heart and brain. Syphilis was a major cause of disability and death, but it is much less common since the discovery of antibiotics in 1945. The disease is uncommon in the US but the number of people infected has increased significantly since 2007, which suggests that people do not protect themselves adequately during sex. According to the CDC, this rise in the rate of reported cases of syphilis has been attributed to increased cases among men, gay men, bisexuals, and other men who have sex with men (MSM).

Causes of Syphilis

Syphilis can be transmitted through oral, genital, or anal sex with an infected partner. More rarely, it can be spread through the exchange of needles or through a skin lesion. Finally, it can be passed from mother to child during pregnancy.

Transmission occurs when the bacteria enter the body through mucous membranes or minor cuts in the skin, often unnoticed. For instance, a person may contract syphilis from contact with a syphilitic sore, which occurs primarily in the genital area but can also be found in the mouth or rectum. Understanding these mechanisms is crucial for effective prevention.

Possible Complications

Untreated syphilis can be very destructive and lead to many complications such as internal or external damage, serious cardiovascular and mental health problems. It can, in some cases, lead to death. Having syphilis also increases your chances of getting HIV.

Complications can arise at different stages of the disease. For example, during the tertiary stage, cardiovascular syphilis can lead to life-threatening conditions like aneurysms or aortic valve disease. Neurological effects can range from mild cognitive changes to severe conditions like paralysis or blindness. Congenital syphilis can cause miscarriage, stillbirth, or infant death shortly after birth.

When to Consult a Doctor?

If you’ve had unprotected risky sex, or if you notice ulcers, redness, or pimples on your genitals, see your doctor for the appropriate screening tests. Early detection is key in managing syphilis effectively, and a simple blood test can diagnose the infection.

Symptoms of Syphilis

Syphilis has 3 stages as well as a latency period. The primary, secondary, and early latent stages of syphilis are considered infectious. Each stage has different symptoms.

Primary Stage

Symptoms first appear 3 to 90 days after infection, but usually 3 weeks. At first, the infection takes on the appearance of a red pimple; the bacteria then multiply and eventually create a painless ulcer (s) at the site of infection, usually in the genital, anal, or throat area. This ulcer is called a syphilitic chancre. It may be visible on the penis but easily hidden in the vagina or anus, especially as it is painless. Most people who are infected develop only one chancre, but some develop more than one; eventually, the sore heals on its own within 1 to 2 months. If it has not been treated, however, this does not mean that the infection is cured.

Secondary Stage

When untreated, syphilis progresses. 2 to 10 weeks after the onset of ulcers, the following symptoms occur:

• Fever, fatigue, headache, and muscle pain
• Hair loss (alopecia)
• Redness and rash on the mucous membranes and skin, including on the palms of the hands and soles of the feet
• Inflammation of the lymph nodes
• Inflammation of the uvea (uveitis), the blood supply to the eye, or the retina (retinitis)

These symptoms may go away on their own, but that does not mean the infection is cured. They can also appear and reappear intermittently, for months or even years. This stage is crucial for intervention, as the disease is highly contagious during this period.

Latency Period

After about 2 years, syphilis goes into a latent state, when no symptoms appear. However, the infection can still develop. This period can last from 1 year to 30 years. During this time, the infection is less likely to be transmitted to others, but it can still cause damage to the body.

Tertiary Stage

If left untreated, 15-30% of people infected with syphilis will suffer from very serious symptoms which in some cases can even lead to death:

• Cardiovascular syphilis (inflammation of the aorta, aneurysm or aortic stenosis, etc.)
• Neurological syphilis (stroke, meningitis, deafness, visual disturbances, headache, dizziness, change in personality, dementia, etc.)
• Congenital syphilis. Treponema is transmitted from the infected mother through the placenta and will lead to spontaneous abortions, neonatal death. Most affected newborns will not have any symptoms at birth, but they will appear within 3 to 4 months
• Gum (gingiva): destruction of tissue in any organ

Understanding these stages is critical for both patients and healthcare providers, emphasizing the importance of early and consistent treatment.

People at Risk of Syphilis

• Men who have sex with other men
• People who have unprotected sex
• People who have multiple sexual partners
• People with HIV or other STIs
• People who inject drugs and their partners

These groups are at increased risk due to higher rates of exposure and potential for transmission. However, syphilis can affect anyone who is sexually active, making universal precautions and awareness vital.

Prevention of Syphilis

Prevention aims to reduce the incidence of syphilis by preventing the transmission of the bacteria. Basic preventive measures include:

Using Condoms Correctly

Correct and consistent use of condoms helps prevent the transmission of syphilis during anal or vaginal sex. Condoms or dental dams can also be used as a means of protection during oral sex. However, it’s important to recognize that while condoms reduce the risk, they do not eliminate it entirely, as syphilis sores can be located in areas not covered by a condom.

Screening Measures

• Systematic screening for syphilis at the 1st pregnancy visit: Given the resurgence of syphilis in the United States and Europe, systematic screening is essential for all pregnant women. Early detection can prevent congenital syphilis.
• Screening after unprotected sex: Getting tested helps prevent the infection from being passed on to new partners. In the event of a positive result, inform anyone you have had sex with who may have been exposed. This person will need to be tested and treated, if necessary. Syphilis can be detected with a blood test.

Regular testing is an important part of sexual health, especially for those in high-risk groups. Testing is available at most healthcare facilities, and many community health organizations offer free or low-cost testing.

Medical Treatments of Syphilis

Syphilis is treated with antibiotics, usually penicillin, by intramuscular injection. If you are allergic to penicillin, other antibiotics are available. If the infection has lasted for less than 1 year, a single dose may be sufficient. Further blood tests will be done after treatment to check if the antibiotics had worked. People who are immunosuppressed, especially those with HIV may need longer treatment.

Treatment is most effective in the early stages of the disease, highlighting the importance of early diagnosis. Patients should follow their healthcare provider’s recommendations and complete the full course of antibiotics to ensure eradication of the infection.

Living with Syphilis

Living with syphilis requires ongoing management and monitoring, especially if diagnosed in the later stages. Here are some practical tips for managing the condition:

• Regular Follow-Ups: After initial treatment, regular follow-up blood tests are necessary to ensure the infection has been cured and to check for any signs of relapse.
• Informing Partners: It’s crucial to inform sexual partners about the infection so they can also get tested and treated if necessary. Open and honest communication is key to preventing further spread.
• Safe Practices: Continue practicing safe sex to avoid reinfection and protect partners.

Common Misconceptions

Misconceptions about syphilis can lead to stigma and fear, which may prevent individuals from seeking testing and treatment. Some common myths include:

• “Syphilis is rare and only affects certain groups.” While certain populations may have higher rates, syphilis can affect anyone who is sexually active.
• “If symptoms disappear, the infection is cured.” Symptoms may resolve on their own, but the infection remains active and can cause severe complications if left untreated.
• “Syphilis can be self-treated with over-the-counter medications.” Syphilis requires prescription antibiotics and management by a healthcare professional.

The Role of Public Health

Public health initiatives play a crucial role in controlling syphilis. Efforts include:

• Education and Awareness Campaigns: Increasing public awareness about syphilis, its symptoms, and prevention methods can encourage more people to engage in safe sex practices and seek testing.
• Access to Testing and Treatment: Ensuring that testing and treatment are accessible and affordable for all individuals, especially in high-risk communities.
• Partner Notification Services: Supporting services that assist in notifying sexual partners of possible exposure, thereby reducing the spread of the infection.

The Importance of Community Support

Community support is vital in combating syphilis and supporting those affected. Engaging with local health organizations, support groups, and online forums can provide valuable resources and a sense of community for individuals dealing with the infection.

Final Thoughts

As syphilis rates continue to rise, understanding the disease, recognizing its symptoms, and knowing how to prevent and treat it is more important than ever. Armed with knowledge and resources, individuals can protect themselves and their communities from this potentially devastating infection. Remember, regular testing, safe practices, and open communication with partners are key components in the fight against syphilis.