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Syphilis

Syphilis is sexually transmitted infection (STI) caused by the spirochete bacterium Treponema pallidum. This disease can be passed to another person through kissing or close physical contact. The infected person is often unaware of the disease and unknowingly passes it on to his or her sexual partner.

The sexual behaviour  that spreads syphilis can also spread other Sexually transmitted diseases(STD's) like gonorrhea, HIVs.  

Stages of disease

The symptoms of syphilis develop in three stages, described below.

  • Stage 1 (Primary syphilis) – Symptoms of syphilis begin with a painless but highly infectious sore on the genitals or sometimes around the mouth. If somebody else comes into close contact with the sore, typically during sexual contact, they can also become infected. The sore lasts two to six weeks before disappearing.
  • Stage 2 (Secondary syphilis) – Secondary symptoms, such as a skin rash and sore throat develop. These symptoms may disappear within a few weeks, after which person may experience a latent (hidden) phase with no symptoms, which can last for years. After this, syphilis can progress to its third, most dangerous stage.
  • Stage 3 (Tertiary syphilis) – Around a third of people who are not treated for syphilis will develop tertiary syphilis. At this stage, it can cause serious damage to the body.

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The symptoms of syphilis are the same for men and women. Also symptoms are mild and thus can be difficult to recognize. 

The symptoms develop in three stages:

  • Primary syphilis
  • Secondary syphilis
  • Tertiary syphilis

Primary syphilis

The initial symptoms of syphilis can appear any time from 10 days to three months after one have been exposed to the infection.

The most common symptom is the appearance of a small, painless sore or ulcer (called chancre). The sore will appear on the part of  body where the infection was transmitted, typically the penis, vagina, anus, rectum, tongue or lips. Most people only have one sore, but some people can have more.

The sores are painless and may be overlooked, so the condition can be spread without realizing that have an infection.

The sore will then disappear within two to six weeks and, if the condition is not treated, syphilis will move into its second stage.

Secondary syphilis

The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore.

Common symptoms include:

  • A non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet
  • Tiredness
  • Headaches
  • Swollen lymph glands
Less common symptoms include:
  • Fever
  • Weight loss
  • Patchy hair loss
  • Joint pains

These symptoms may disappear within a few weeks, or come and go over a period of months.

Latent phase

Syphilis will then move into its latent (hidden) phase, where one will experience no symptoms, even though person  remains infected. Latent syphilis can still be passed on during the first year of this stage of the condition, usually through sexual or close physical contact. However, after a couple of years, one cannot pass the infection to others, even though he/she remain infected.

The latent stage can continue for many years (even decades) after person has first become infected.

Without treatment, there is a risk that latent syphilis will move on to the most dangerous stage – tertiary syphilis.

Tertiary syphilis

The symptoms of tertiary syphilis can begin years or even decades after initial infection. Around a third of people who are not treated for syphilis develop serious symptoms at this stage.

The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing any of the following symptoms:

  • Stroke
  • Dementia
  • Loss of co-ordination
  • Numbness
  • Paralysis 
  • Blindness
  • Deafness
  • Heart disease 
  • Skin rashes
  • At this stage, syphilis can be dangerous enough to cause death.

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Syphilis is caused by the bacteria Treponema pallidum.

The bacteria can enter one's body if he/she have close contact with an infected sore, normally during vaginal, anal or oral sex or by sharing sex toys.

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Physical examination:

The doctor will examine genitals. For men, it involves examining  the penis, foreskin and urethra (the hole at the end of the penis where urine comes out). For women, it involves an internal examination of the vagina. Both men and women may also have their anus examined.

Blood tests:

If one is infected with syphilis, then his/ her body produces antibodies (proteins released as part of immune response) against the syphilis bacteria.

Therefore, one way to determine whether one have syphilis is to have a sample of blood tested for the presence of these antibodies.

A positive result (antibodies present) indicates that one can  either have the infection or used to have it (because the antibodies can remain in the body for years, even after a previous infection was successfully treated).

A negative result does not necessarily mean that one does not have syphilis as the antibodies may not be detectable for three months after infection. Person may be advised to repeat the test in three months time.

Every pregnant woman should have a blood test for syphilis as the infection can kill unborn or newborn babies. The blood test is usually done during an antenatal appointment at weeks 11–20 of pregnancy. If the test is positive, treatment for both the mother and baby can begin.

 Venereal Disease Research Laboratory test (VDRL):

The VDRL test is a screening test for syphilis. It measures substances, called antibodies, that body may produce if a person comes in contact with the bacteria that causes syphilis. This bacteria is called Treponema pallidum.

Swab test

If sores are present, a swab (like a cotton bud) will be used to take a small sample of fluid from the sore. This is then either looked at under a microscope in the clinic or sent to a laboratory for examination.

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Penicillin, an antibiotic, injected into the muscle, is the best treatment for syphilis. If someone is allergic to penicillin, then healthcare provider may give another antibiotic to take by mouth.

In a later stage of disease, more doses of antibiotics will be needed.

Prevention refers to practices done to prevent the spread of syphilis.  Practices may be done by individuals to protect their own health:

  • 1) Protected physical contact through the use of condoms reduces the risk of infection
  • 2) Promoting sex-education among teen-agers
  • 3) Providing awareness among the population about their sexual health especially in high risks population (high risks population involves sex workers and their partners, Intravenous drug users, truck drivers, labor migrants, refugees and prisoners).

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  • CREATED / VALIDATED BY : NHP CC DC
  • LAST UPDATED ON : Feb 04, 2016

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