WHAT IS SYPHILIS?

It is a sexually transmitted infection caused by the bacteria Treponema pallidium.

HOW IS SYPHILIS TRANSMITTED?

• Unprotected sexual intercourse with an infected person (vaginal, anal, oral)
  
• Mother-to-child (transplacental infection)
  
• Blood transfusion with contaminated blood products (all blood donations are screened in the UK)
  
• Contaminated needle stick injury and sharing intravenous needles with an infected person

WHAT ARE THE STAGES OF SYPHILIS?

Syphilis is divided into:

A) Primary Syphilis

• Occurring from 9 to 90 days following infection
  
• Presents as a painless sore (called a chancre) usually on the penis, vulva or cervix

B) Secondary Syphilis

• Occurring a few weeks to up to 2 years after primary syphilis
  
• Presents with non-itchy rash, especially on palms and soles
  
• Lymph node enlargement
  
• Wart-like growths on the genitals and anus
  
• Other signs include hair-loss, mouth ulcers, liver and brain inflammation

C) Latent Syphilis

• No symptoms but the internal organs may continue to be affected by the disease
  
• Early latent syphilis - < 1 year after infection
  
• Late latent syphilis - > 1 year after infection

D) Tertiary Syphilis

• Occurring 5 to 30 years after secondary stage
  
• Presents with irreversible damage to vital organs such as brain (causing insanity) blood vessels and heart (causing heart failure) , nerve fibres and spinal cord (causing numbness and paralysis)

E) Congenital Syphilis

• Bone deformities
  
• Blindness
  
• Deafness
  
• Deformed facies
  
• Dental deformities
  
• Skin rashes
  
• Neonatal death

HOW IS SYPHILIS DIAGNOSED?

• Positive blood test (4 to 6 weeks after exposure) called the VDRL or RPR test (screening test)
  
• This has to be confirmed by a positive TPHA (confirmatory test)
  
• Secretions from the chancre or skin lesions in the secondary stage examined under dark-ground microscopy may reveal the bacteria

WHAT IS THE TREATMENT FOR SYPHILIS?

• Penicillin by injection is the best treatment
  
• Alternative antibiotics are available for patients who are allergic to penicillin
  
• In primary, secondary and latent syphilis adequate treatment will result in a complete cure
  
• In tertiary and congenital syphilis treatment can stop the progress of the disease but may not be able to restore full function or reverse permanent damage

WHAT SHOULD I DO?

• Seek medical treatment as soon as possible if you suspect you may be infected
  
• Inform your doctor of any drug allergy
  
• Refrain from sexual intercourse until you have completed treatment
  
• Go for repeat blood tests till your doctor confirms that you are cured
  
• Do not donate blood
  
• Ensure that your sexual partner(s) come for a check-up so that he/she can be treated early if found to be infected
  
• Reinfections can occur as there is no permanent immunity conferred by a previous infection

KEY FACTS

• Early detection and treatment ensures complete cure
  
• Remember to inform your examining physician if you have been treated for syphilis in the past
  
• Always practise safer sex with casual partners and prostitutes (sex workers)

WHAT IS SAFER SEX?

• This is sex without the exchange of body fluids, e.g. vaginal secretions or semen during sex
  
• Use condoms correctly and every time you have sex
  
• Do not consume alcohol before or during sex, this may impair your judgement