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
- 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
- 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