What is syphilis?
Syphilis is a sexually transmitted disease caused by bacteria called Treponema pallidum. Unless treated, it can cause heart and brain damage, even death. Pregnant women can pass the infection to their unborn babies.
How is syphilis spread?
Syphilis is spread by direct contact with primary stage lesions of the skin, mucous membranes, and bodily fluids (e.g., saliva, semen, blood, vaginal discharges) of infected people during sexual contact. Transmission can occur through blood transfusion if the donor is in the early stages of the disease, or by sharing needles with an infected person. Fetal infection usually occurs through placental transfer (from the mother to the baby before the baby is born), or at delivery.
What are the symptoms?
Syphilis is characterized by progressive stages. Most people with syphilis are treated early and do not progress to the later stages.
- Primary syphilis: the typical sore (chancre) of primary syphilis is solitary, usually painless and covered by a scab, or it may look like an area of erosion or an ulcer with a raised border, like a blister or a pimple. It disappears in three to five weeks, but if the disease is untreated, the person is still contagious and still has the disease.
- Secondary syphilis: patients with secondary syphilis may have a painless rash on his or her body, especially the palms of the hands or the soles of the feet. The person may have hair loss from the scalp, eyebrows, or pubic area. The patient may also have headache, nausea, weight loss, mild fever and general malaise. Syphilis can also be spread at this stage.
- Latency: this stage of syphilis has been divided into early latency and late latency. An individual who has had syphilis for a year or less is considered to have early latent syphilis. An individual who has had syphilis for one year or more is considered to have late latent syphilis. Although no symptoms occur in the latent stages, the organism is still present in the body.
- Late syphilis: during this stage, an individual is no longer contagious. However, heart problems, central nervous system damage, blindness, and even death may take place during this stage.
How long can an infected person spread syphilis?
Transmission is most likely to occur during the first year of infection. An infection that has persisted for more than four years is rarely communicable. The exception is an untreated pregnant woman who may transmit syphilis to the fetus regardless of the duration of her disease.
How is syphilis diagnosed?
Serologic tests of blood and cerebrospinal fluid (CSF) may be used for laboratory diagnosis. A dark-field examination of all genital ulcerative lesions can also be useful. Syphilis has been called the "great imitator" because so many of the signs and symptoms are indistinguishable from those of other diseases.
What is the treatment for syphilis?
Intramuscular penicillin is the preferred drug for treatment of all stages of syphilis. Adequate treatment for the mother early in pregnancy can prevent infection of the fetus.
What are the complications of untreated syphilis?
- Central nervous system damage (neurosyphilis, optic atrophy, hearing loss, etc.).
- Heart problems (aortic aneurysm, coronary artery disease, aortic valve disease).
- Spontaneous abortion or stillbirth.
- Congenital syphilis (the transmission of the bacteria from an infected mother to her infant). This is a very serious condition that can result in the death of the infant, or in serious and permanent damage to the infant.
How can syphilis be prevented?
Some general guidelines apply:
- You can reduce your risk of getting syphilis by not having sex with anyone or by having sex only with one uninfected partner who has sex only with you.
- Regular examinations for sexually transmitted diseases are advised when unprotected sex is practiced.
- Patients should avoid sexual intercourse until therapy is completed by both themselves and their sexual partners to minimize the risk of reinfection.
- Individuals should seek medical treatment when symptoms are present, even if these are mild symptoms.
Where can I get more information?
- Your personal doctor.
- Your local health department listed in your telephone directory.
- The Utah Department of Health, Bureau of Epidemiology (801) 538-6191
UTAH DEPARTMENT OF HEALTH
BUREAU OF EPIDEMIOLOGY