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What is syphilis?
How common is
people get syphilis?
What are the signs and symptoms in adults?
How does syphilis affect a pregnant women and her
What is the link between syphilis and HIV?
What is the treatment for syphilis?
can syphilis be prevented?
Where can I buy home test kits for contributing factors of this
What is syphilis? (top)
Syphilis is a sexually transmitted disease (STD) caused by the bacterium
Treponema pallidum. It has often been called “the great imitator”
because so many of the signs and symptoms are indistinguishable from
those of other diseases.
How common is syphilis? (top)
In the United States, health officials reported over 32,000 cases of
syphilis in 2002, including 6,862 cases of primary and secondary (P&S)
syphilis. In 2002, half of all P&S syphilis cases were reported from 16
counties and 1 city; and most P&S syphilis cases occurred in persons 20
to 39 years of age. The incidence of infectious syphilis was highest in
women 20 to 24 years of age and in men 35 to 39 years of age. Reported
cases of congenital syphilis in newborns decreased from 2001 to 2002,
with 492 new cases reported in 2001 compared to 412 cases in 2002.
Between 2001 and 2002, the number of reported P & S syphilis cases
increased 12.4 percent. Rates in women continued to decrease, and
overall, the rate in men was 3.5 times that in women. This, in
conjunction with reports of syphilis outbreaks in men who have sex with
men (MSM), suggests that rates of syphilis in MSM are increasing.
How do people get syphilis?
Syphilis is passed from person to person through direct contact with a
syphilis sore. Sores occur mainly on the external genitals, vagina,
anus, or in the rectum. Sores also can occur on the lips and in the
mouth. Transmission of the organism occurs during vaginal, anal, or oral
sex. Pregnant women with the disease can pass it to the babies they are
carrying. Syphilis cannot be spread through contact with toilet seats,
doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or
What are the signs
and symptoms in adults?
Many people infected with syphilis do not have any symptoms for years,
yet remain at risk for late complications if they are not treated.
Although transmission appears to occur from persons with sores who are
in the primary or secondary stage, many of these sores are unrecognized.
Thus, most transmission is from persons who are unaware of their
The primary stage of syphilis is usually marked by the appearance of a
single sore (called a chancre), but there may be multiple sores. The
time between infection with syphilis and the start of the first symptom
can range from 10 to 90 days (average 21 days). The chancre is usually
firm, round, small, and painless. It appears at the spot where syphilis
entered the body. The chancre lasts 3 to 6 weeks, and it heals without
treatment. However, if adequate treatment is not administered, the
infection progresses to the secondary stage.
Skin rash and mucous membrane lesions characterize the secondary stage.
This stage typically starts with the development of a rash on one or
more areas of the body. The rash usually does not cause itching. Rashes
associated with secondary syphilis can appear as the chancre is healing
or several weeks after the chancre has healed. The characteristic rash
of secondary syphilis may appear as rough, red, or reddish brown spots
both on the palms of the hands and the bottoms of the feet. However,
rashes with a different appearance may occur on other parts of the body,
sometimes resembling rashes caused by other diseases. Sometimes rashes
associated with secondary syphilis are so faint that they are not
noticed. In addition to rashes, symptoms of secondary syphilis may
include fever, swollen lymph glands, sore throat, patchy hair loss,
headaches, weight loss, muscle aches, and fatigue. The signs and
symptoms of secondary syphilis will resolve with or without treatment,
but without treatment, the infection will progress to the latent and
late stages of disease.
The latent (hidden) stage of syphilis begins when secondary symptoms
disappear. Without treatment, the infected person will continue to have
syphilis even though there are no signs or symptoms; infection remains
in the body. In the late stages of syphilis, it may subsequently damage
the internal organs, including the brain, nerves, eyes, heart, blood
vessels, liver, bones, and joints. This internal damage may show up many
years later. Signs and symptoms of the late stage of syphilis include
difficulty coordinating muscle movements, paralysis, numbness, gradual
blindness, and dementia. This damage may be serious enough to cause
does syphilis affect a pregnant woman and her baby? (top)
The syphilis bacterium can infect the baby of a woman during her
pregnancy. Depending on how long a pregnant woman has been infected, she
may have a high risk of having a stillbirth (a baby born dead) or of
giving birth to a baby who dies shortly after birth. An infected baby
may be born without signs or symptoms of disease. However, if not
treated immediately, the baby may develop serious problems within a few
weeks. Untreated babies may become developmentally delayed, have
seizures, or die.
How is syphilis diagnosed?
Some health care providers can diagnose syphilis by examining material
from a chancre (infectious sore) using a special microscope called a
dark-field microscope. If syphilis bacteria are present in the sore,
they will show up when observed through the microscope.
A blood test is another way to determine whether someone has syphilis.
Shortly after infection occurs, the body produces syphilis antibodies
that can be detected by an accurate, safe, and inexpensive blood test. A
low level of antibodies will stay in the blood for months or years even
after the disease has been successfully treated. Because untreated
syphilis in a pregnant woman can infect and possibly kill her developing
baby, every pregnant woman should have a blood test for syphilis.
What is the link
between syphilis and HIV? (top)
Genital sores (chancres) caused by syphilis make it easier to transmit
and acquire HIV infection sexually. There is an estimated 2- to 5-fold
increased risk of acquiring HIV infection when syphilis is present.
Ulcerative STDs that cause sores, ulcers, or breaks in the skin or
mucous membranes, such as syphilis, disrupt barriers that provide
protection against infections. The genital ulcers caused by syphilis can
bleed easily, and when they come into contact with oral and rectal
mucosa during sex, increase the infectiousness of and susceptibility to
HIV. Having other STDs is also an important predictor for becoming HIV
infected because STDs are a marker for behaviors associated with HIV
What is the treatment
for syphilis? (top)
Syphilis is easy to cure in its early stages. A single intramuscular
injection of penicillin, an antibiotic, will cure a person who has had
syphilis for less than a year. Additional doses are needed to treat
someone who has had syphilis for longer than a year. For people who are
allergic to penicillin, other antibiotics are available to treat
syphilis. There are no home remedies or over-the-counter drugs that will
cure syphilis. Treatment will kill the syphilis bacterium and prevent
further damage, but it will not repair damage already done.
Because effective treatment is available, it is important that persons
be screened for syphilis on an on-going basis if their sexual behaviors
put them at risk for STDs.
Persons who receive syphilis treatment must abstain from sexual contact
with new partners until the syphilis sores are completely healed.
Persons with syphilis must notify their sex partners so that they also
can be tested and receive treatment if necessary.
How can syphilis be prevented?
The surest way to avoid transmission of sexually transmitted diseases,
including syphilis, is to abstain from sexual contact or to be in a
long-term mutually monogamous relationship with a partner who has been
tested and is known to be uninfected.
Avoiding alcohol and drug use may also help prevent transmission of
syphilis because these activities may lead to risky sexual behavior. It
is important that sex partners talk to each other about their HIV status
and history of other STDs so that preventive action can be taken.
Genital ulcer diseases, like syphilis, can occur in both male and female
genital areas that are covered or protected by a latex condom, as well
as in areas that are not covered. Correct and consistent use of latex
condoms can reduce the risk of syphilis, as well as genital herpes and
chancroid, only when the infected area or site of potential exposure is
Condoms lubricated with spermicides (especially Nonoxynol-9 or N-9) are
no more effective than other lubricated condoms in protecting against
the transmission of STDs. Based on findings from several research
studies, N-9 may itself cause genital lesions, providing a point of
entry for HIV and other STDs. In June 2001, the CDC recommended that N-9
not be used as a microbicide or lubricant during anal intercourse.
Transmission of a STD, including syphilis cannot be prevented by washing
the genitals, urinating, and or douching after sex. Any unusual
discharge, sore, or rash, particularly in the groin area, should be a
signal to refrain from having sex and to see a doctor immediately.
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contributing factors of this condition