Baines aweful Medical Minute

Blame Daddyfatsack for this one:  (If I could, I would give myself a thumbs down for this one)

What is syphilis?

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 of syphilis are indistinguishable from those of other diseases.

How is syphilis spread?

The syphilis bacterium is passed from person to person through direct contact with a syphilis sore (also called a chancre). Sores occur mainly on the external genitals, in the vagina, on the anus, and in the rectum. Sores also can occur on the lips and in the mouth (areas covered by mucous membranes). Transmission of the bacterium occurs during vaginal, anal, or oral sex. Persons with either primary or secondary syphilis (early stages of the disease) can transmit the disease. Pregnant women with the disease can pass it to the babies they are carrying. Syphilis cannot be spread through casual contact, such as with toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils.

In the United States, health officials reported more than 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 aged 30 to 44. The occurrence of reported cases of P&S syphilis was highest in women 20 to 24 years in age and in men 35 to 39 years of age.

The number of reported P&S syphilis cases increased 12.4 percent between 2001 and 2002. In 2002 the rate of syphilis increased among men in the United States for the second year in a row. The P&S syphilis rate increased among men in all regions in the United States and in all racial/ethnic groups except non-Hispanic Blacks and American Indian/Alaska Natives. Rates among women continue to decrease, and overall, the rate among men was more than 3 times that among women.

Is there a cure for syphilis?

Yes, syphilis is easy to cure in its early stages. A single dose 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. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done. There are no home remedies or over-the-counter drugs that will cure syphilis.

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.

How can I protect myself from getting syphilis?

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 not infected.

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.

For persons whose sexual behaviors place them at risk for STDs, correct and consistent use of male latex condoms can help reduce the risk of syphilis transmission. However, genital ulcer diseases like syphilis are transmitted primarily through "skin-to-skin" or "surface-to-surface" contact from sores that may not be covered by condoms. Correct and consistent use of male latex condoms can reduce the risk of transmission only if infected areas or sites of potential infection are covered.

Condoms lubricated with spermicides containing 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.

Washing the genitals, urinating, and/or douching after sex does not prevent STDs, including syphilis. 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.

The CDC's 2002 Sexually Transmitted Diseases Treatment Guidelines recommend that MSM who are at risk for STDs be tested for syphilis annually. http://www.cdc.gov/mmwr/PDF/RR/RR5106.pdf

Where can I get more information?

Division of STD Prevention (DSTD)
Centers for Disease Control and Prevention
www.cdc.gov/std

Personal health inquiries and information about STDs:

CDC National STD and AIDS Hotlines
(800) 227-8922 or (800) 342-2437
En Espanol (800) 344-7432
TTY for the Deaf and Hard of Hearing (800) 243-7889

Primary Stage

The primary stage of syphilis is usually marked by the appearance of a single sore, but there may be multiple sores. The duration between infection with syphilis and the onset of the first symptoms can range from 10-90 days (average 21 days). The chancre is usually firm, round, small, and painless. It appears at the spot where the syphilis bacterium entered the body. The chancre generally lasts 3-6 weeks, and it heals with or without treatment. However, if adequate treatment is not administered, the infection will progress to the secondary syphilis.

Secondary Stage

The secondary stage of syphilis is characterized by skin rash and mucous membrane lesions. 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.

Late Stage

The latent (hidden) stage of syphilis begins when secondary symptoms disappear. Without treatment, the infection remains in the body. In the late stages of syphilis, the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints may subsequently be damaged. 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 death.

Resources:

CDC National Prevention Information Network (NPIN) P.O. Box 6003
Rockville, MD 20849-6003
1-800-458-5231
1-888-282-7681 Fax
1-800-243-7012 TTY
E-mail: info@cdcnpin.org
www.cdcnpin.org

American Social Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877
www.ashastd.org
STD questions: std-hivnet@ashastd.org

American College Health Association
P.O. Box 28937
Baltimore, MD 21240-8937
(410) 859-1500
www.acha.org

BLARG!