Syphilis is a venereal disease caused by the bacterium Treponema pallidum. It is sexually transmitted and takes second place among the most dangerous STDs after HIV. It has four stages, among which primary and secondary are the most infectious. It is also transmitted from an infected pregnant mother to her child. Babies who are born from untreated syphilitic mothers are either stillbirths or are born with congenital syphilis. The symptoms of congenital syphilis include failure to gain weight, saddle nose, rashes of the mouth, genitals, and anus, as well as pain in the bone, Hutchinson's teeth, joint swelling and scarring of the skin. All of these conditions are proven to be dangerous to newborns.
The initial signs of syphilis are small and painless sores, which can be found on the sex organs, rectum, and even inside the mouth. The painless sores are known as "chancres". Since chancres are small and painless, many people fail to notice.
Diagnosing syphilis can be a challenging task. A person can be positive for syphilis and may not experience any signs or symptoms for years. However, it is best to diagnose such infection at its early stages so that it can be treated promptly. If syphilis remains untreated for a very long time, it can lead to severe damage to few important organs such as the heart and brain.
Syphilis can only be transmitted from direct contact with the chancres. It cannot be spread by sharing the same toilet with another person, wearing someone’s clothes, or by using someone’s personal things.
What are the stages of syphilis infection?
This stage develops after 3-4 weeks of coming in contact with the bacteria that causes the infection. The beginning of this stage is from the formation of tiny, round, and painless sores. These sores are very infectious. The sores are formed where the bacteria enters the body such as the mouth, genitals, or rectum. The sores appear on an average of three weeks after coming into contact with the infection. But at times, it can take up to 10-90 days and the sores will remain for 2-6 weeks.
In this stage, an infected person will experience rashes being formed on the skin and will develop a sore throat. The rashes do not cause itchiness and are mostly formed on the palms and soles. However, these skin rashes can be formed on any part of the body. Many people even fail to recognize the rashes since they do not itch at all.
Some of the other signs and symptoms of the secondary stage of syphilis include:
These symptoms will reduce over a period of time with or without treatment. However, the infection will still remain without proper treatment.
This is the third and hidden stage of syphilis. The symptoms of the primary and secondary stages will gradually reduce and disappear. In this stage, there will be no visible signs or symptoms. However, the person will still be infected with syphilis. At times, the symptoms of the secondary stage may reappear. But in many cases, a person may remain in the latent stage for years without being aware and will gradually move to the tertiary stage.
This is the final stage of syphilis and around 15-30 percent of patients who do not receive treatment in the first three stages progress to this stage. A person may enter this stage after many years of having the infection. This stage can be life-threatening and some of the other complications of this stage are:
- Mental disorders
- Loss of memory
- Damage to the soft tissues and bones
- Neurological problems like stroke
- Heart problems
- Neurosyphilis (an infection of the brain or spinal cord due to syphilis)
More than 90 percent of syphilis cases are found in developing countries, and there are thousands of new cases each year. There are 700,000 cases of pregnant women being affected by syphilis, and among them, perinatal deaths have numbered up to 20 percent in the Sub-Saharan Africa. Earlier in the 18th and 19th century, syphilis is very common in Europe, and currently, it continues to be one of the major problems in the United States. From the year 2000, syphilis increased primarily in men, mostly in the UK, Australia, Canada, and the USA. Syphilis rates have remained stable in women and the rate is less than that of men.
How is syphilis diagnosed?
If a person suspects that he or she is suffering from syphilis, then it is necessary to consult the doctor for a proper diagnosis and treatment. The doctor will recommend the patient to undergo a blood and urine test, and will also conduct a physical examination. In case the patient has sores on the body, the doctor will take a sample of the sore to test if there is a presence of the syphilis bacteria.
In cases where the doctor suspects that the patient is suffering from nervous system issues since the patient has already progressed to the tertiary stage, the patient will have to undergo a spinal tap or lumbar puncture. In this procedure, the fluid from the spinal cord is tested to check the presence of the syphilis bacteria.
If the patient is pregnant, the doctor will conduct a screening to check if there are syphilis bacteria anywhere in the body. If the bacterium is present, the fetus may get infected.
What are the complications associated with syphilis?
Expecting mothers and newborn babies
Pregnant women who get infected with the syphilis bacteria are at a greater risk of miscarriages, stillbirths, and premature births. There is also a possibility that the mother can transfer the infection to her baby. This condition is known as congenital syphilis, which is a serious disease that can be very fatal. Children who are born with this condition can suffer from the following problems:
- Physical deformities
- Slow development
- Inflamed liver or spleen
In cases where congenital syphilis was not detected in the child, the infection will progress to the last stage of syphilis, and there can be damage to the bones, teeth, eyes, ears, and brain.
Patients suffering from syphilis are at a higher risk of getting HIV. The reason is that HIV can easily enter the body from the sores caused by syphilis. Patients who are HIV-positive may experience a different set of syphilis symptoms compared to those without HIV.
When should one test for syphilis?
The primary stage may go unnoticed by many people. Moreover, the symptoms that a person suffers from in the secondary stage can be linked to many other illnesses. Thus, if anyone experiences some of the symptoms mentioned in the primary and secondary stage, then it is important to consult a doctor and get tested for syphilis. Even if you do not have any of the symptoms, it is still better to get tested in the following cases:
- If you had unprotected sex with a person who may be infected with syphilis
- Have had multiple sexual partners
- If you are pregnant
- If you are a sex worker
- If you had sex in exchange for drugs
- If you are in prison
- If you had a partner who has had unprotected sex with multiple people
- Men having sex with men
If the person turns out to be positive for syphilis, it is very important to complete the treatment. It is extremely important to complete the entire course of antibiotics as prescribed by the doctor for a complete cure. One should not discontinue the antibiotic course even if the symptoms have disappeared. Also, avoid any sexual activity until the doctor declares it is safe. Along with syphilis, also get tested for HIV.
Those who test positive for syphilis should inform their sexual partners so that they can also get themselves checked and be treated if tested positive.
Is syphilis curable?
Yes, syphilis is absolutely curable. Antibiotics are prescribed to treat syphilis because the causative agent is a bacterium. Treatment may vary according to the different phases of the disease. Broadly speaking, a single dose of penicillin G is the first option of treatment for early infections. The dose is given through an intramuscular injection.
However, penicillin cannot be given to pregnant women due to possible allergic reactions and birth defects it may bring. Doxycycline and tetracycline can be administered instead.
In the case of late infections, intravenous injections of penicillin have to be given for at least 10 days. If penicillin cannot be used due to allergies or antibiotic resistance, then ceftriaxone can be given as an alternative. However, the tertiary stage of syphilis can be very difficult to treat since the bacteria has already invaded most of the vital sites in the body.
What are the adverse effects of treatment?
All medications have some side effects. Some adverse effects of syphilis treatments are so severe that emergency help is required, such as anaphylactic shock due to a severe allergic reaction, severe cramps, and unusual bleeding.
Some common side effects that do not require medical attention are diarrhea, headache, mouth sores, and vaginal discharges. Another common adverse effect is the Jarisch-Herxheimer reaction, which is characterized by fever and headache. Such reaction in the body happens when there is a lot of bacteria destroyed by the antibiotics. It occurs within eight hours of the first treatment with antibiotics.
In pregnant women, certain medications can harm the fetus. For this reason, other vitamins, herbs, and certain supplements might be worth considering.
What are the preventive measures?
It is always better to prevent the disease because even the most advanced methods of diagnosis can fail in detecting syphilis, mostly due to the unawareness or negligence of people affected by syphilis, awkward places of chancres, and the absence of syphilis symptoms.
Prevention, often in the case of sexually transmitted infections, can be up to 100 percent effective, which are far better odds than congenital syphilis gives to newborn babies. There are several ways to prevent syphilis such as avoiding sexual contact with an infected person and avoiding sex with multiple partners.
The Centers for Disease Control and Prevention advises those who may be at risk of syphilis to have a committed sexual relationship with an uninfected person. Also, to avoid any kind of complications in pregnancy, a complete workup should be done while the mother is planning her pregnancy.
The early diagnosis of syphilis in a pregnant mother within the third trimester can help to completely cure the disease and prevent congenital syphilis.
The science behind the cure
Stating that syphilis is curable may not be entirely true without evidence. Syphilis, as we know, is a deadly disease that is transmitted sexually. However, its control and cure lie in the diagnosis and extent of damage it has done to the body. If a patient infected with syphilis reaches a state of organ damage, blindness, or other serious health conditions, the infection will likely to get worse despite treatment.
Syphilis is curable to the best extent possible on a case-by-case basis. While some patients who have initial symptoms such as rashes or sores reach out for treatment, and if the underlying disease is not severe, topical applications and treatments can completely get rid of the infection. These treatments are done in conjunction with proper medication and diet therapy.
In the case of tertiary syphilis, curing the infection would be impossible as this phase often leads to nerve or brain damage. Moreover, if still left untreated, the infection could even result in death. At the first symptom or sign, one must practice extra caution to observe the surfacing of more rashes and sores in the different parts of the body, especially the genital areas.
Even if it is a very mild or initial attack, such symptom must not be ignored. The problem with syphilis is that it can remain dormant for a long period of time. The symptoms can suddenly flare-up after a long span of time and later manifest themselves in severe forms. At this point, taking care of the patient and handling of the eruptions can be very challenging.
Putting off treatment for syphilis under the assumption that it is curable at any time, and ignoring immediate treatment could prove to be detrimental to one's health. Not everyone catches the rash streak at the first instance.
The test results for syphilis could take some time. Thus, it is very important to understand the stages of syphilis and wait for the doctor's diagnosis if your condition is curable or not based on diagnostic test results.