What you should know about Syphilis

Syphilis has not gone away, and in some places it is on the rise. During the 16^th and 17^th centuries, there was a rebirth of humanism and the arts which engulfed Europe. It was accompanied by a loosening of sexual restrictions which had previously been observed.  The Protestant Reformation, led by Martin Luther, John Calvin, and others, generally advocated less negative attitudes toward sexual matters than the Catholic Church did. For example, although Luther was hardly liberal in his sexual attitudes, he thought that sex was not inherently sinful and that chastity and celibacy were not signs of virtue. At the same time, Europe was caught in a massive epidemic of syphilis – which might have worked to limit sexual freedom.

Syphilis is a spiral-shaped microorganism, Treponema pallidum, discovered in 1905. 

This photomicrograph of Treponema pallidum bacteria was taken from a tissue section. From Hardin Library for the Health Sciences, University of Iowa.

Syphilis is usually transmitted by sexual contacts, but it can also be acquired from blood transfusion or transmitted from a pregnant mother to the fetus.

The earliest sign of syphilis in its primary stage is a sore called a chancre (pronounced “shanker”). The chancre generally appears two to four weeks after infection. The most common locations for the chancre in 75 percent of cases, are the genitals and anus, but it can also develop on the lips, in the mouth, on a finger, on a breast, or on any part of the body where the bacteria can enter the skin.  The chancre begins as a dull-red spot which develops into a pimple. The pimple ulcerates, forming a round or oval sore usually surrounded by a red rim. The chancre usually heals within four to six weeks, leading to the erroneous belief that the “problem” went away.

                                                Primary stage chancre

Secondary syphilis is rare because it is mostly prevented by early medical intervention.  The second stage without treatment, begins anywhere from one week to six months after the chancre heals. The symptoms include a pale red or pinkish rash often found on the palms and soles, fever, sore throat, headaches, joint pains, poor appetite, weight loss, and hair loss. Moist sores called condyloma lata may appear around the genitals or anus and are highly infectious. The symptoms of this secondary stage of syphilis usually last three to six months but can come and go periodically. After all the symptoms disappear, the disease passes into a latent stage. At this stage the disease is no longer contagious, but the infecting microorganisms burrow their way into various tissues, such as the brain, spinal cord, blood vessels, and bones. Fifty to 70 percent of people with untreated syphilis stay in this stage for the rest of their lives. The remainder, pass on to the late syphilis stage.  It involves serious heart problems, eye problems, and brain or spinal cord damage. These complications can cause paralysis, insanity, blindness, and death.

Syphilis is usually diagnosed by a blood test. Although tests are not completely fool-proof in detecting the primary stage of syphilis, secondary syphilis can be diagnosed with 100 percent accuracy. Diagnosis also depends on a carefully performed physical examination looking for signs of primary or secondary syphilis. Chancre sores can be observed on male sex organs, and chancres of the cervix or vagina may be detected only by a pelvic examination. Examination of the fluid taken from a chancre under a special microscope will usually show the characteristic spiral-shaped organism.

Syphilis can easily be treated with one injection in its primary and secondary stages. Later stages of syphilis require treatment over a longer period of time, but the treatment is usually successful.

Persons who have been sexually exposed to someone with proven early syphilis should promptly seek medical help.