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Syphilis

Please note that some of the language in this article is sexually explicit.

Syphilis:

This is one of the oldest STI’s (sexually transmitted infections) that has been recorded in history which has killed many victims over the years. In the past this has been one of the rarer STI‘s in the UK and in 2004, there were 2,254 cases diagnosed in GUM clinics, but recent reports have found that it is once again on the increase. It is an infection which is known to be passed from an infected mother to her unborn child. The damaging effects for the unborn child in growth and development, is why in the UK pregnant mothers are routinely screened. Rarely some children do contract this disease and it is called congenital syphilis which is divided into two categories late and early.

Congenital syphilis:

  • In Early congenital syphilis the baby may be of a low birth weight, with jaundice developing after about two to three weeks, the baby may have sores on the body or in the mouth and develop hepatitis.

  • In Late congenital syphilis the child will not be diagnosed until they are over two years old and will be suffering from various conditions impaired vision, facial abnormalities, deteriorating intelligence, seizures and skeletal disorders.

Syphilis is caused by the bacteria Treponema pallidum and is known by a variety of different names “cupids’ disease” “syph” “pox” and more controversially “French disease”. The disease itself is one which is difficult to diagnose as the symptoms are varied, closely resembling many other diseases.
The disease process is set out in four key stages:

  1. Primary Syphilis

  2. Secondary Syphilis

  3. Latent Syphilis

  4. Tertiary Syphilis

How is it transmitted?

The disease can make an appearance up to six months after the initial contact, and more worryingly some people do not develop symptoms until much later. Many of the sores (called chancres) which are small firm painless ulcerations, in the primary stage of syphilis go unrecognised as an STI .The chancres will disappear after three to six weeks, without any treatment leaving behind only a small scar. Therefore people who are unaware of the disease can easily and readily continue to infect others.

Contact is via penetrative sexual intercourse vaginal, anal or oral, the sores occur on the genitals, vagina, and vulva or around the anus or inside the rectum. They can also occur in the mouth or around the lips.

Symptoms:

Primary:

In the primary stage – single or multiple chancres appear around the sexual organs

Secondary:

In the secondary stage – The bacteria invades the body via the bloodstream, the rate at which the secondary stage begins varies from person to person some people can have the infection for years before the next set of symptoms appear. A person is highly contagious during the secondary stage.

  1. Flu –like symptoms - high temperature, feeling tired, aching muscles.

  2. Enlarged lymph glands

  3. Areas of hair loss

  4. A dark patchy rash which isn’t itchy and approximately 2cm across will appear in different areas all over the body. Characteristically the palms of the hands and the soles of the feet are involved in the rash. When the rash disappears and this can take up to three months, some discolouration of the skin may occur.

  5. Inflammation of other organs, such as liver and kidneys may become involved as the immune system attempts to stop the infection.

  6. Condyloma lata are wart like growths which are flat, smooth and moist which may occur around the genital area.

If the symptoms of this stage are not treated the latent stage of syphilis occurs.

Latent:

In the Latent stage- This is where the disease can go into a dormant phase and may remain that way, the infection still remains in the body where a third of all cases will proceed on to the tertiary phase.

Tertiary:

The Tertiary stage- In this stage, which can happen years after the initial syphilitic encounter, the irreversible internal damage to major organs occurs, the brain, heart eyes, bones, joints and liver are affected by destructive lesions which have developed  called Gummas. These are hard nodules which affect the body systems, skeletal, central nervous system, and cause areas of damage in each of the organs they have invaded.

Neurosyphilis:

Neurosyphilis is the name given to a small percentage of people who are in the tertiary phase of syphilis which are suffering from neurological damage caused by the disease. This damage can affect muscular movement and co-ordination affecting the ability to walk; it can cause strokes, along with degenerating mental abilities leading to dementia.

Diagnosis:

The doctor will adapt the diagnosis depending on the syphilitic stage you at. If you have a chancre / sore evident the doctor may take a biopsy from this as well as taking a blood sample. If you are in the latent stage of the disease you may possibly have a spinal fluid biopsy taken to assess the central nervous system involvement. These samples will be analysed in the laboratory and you will be informed of the results and treatment will be commenced. The treatment will be free and it is important to stress that returning to the clinic for follow ups is important.

Treatment:

Treatment is antibiotics in the primary and secondary stages of the disease, with follow up testing to ensure the disease has disappeared. The disease can be also treated with larger doses of antibiotics later however the damage to the internal organs may be permanent. Sexual intercourse should be avoided during treatment to prevent any further infections.
The health advisors at the clinic will be keen to locate your previous sexual partners due to the serious nature of this disease to offer them screening and treatment.

Prevention:

  • Always use condoms – they will offer a good degree of protection.

  • Use Oral Dams- These prevent the bacteria entering other orifices

  • Regularly examine yourself to be aware of what is “normal” for you.

  • Discuss your partners sexual history prior to engaging in sexual intercourse

  • If in doubt both partners should be tested  for STI’s prior to sexual intercourse
  • Multiple partners means multiple chances for you to contract an STI
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