Danger level: Medium

What is it?

Syphilis is a sexually transmitted disease that has 4 stages.

Who gets it?

Syphilis used to be much more common – in 1941, before antibiotics were used extensively, there were 100,000 new cases (!). In 2004 that number was 7,980.

It affects African Americans more than white people (they are about 6 times as likely to get it), especially men. It affects men 11 times as much as women, and in terms of age it mostly occurs in the years when sexual activity is highest: 15-40 years.

There are some factors that can put someone at risk for getting syphilis:

1. Men having sex with men
2. High risk sexual activity – Such as not using a condom
3. Inmates in correctional facilities

What causes it?

Syphilis is caused by a germ called Treponema pallidum. It’s characterized by a spiral shape, like in this picture:

Treponema pallidum. What a beauty.

It’s transferred from person to person during sexual contact (but can also be transferred by skin contact, or in pregnancy from a mother to a child).

How does it feel?

Syphilis has 4 stages:

Primary Syphilis

After infection, the treponema germ grows and multiplies for about a month, after which a lesion appears on the site of infection (the penis, vagina, anus and even the lips and mouth). That lesion is painless, and it’s called a chancre. (We won’t put a picture of how it looks, since this is a family oriented site, but you can search Google Images for it).

Secondary Syphilis

The germ spreads throughout the body through the bloodstream. About 6-8 weeks after the initial infection, this stage occurs. What happens here?

1. Rash – A red-pink rash throughout the body. This rash is infectious – people with secondary syphilis are the most contagious. Those rashes usually heal by themselves if not treated, without leaving scars.
2. Other symptoms – Fever, sore throat, weakness, loss of appetite, weight loss, headache. Sounds familiar? That’s because these things can happen in many other diseases as well, which gave syphilis the nickname “the great imitator”.

The rash in secondary syphilis. It can be found on the palms of the hands and soles of the feet as well, like in this picture.

Latent Syphilis

At this period, there are no symptoms at all.

Tertiary Syphilis

This is the third stage of the disease. It happens in about 1/3 of people with syphilis and can occur anywhere between a year after infection to many years (even 50) later. There are a few things than can happen in this stage:

1. Gummas – These are soft masses which can appear almost anywhere on the body. They grow and heal slowly, and they leave scars.
2. Syphilis of the bone – This causes lesions in the bones that cause pain, mostly at night.
3. Heart and blood vessel involvement – This can cause problems with the aorta or with the blood vessels supplying the heart.
4. Neurosyphilis – This can cause all sorts of neurological problems, like meningitis (inflammation of the brain coverings), problems with the brain’s blood vessels (which can lead to stroke), problems with the brain itself (causing behavioral problems resembling a mental disorder or dementia) and problems with the spine (causing pain and problems walking, among other things).

How is it discovered?

The disease is discovered by a simple blood test, that checks for the presence of antibodies (molecules that fight diseases in our body) directed against that germ. Also looking at the germ through a microscope will prove the existence of the disease.

How is it treated?

Syphilis is treated by an antibiotic called penicillin.

What happens after treatment?

The doctor will perform tests a few more times after the treatment, to make sure the germ has gone. It takes up to a year for the tests to become negative.

Tertiary syphilis is less responsive to treatment, and less people get cured at that stage. Avoiding treatment altogether can lead to death.

The bottom line: How do I avoid it?

1. Avoid intimate contact with someone you know is infected.
2. Use a condom in every sexual encounter.
3. If you find a lesion (chancre) after having a sexual contact, go to a doctor and get treated.

This movie sums up the disease nicely:

Have a story about your own encounters with the disease? Share in the comments.

What next?

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