Syphilis is called the ”great imitator” because it shows signs that other diseases show. The organism that causes syphilis is a spirochete bacterium known as Treponema Pallidum.
Syphilis was first noted in history around the 1490’s as morbus gallicus, or the French Disease, after soldiers returning from war in Naples brought back home with them the disease. The disease’s antiquity is still debated, however some claim that the disease originated in the Americas. The syphilis causing bacterium, Treponema pallidum, is just one of four treponemes that infect humans (Bowers, 2001).
Syphilis was once a major public health threat, commonly causing serious long-term health problems such as arthritis, brain damage, and blindness. It defied effective treatment until the late 1940’s, when the antibiotic penicillin was first developed.
New cases of syphilis doubled between 2005 and 2013, often in combination with human immunodeficiency virus (HIV). This has been attributed partly to increased promiscuity, prostitution, decreasing use of condoms, and unsafe sexual practices among men who have sex with men. Syphilis is thought to have infected 12 million additional people worldwide in 1999, with greater than 90% of cases in the developing world.
How is syphilis transmitted?
Syphilis is a highly contagious disease spread primarily by sexual activity, including oral and anal sex. By having vaginal, anal or oral sex without a condom with someone who has the infection; from mother-to-baby across placenta during pregnancy. Syphilis is spread by contact with open sores (usually during sex). Occasionally, the disease can be passed to another person through prolonged kissing or close bodily contact. Syphilis prevalence is growing, particularly among men who have sex with men.
Syphilis cannot be spread by toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils.
What are the different stages of development?
There are three stages of Syphilis.
Stage 1: Primary chancre
10 – 90 days
After an incubation period of 12 to 90 days (average of 21 days) it starts with a small painless sore where the bacteria entered the body. The appearance of a single sore marks the first (primary) stage of syphilis symptoms, but there may be multiple sores. The sore appears at the location where syphilis entered the body. The sore is usually firm, round, and painless. Because the sore is painless, it can easily go unnoticed. The sore lasts 3 to 6 weeks and heals regardless of whether or not a person is treated. However, if the infected person does not receive adequate treatment the infection progresses to the secondary stage.
Stage 2: Secondary eruptions
6 weeks to 6 months
It begins with the appearance of one of the systemic manifestations of the disease. Skin rashes and/or sores in the mouth, vagina, or anus (also called mucous membrane lesions ). This stage usually starts with a rash on one or more areas of the body. Rashes associated with secondary syphilis can appear from the time when the primary sore is healing to several weeks after the sore has healed. The rash usually does not cause itching. This rash may appear as rough, red, or reddish brown spots both on the palms of the hands and/or the bottoms of the feet. However, this rash may look different on other parts of the body and can look like rashes caused by other diseases.
Large, raised, gray or white lesions may develop in warm, moist areas such as the mouth, underarm or groin region. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. Other symptoms of secondary syphilis include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The symptoms of secondary syphilis will go away with or without treatment. Without appropriate treatment, the infection will progress to the latent and possibly late stages of disease.
Stage 3: Tertiary disease
10 – 30 years after period of latency
The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person can continue to have syphilis in their body even though there are no signs or symptoms. This latent stage can last for years. Syphilis that has been left untreated can cause heart problems, mental issues, and even death.
Approximately 8% of individuals with untreated syphilis will develop Neurosyphilis, a stage that includes physical and psychiatric symptoms. Neurosyphilis frequently affects more men than women and Caucasians more frequently than African Americans. This condition may appear at any given point ranging between five through thirty-five years after primary syphilis onset (Frey, 2006).
Pregnant women with the disease can spread it to their baby. This disease, called congenital syphilis, can cause abnormalities or even death to the child. Depending on how long a pregnant woman has been infected with syphilis, she has a good chance of having a stillbirth (birth of an infant who has died prior to delivery) or of giving birth to a baby who dies shortly after birth.
If not treated immediately, an infected baby may be born without symptoms but could develop them within a few weeks. These signs and symptoms can be very serious. Untreated babies may become developmentally delayed, have seizures, or die.