Hot Topic: Syphilis and Why It Still Matters
What is Syphilis?
Syphilis is an infectious disease that travels in your blood and if not treated can attack your central nervous system causing blindness and other brain problems. Syphilis is caused by bacteria called treponema pallidum which can be treated with medication.
Individuals can get syphilis by having anal, oral, or vaginal sex with a person who is already infected or by coming in contact with an infected person’s bodily fluids. For example, sharing sex toys that have not been cleaned with someone who has syphilis can result in transmission. Syphilis can also be transmitted from pregnant women to their unborn child in the womb; however, if the mother is treated as soon as possible, she can make sure her baby is not infected. Transmission of syphilis from mother to child is called congenital syphilis.
What are the Stages of Syphilis?
Most infectious stage, most likely to pass syphilis to someone else in this stage. This is the stage where people will have a bump called a chancre.
A bump/chancre on the tongue. Photo courtesy of CDC
Symptoms: About 3 weeks after sex most people develop a bump/chancre which is painless and heals on its own without medication within 3-6 weeks. The bump/chancre may look a zipper cut or a bump from shaving your pubic hair. The chancre can appear on a penis, inside or around a vagina, in a mouth, or inside or around an anus (the location depends on where you had sex with the infected person).
The stage after the primary chancre has appeared. You can have secondary symptoms and the chancre at the same time. Like the primary stage, the secondary stage is the most infectious, making it easier to pass syphilis to your partner(s).
A symptom of secondary syphilis (rash on hands). Photo courtesy of CDC
Symptoms: Most people will have at least one of the following symptom: rash on hands and feet, body rash, hair loss (alopecia), pus filled bumps (condylomata lata), or swelling of the lymph nodes (lymphadenopathy).
Someone who is infected with syphilis and got it less than 1 year ago but does not have any symptoms.
Someone who is infected with syphilis and got it 1 year or more ago but does not have symptoms.
Occurs 1 to 20 years after being infected and not getting treatment. Most people with this stage of syphilis with have at least one of the following symptoms: soft lesion growths, lesions on the heart, hearing problems, or eye problems.
Neurosyphilis can happen in the primary, secondary, or latent stage. Some people will not have symptoms. For those with symptoms, they may have hearing loss, vision loss or blindness, and other brain problems
Why it Still Matters
Rates of primary & secondary syphilis in Baltimore City & Maryland are higher than the national rate.
Graph courtesy of Maryland Department of Health
Can it be treated?
Yes, primary, secondary, latent, and congenital syphilis can be treated with either one or three shots of benzathine penicillin (Bicillin) in the butt cheek. Treatment for tertiary and neuro-syphilis is daily intervenous (IV) injections of aqueous crystalline penicillin given in the vein, typically in the arm. You will need to get a confirmatory and RPR syphilis test to know which treatment you will need. Speak to a health provider to get tested and to find out which treatment is best for you!
Allergic to Penicillin? Worried about getting treated?
No fear, there are alternative medications to treat each stage of syphilis that do not contain penicillin. Speak to a health care provider to find out which medication you should take after receiving a syphilis test.
Syphilis and PrEP
The introduction of a once-a-day pill called PrEP to prevent HIV infection is revolutionary. However, some people who take PrEP may be more likely to not use condoms because their chances of getting HIV are lower. PrEP does not protect you from syphilis or other STDs. People on PrEP should continue to use condoms to prevent getting other STDs.
Pre-Exposure Prophylaxis (PrEP). Photo by NIAID. Obtained through Flickr.
Syphilis and HIV
Being infected with syphilis can increase your chances of getting HIV. This happens because having bumps and lesions causes openings in your skin where HIV can enter your body. For people with HIV, your immune system is weaker because of the HIV infection so it is harder for your body to fight off the syphilis infection.
Syphilis and Pregnancy
A mother infected with syphilis can pass the virus to her baby through the placenta. The chance of passing syphilis to your baby is highest during the primary and secondary stage. The best thing a woman can do when she is pregnant is to get tested so if she does have syphilis she can get treated. And if she is having sex while pregnant she should always use condoms with her partner(s) for anal, vaginal, and oral sex and make sure her partner(s) get tested before sex.
What happens if I don’t get treated?
Mothers who are not treated for syphilis can have miscarriages or give birth to stillborn babies. Babies infected with syphilis that are born are at risk of being born with a body rash, blindness, deafness, bone deformities or other neurological problems.