Syphilis is known as a bacterial infection that is caused by the spirochete bacterium Treponema pallidum. The primary way of transmitting this infection is through sexual contact, but may also be passed from mother to fetus during pregnancy or at birth which results in congentital syphilis. The exact origin of syphilis is unknown, but has been studied over the years and two interesting hypotheses have arisen. The first is that it was carried from the Americas to Europe from Christopher Columbus and his crew and the second is that syphilis must have been in Europe previously but went completely unrecognized.
These have been also referred as the “Columbian” and “Pre-Columbian” hypotheses. But as of late 2011 it was validated that the Columbian hypothesis was indeed the most logical. Signs and symptoms of syphilis may vary because there are four stages. This includes the following: Primary, secondary, latent, and tertiary. During the primary stage a chancre will usually appear (a firm, painless, non-itchy skin ulceration) and is acquired by direct sexual contact from someone who has infectious lesions. This happens between 3 – 90 days of contact.
This may happen only 40% of the time and the lesion can take on almost any form. At times multiple lesions may appear and can be tender or painful (only about 30%) this can appear outside of the genital area. The most common location on a female is the cervix and the penis on males. This can also found in the anal and rectal area. During this time the lymph nodes enlarge and can occur on the infected area. If not treated the lesion may persist for 3 – 6 weeks. Secondary syphilis occurs 4 – 10 weeks after the primary stage.
Symptoms are most commonly on the skin, mucous membranes, and lymph nodes. At times there may be a reddish-pink, non-itchy rash that most commonly appear the palms of the hands or the soles of the feet and can also form flat, whitish, wart-like lesions known as condyloma latum on mucous membranes. These lesions are very infectious and harbour bacteria. Other symptoms include sore throat, malaise, weight loss, hair loss, and headache. There are also rare manifestations that have occurred that include kidney disease, arthritis, and hepatitis.
Acute symptoms resolve after 3 – 6 weeks, but only 25% of people will present secondary syphilis symptoms. The next stage is latent syphilis which shows little to no symptoms at all and is defined as having serologic proof of infection without any symptoms. It has been described as early (less than 1 year after secondary stage) or late (more than 1 year after secondary stage). Latent syphilis is asymptomatic, which means a patient can be a carrier and sho no symptoms at all and not as contagious as early latent syphilis.
Tertiary syphilis is the most severe and the last stage and may occur 3 -15 years after first initial contact from the infection and can be divided into three different forms: gummatous syphilis, late neurosyphilis, and cardiovascular syphilis. Without treatment a third of the people of get infected will develop tertiary syphilis. A person who has tertiary syphilis is not contagious. Gummatous syphilis occurs 1 – 46 years after initial contact to infection and is charactierized by the formation of chronic gummas, which are soft, tumor-like balls of inflammation and will vary incredibly by size.
This will typically affect the skin, bone, and liver, but can pretty much occur anywhere. Neurosyphilis is an infection that involves the central nervous system and can occur very early, being either asymptomatic or in the form of syphilitic meningitis. Late neurosyphilis can occur 4 – 25 years after contact. Cardiovascular syphilis will occur 10 – 30 years after initial contact and the most common complication related to this is syphilitic aorist (inflammation of the adventitia, including the vessels that supply the aorta itself with blood, the vasa vasorum), which can result in aneurysm formation.
Syphilis has been believed to have affected approximately 12 million people. 90% of these cases are in the developing world and affects between 700,000 – 1. 6 million pregnancies a year which results in stillbirths and congential syphilis. Rates are higher in intravenous drug users and are also infected with HIV which can make the disease worse. Syphilis is six times higher in the male population than in the females and African Americans have accounted for more than half of these cases as of 2010.
Treatment of syphilis is a single dose of intramuscular penicillin G or oral azithromycin. This will be taken in early stages of the infection if it has been caught on early. If the person has only come to knowing of the infection in the late stages they are recommended to take large doses of intravenous penicillin for a minimum of 10 days. If the patient is allergic to penicillin, ceftriaxone may be used. Syphilis can be prevented, but not by any vaccine, only by common sense and safe sexual contact.
Congenital syphilis can also be prevented by screening of the pregnant mother during the early stages of pregnancy and treating the mother who is affected. Syphilis is common around the world and as a country in Canada we should count on our health care system to make this disease more aware to the community for tips on safer sex for youth and to prevent it from spreading to others.
REFERENCES http://en. wikipedia. org/wiki/Syphilis http://en. wikipedia. org/wiki/History_of_syphilis.