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Rebirth of Syphillis

On the decline for nearly a decade, Syphillis is re-emerging as a sexual health menace; what you need to know to protect yourself and your partner.

It¡¯s back, and it¡¯s not pretty. Syphillis, a sexually transmitted disease that¡¯s been lying low for the past decade, has dramatically increased in the wake of renewed risky sexual behavior trends. Its resurgence, dangerous in and of itself, is even more so for the fact that with it comes an increased risk of HIV/AIDS infection. To navigate your way through the changing sexual health landscape, you need some facts.

The History

Syphillis isn¡¯t new. Treponema pallidum, the bacteria that causes the disease, was responsible for epidemics in Europe over the past five hundred years. However, only three years ago, it appeared to be going the way of Smallpox and Polio. Between 1990 and 2000, infection rates dropped 89.2% in the U.S. However, since 2000 diagnoses have been increasing nationwide, particularly in large urban areas. Between 2001 and 2002, cases in Massachusetts spiked 87%. New York City¡¯s cases were up 50% for the same period, and Los Angeles reported a 27% rise. The problem isn¡¯t uniquely American though; Britain, Germany and other Western European nations have reported similar increases.

Overall, the number of cases in this country is still relatively low, at just over 6,000. The resurgence has occurred mainly among those on society¡¯s margins ? sex workers, impoverished teens and substance users. However, experts believe broader trends are also behind the new infections. A recent report by the British government linked the increase to greater opportunities for casual and usually unprotected sex.

The Biology

Syphillis has been nicknamed ¡°the great imitator¡±, as it¡¯s early signs and symptoms to those of many other diseases. The bacteria¡¯s hallmark is a small, usually painless ulcer (otherwise known as a ¡°chancre¡±) at the site of infection ? usually the genitals, though ulcers can also occur in the oral and rectal areas. After infection, the bacteria spreads from the initial sore through the rest of the body and if left untreated, the disease progresses through four stages (primary, secondary, latent and tertiary).

The initial genital chancre is the only outward symptom of primary stage Syphillis. Once it appears, often within 2 to 6 weeks of infection, it will disappear without treatment. If it goes untreated, about one-third of those infected will move onto the later stages.

Secondary Syphillis is marked by the appearance of a rash of penny-sized brown sores, usually on the palms, 3 to 6 weeks after the chancre appears. Mild fever, fatigue and headache may accompany the rash, but as in the primary stage, both will disappear eventually without treatment.

The symptoms may continue to appear and disappear for 1 to 2 years until, if left untreated, the disease will lapse into latency and symptoms subside. In the final stage of Syphillis, complications arise from the bacteria damaging vital organs; the heart, brain, eyes, nervous system and joints can all be affected, leading to mental illness, blindness, heart disease and among a host of other effects, eventual death is a possibility.

These results of Syphillis have the potential to be further complicated during the primary stage. As openings in the skin, the genital chancres are especially vulnerable to HIV infection. Where Syphillis is present, the risk of contracting HIV during sex with an infected partner goes up 200% to 500%.

The Treatment

Though its symptoms can be innocuous, Syphillis is easily identified by doctors who know what they¡¯re looking at. Using certain microscopy techniques, or a simple blood test, the presence of Treponema pallidum can be detected. A cure isn¡¯t that much more difficult; a simple regimen of antibiotics such as penicillin can kill the bacteria, though any damage that it has done to the body¡¯s internal organs is irreversible.

Treatment also doesn¡¯t protect against re-infection if the patient engages in sex with another infected partner. Still, the far greater threat is that while the disease¡¯s symptoms go unnoticed, continuing sexual activity will expose the sufferer to a much greater risk of HIV / AIDS.

The Bottom Line¡¦

¡¦is prevention. All the antibiotics in the world won¡¯t help if Syphillis becomes a gateway infection for HIV / AIDS. Using the perennial safer sex staple, a latex condom, during intercourse is a good start. However, it isn't a catchall. When sufferers are contagious, during the disease's primary and secondary stages, syphilitic canchres be on areas not covered by a condom. However, to the extent that condoms are used, it¡¯s important to remember to employ them during oral sex, as chancres on the inside of an infected person¡¯s mouth can spread the bacteria during genital contact

Ultimately, as with most advice, it's the most often repeated that's the best; knowing one's partner and getting regularly screened for this infection is the only sure way to stay healthy as Syphillis comes back into circulation.

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