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.
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.
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%.
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
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