Syphilis: All you need to know about this sexually transmitted infection

Syphilis, a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum, poses significant health risks if left untreated. The infection progresses through stages—primary, secondary, latent, and tertiary—each presenting with distinct signs and symptoms. Typically transmitted through sexual contact, the condition begins as a painless sore appearing on the genitals, rectum, or mouth. Direct contact with these sores results in the transmission of the disease between individuals, and it can also be transmitted from an infected mother to her baby during pregnancy, childbirth, or breastfeeding. Slowly and gradually, it can even affect various organs, including the skin, cardiovascular health, and nervous system. Here’s all you need to know about syphilis.

What are the symptoms of syphilis?

Symptoms of syphilis typically progress through stages.

• Primary syphilis manifests as painless sores (chancres) on the genitals, anus, or mouth, which can go unnoticed.
• Secondary syphilis involves rash, fever, swollen lymph nodes, and flu-like symptoms.
• Without treatment, it can progress to latent and tertiary stages, causing severe damage to organs like the heart, brain, and nerves, leading to paralysis, blindness, and even death.
• Late-stage symptoms can vary widely and include gummas (tissue swellings), neurological issues, and cardiovascular complications.

Considering the outcomes of syphilis, early detection is crucial to prevent long-term complications and transmission.

How does syphilis spread?

It is primarily spread through direct contact with an infected person’s sore during vaginal, oral, or anal sex. These sores can be found on the genitals, in the rectum, or in the mouth. The bacteria can also be transmitted from an infected mother to her unborn baby during pregnancy or childbirth, leading to congenital syphilis. Additionally, it can spread through blood transfusions or by sharing needles with someone who has this infection. Safe sexual practices, regular testing, and prompt treatment are crucial in preventing the spread of the infection.

What are the stages of syphilis?

This infection unfolds in four distinct stages, each accompanied by its own set of symptoms. The infection is most contagious during the initial two stages, namely primary and secondary syphilis.

Primary syphilis

It occurs two to 12 weeks after exposure, this stage features the development of a painless, smooth sore called a chancre (painless ulcer) on the genitals or mouth. Although the sore resolves on its own, the infection persists if left untreated, advancing to the second stage. Transmission is possible through vaginal, anal, or oral sex.

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Secondary syphilis

In the second stage of the disease, around one to six months after the chancre disappears, a non-itchy, rough syphilis rash emerges, covering the entire body, including palms and soles. Additional symptoms may include fever, fatigue, muscle aches, weight loss, and swollen lymph nodes. Despite symptom fluctuations, the infection persists, necessitating treatment.

Latent syphilis

When left untreated during the initial stages, the infection enters the latent phase, devoid of outward symptoms. Some patients may experience intermittent mild flare-ups during the latent stage, lasting up to 20 years, can lead to damage in organs such as the heart, bones, and nerves. Transmission during this stage is rare.

Tertiary syphilis

Late (tertiary) syphilis is characterised by serious health issues such as brain damage, heart disease, movement disorders, nerve damage, seizures, and vision problems, including blindness.

Diagnosis of syphilis

The diagnosis of this infection involves testing blood samples for the presence of antibodies and proteins created by the immune system to combat infections. These antibodies remain in the body for years, allowing blood tests to detect current or past infections. Additionally, fluid from a sore can be studied under a microscope to confirm the infection, and in cases of suspected nervous system problems, a lumbar puncture may be performed to test the cerebrospinal fluid surrounding the brain and spinal cord.

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Treatment of syphilis

Treatment for the infection is relatively simple, particularly when detected early. A single shot of penicillin is the recommended treatment for primary, secondary, or early-stage latent syphilis. Individuals who are allergic to penicillin may be offered an alternative antibiotic or undergo a gradual process to build a tolerance to penicillin over time, known as penicillin desensitisation.

After the treatment, regular blood tests and exams are essential to monitor the effectiveness of penicillin. It is crucial to abstain from sexual contact with new partners until the treatment is complete, as confirmed by blood tests and the absence of sores. Additionally, informing sex partners about testing and treatment and getting tested for the human immunodeficiency virus (HIV) are recommended steps in post-treatment care. In pregnancy, there are three doses, each to be taken a week apart.