Also
known as: VD, Louies disease
Myths
dispelled
Here are some facts to clear up some common misconceptions.
Syphilis
was probably not brought to the New World by Columbus's crew.
Even though your chancre goes away without treatment, you are
not cured.
You cannot catch syphilis from toilet seats or in gyms or swimming
pools (unless you're doing more than laps).
Intro
No, it's not some disease relegated to history books (fossilized
remains of human prehistoric man show signs of bone destruction
often seen from syphilis -- and even George Washington was rumored
to have had it!) Syphilis is very much a health threat in our
oh so modern times. The Centers for Disease Control and Prevention
(CDC) estimates that more than 40,000 new infections occurred
last year, with at least half of them in men who have sex with
men. Although physicians have been able to successfully treat
syphilis since the advent of penicillin in 1943, many cases still
go undiagnosed. If ignored, the disease can be fatal.
What
is it?
Syphilis is a sexually transmitted infection caused by the corkscrew
shaped bacteria (spirochete) Treponema pallidum. The bacteria
lands on your body during sex with an infected partner. The most
common sites of infection are the penis, anus or vagina. Within
90 days of infection (two to four weeks average) a red, painless
ulcer called a chancre appears. The chancre, though usually singular,
can be multiple, and will heal even without treatment within three
to eight weeks.
This first stage of infection is called primary syphilis. The
chancre weeps a clear fluid that is chock full of syphilis-causing
bacteria, and it is during this stage that you are highly contagious.
After the chancre heals, the bacteria spread throughout your body.
This is called secondary syphilis. Infected individuals usually
complain of fever, joint pains, fatigue, liver problems, enlarged
lymph nodes, eye problems and a copper colored skin rash that
usually appears on your palms and soles. You are still contagious
at this stage. If untreated, 40 percent of infected individuals
progress to Tertiary Syphilis within 10 to 20 years. Although
no longer contagious, the disease can prove lethal, as it attacks
your brain (destroying your vision and hearing) and may ultimately
lead to insanity. The disease also attacks your heart valves and
major arteries (most commonly the aorta). And more bad news: even
if you've had syphilis once before and were cured, you can still
catch it again.
Diagnosis
Today the most common test for syphilis is a blood test that looks
for antibodies to the spirochete. It is called a VDRL (Venereal
Disease Research Laboratory) or FTA-ABS (florescent treponemal
antibody absorption) test. Another blood test often used to confirm
the presence of active infection is called an RPR (rapid plasma
reagin).
Symptoms
Primary syphilis: a painless red ulcer called a chancre. Secondary
syphilis: symptoms of viral illness including fever, joint pains,
swollen lymph nodes. A copper-colored skin rash, particularly
on your palms and soles is classic. Like the chancre, the rash
also goes away even without treatment within two to six weeks.
Tertiary syphilis: central nervous system damage including blindness,
loss of hearing and insanity. Heart disease (destruction of heart
valves) and vascular disease (aortic anneurysm) are also common.
How
to treat it?
Primary syphilis or syphilis of less than one year duration: Benzathine
penicillin G - 2.4 million units by injection or oral doxycycline
100mg twice a day or tetracycline 500mg four times a day for 2
weeks. Syphilis infections of greater than one year duration or
of unknown duration: Benzathine penicillin G - 2.4 million units
by injection weekly for 3 weeks or either of the above oral medications
for four weeks duration. A penicillin derivative is still the
drug of choice, but doxycycline or tetracycline works well for
penicillin-allergic individuals. No matter what type of syphilis
you have, a critical treatment step is notification of all of
your sexual partners. They must also be treated.
Prevention
Although a condom will generally prevent syphilis infection, it
must be worn from the start of close physical contact.
If your partner has a chancre at the base of his shaft, scrotum
or pubic hair, a condom will probably not protect you. The spirochete
is extremely sensitive to drying and is easily killed with soap
and water. Washing up after sex will go a long way in preventing
infection.
Incubation
period
A chancre develops within 90 days, and within two to four weeks
is average. It heals within three to eight weeks, and if untreated,
secondary syphilis begins. If syphilis is still not treated, tertiary
syphilis may begin 10 to 20 years later.
Sex
A condom may not protect you, especially if your partner has a
chancre on the base of his shaft or on his scrotum. Chancres of
the anus or vagina can be extremely difficult to spot.
Prevalence
There were more than 40,000 cases of syphilis in the United States
last year.
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