Syphilis is a sexually transmitted infection, known to men and women for centuries. It used to be known as the pox and undoubtedly contributed to the death of many people in the past, before the introduction of antibiotics. It is relatively uncommon in the UK, but there has been a dramatic increase in the number of cases, particularly among gay men, diagnosed in genitourinary clinics since 1998.
In England, between 1998 and 2000 rates of diagnoses of infectious syphilis (primary and secondary) in males increased by 150%. This is largely as a result of a number of localised outbreaks that occurred during this period. Ref: Public Health Laboratory Services.
Syphilis is caused by an organism called Treponema pallidum. It is only transmitted during sexual contact, it cannot be caught from toilet seats or swimming pools. People who are infected may have no symptoms, but are still infectious. The best prevention against syphilis is to reduce your number of sexual partners and always to use a condom.
Syphilis has three stages of infection and can be diagnosed and treated at any of these stages.
Primary syphilis presents with a painless sore, usually at the site of infection, but which can appear anywhere. It is highly infectious and can last from 2-6 weeks. The sore is teeming with the organism, which can be cultured by taking a scraping from the sore.
Secondary syphilis occurs 6 weeks to 6 months after the initial sore. There may be a fever, a general feeling of being unwell, swollen glands, a rash on the trunk, palms of hands and/or soles of feet, ulcers in the mouth and hair loss. Lumps resembling warts can develop around the anus. If the illness is not diagnosed and treated at this stage, symptoms can disappear until years later.
Tertiary or late syphilis can affect many organs in the body. Gummas (areas of damaged, scarred tissue produced by the infection) form in the organs. The skin, bones, joints, heart and brain are most commonly affected producing a wide variety of symptoms. Syphilis is the great pretender and can mimic almost any illness.
Treatment is with antibiotics and treatment can successful at any stage of infection, although some damage may be irreversible in the later stages of the illness.
Diagnosis is by blood testing or by growing the organism from the initial ulcer. Testing is best undertaken in a genitourinary clinic where they can screen you for other sexually transmitted infections.
Pregnant women are routinely tested as the infection will pass through the placenta to the baby. Babies infected during pregnancy can be seriously affected by the infection. Any woman testing positive during pregnancy would be counselled about the risk and treatment recommended. Miscarriage, stillbirth and congenital abnormalities are common in pregnancies affected by syphilis.
This article published on
26 January 2006
Next review date 01/01/2013