Syphilis

syphilis: This sexually transmitted disease was spreading like wildfire. Doctors could not cure it. People shunned those who had it. AIDS in the 1980s? No, syphilis (SIF-uh-lis) in sixteenth-century Europe.

Cause A bacterium (Treponema pallidum) causes syphilis when it enters the body during sexual contact. A pregnant woman infected with syphilis can pass it to her developing fetus; the baby may then be born with congenital syphilis.

Incidence In recent years there have been about 20,000 new cases of syphilis in the United States annually. The incidence of syphilis is much lower than that of two other long familiar sexually transmitted diseases, gonorrhea and chlamydia. But syphilis is of especially great concern because of its possibly fatal long-term effects and the harm it can inflict on babies born with it.

Symptoms you are likely to notice The first symptom of syphilis is a red, painless sore called a chancre (SHANG-kuhr) that occurs where the bacteria enters the body. The sore can develop wherever a person's body has been touched during sex but usually erupts on or in the genitals. Additional later symptoms include a rash starting on the palms of the hands or the soles of the feet and spreading to all other parts of the body. The rash may be accompanied by fatigue, fever, swollen lymph nodes, and sore throat.

Symptoms your physician may observe A physician suspecting syphilis in a patient will perform a physical examination for sores or other readily observed signs of the disease. A blood test is obtained to confirm the diagnosis.

Treatment options Antibiotics are effective in treating syphilis. It is important to have all sexual partners tested and treated at the same time so that the bacteria are not passed back and forth.

Stages and progress Syphilis progresses in three stages. Stage one begins with the chancre, which usually appears three to four weeks after infection. The chancre will go away without treatment, but the bacteria are still in the body. Six weeks to six months after the chancre appears, stage two begins with a body rash, swollen glands, fever, and other generalized symptoms. The symptoms of this stage will go away too if untreated. Years later, in stage three, serious health problems occur. Late-stage syphilis can result in severe damage to the heart and blood vessels. It can infect the brain and cause paralysis, blindness, and mental illnesses. It can even cause death.
Untreated syphilis during pregnancy can cause deformities in the baby or, in some cases, death. Widespread public health regulations require that all babies be tested for syphilis right after birth, and that any infected newborns be given treatment.

Prevention Syphilis is passed from an infected to an uninfected person during sexual intercourse. Any person with a syphilitic sore can transmit the bacteria to a sexual partner. Transmission can occur many years after the person carrying syphilis first became infected. The sores can be inside the body, so it is often impossible to tell if a partner is infected.
The surest prevention is to abstain from intercourse. A widely recommended precaution is to use condoms during each sexual encounter. Of course, limiting the number of sex partners reduces the chance of having sex with someone who is infected.

Post-Columbian plague Most scholars today think that syphilis was present in all parts of the world from earliest times. However, an epidemic in Europe began shortly after the voyages of Columbus, causing speculation that it was an American disease brought to the Old World by sailors. The beginning of the epidemic, in 1495, started like many other epidemics, in a war. For about 50 years after that, syphilis was epidemic, killing many and changing sexual practices as the method of transmission became better understood.