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Syphilis 101

What is syphilis?
Syphilis is a sexually transmitted disease that is caused by the bacterium Treponema pallidum.

How is the disease spread?
Syphilis is spread in only one of two ways: through sexual activity, or in the case of a pregnant woman, the disease can be passed to her unborn child while it is still in the uterus.

How can you get syphilis?
The primary means of catching the disease is through coming in physical contact with the lesion – or chancre – of an infected person that still has the spirochetes (bacterial organisms that cause the disease) present.

What types of sexual activity can cause the spread of syphilis?
Syphilis is spread through unprotected vaginal, anal or oral sex.

How is syphilis NOT spread?
You cannot get syphilis from toilet seats, doorknobs, swimming pools, hot tubs, eating utensils, clothing or the body fluids of an infected person.

How do you know if you have syphilis?
Sometime within 10 to 90 days after exposure to the disease, a chancre will form at the site of the infection. It's almost always on the penis, inside the rectum, in the mouth or in the vagina. In rare cases, it could appear on the fingers or nipples. The chancre is usually firm, round, small and painless. Most infections come from direct contact with these chancres. Without treatment, the chancre will disappear on its own within 3 to 6 weeks.

How long is a person with "primary stage" syphilis infectious?
A person in the primary stage of syphilis is only infectious while the chancre is present. Therefore, it's kind of hard to catch the disease, since there's only a 3- to 6-week window of opportunity for it to be spread.

What happens if you don't get the chancre treated?
Without treatment, the disease progresses from its primary stage to a short latent period. Once this occurs, the infected person might not exhibit any symptoms of the disease for a brief time. The infected person is not really infectious during this period, but soon will likely progress to secondary syphilis.

What happens during this "secondary stage" of syphilis?
After the latent period, the infected person will experience different types of rashes on different parts of the body, especially on the hands or feet. The rash often appears as rough, red or brownish spots, although it can often be so faint that it is not noticed. And as in the primary stage, the rash will often go away after 4 to 10 weeks without treatment.

Are there any other symptoms of secondary syphilis you should watch out for?
Secondary stage symptoms can also include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and tiredness, as well as lesions in genital, anal and oral areas.

Is a person in the secondary stage of the disease infectious?
Yes, a person can pass the disease along to others when secondary syphilis signs or symptoms are present, especially if the lesions are moist and in genital, anal or oral locations.

What happens after the secondary stage of syphilis?
Once the secondary symptoms disappear, the latent – or Late Syphilis – stage begins. Although the body is still infected with the disease, it could be 10, 15 or possibly 20 years down the road before any further symptoms show up. All the while, internal damage to the heart, eyes, liver, bones and joints gets underway. This type of damage can actually kill people.

How is syphilis diagnosed?
There are two methods to diagnose syphilis: an inexpensive blood test that can detect syphilis antibodies that are produced by the body shortly after infection; and a "dark field microscopy" that examines scrapings from the chancre to determine whether or not syphilis bacteria are present in the sore.

Can syphilis be treated?
Syphilis is a very easily treated disease: penicillin works as well today to fight the disease as it did 60 years ago. If doctors believe a person has been infected with the disease for less than a year, a single shot of penicillin should clear it up; if the person has had the disease longer than a year, it normally requires 3 shots of penicillin, one dose for three consecutive weeks. If an infected person is allergic to penicillin, another antibiotic may be substituted. No over-the-counter or home remedies will cure syphilis.

Is a person cured of syphilis after receiving penicillin shots?
Yes, the person is cured. However, it does not prevent future infections, nor does it reverse any permanent damage done to the body during the later stage of the infection.

How can a person protect him/herself from contracting syphilis?
Abstaining from sexual activity is the only sure way to protect yourself from any sexually transmitted disease. However, because people are sexually active by their very nature, a latex condom should be properly used with every sexual encounter. However, condoms do not offer complete protection against syphilis, as chancres can sometimes be located in areas that are not covered by the condom.

Where can I go to find out whether or not I have syphilis?
Your primary care physician can either perform or order the tests that are needed to diagnose syphilis. If you are not comfortable discussing such matters with your own doctor, tests can be performed by your local or county health department personnel.

Contact numbers to obtain additional information about syphilis and other STDs, as well as for testing information, are:
City of Detroit Health Department: (313) 876-4176
Oakland County Health Department: (248) 424-7049
Macomb County Health Department: (586) 573-2090
Out-Wayne County Health Department: (734) 727-7100
Michigan Department of Community Health: (517) 241-0870

Source: Mark A. Miller, Michigan Department of Community Health, and the Center for Disease Control.

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