When most people think of life-threatening or life-shortening sexually transmitted diseases, they immediately think of HIV or AIDS. However, there are certain circumstances where even the most common STD’s can lead to death or life-shortening consequences. A good example of this is syphilis.
Syphilis is a bacterial infection caused by spirochete Treponema pallidum and is spread through sexual contact. Syphilis cannot be spread through casual contact, such as holding hands. It is spread from direct contact with a syphilis sore and can be from vaginal, anal, or oral sex. These sores can be found on the penis, vagina, anus, in the rectum, or on the lips and in the mouth. A mother can also spread the disease to her unborn baby if she is infected with syphilis during pregnancy. This disease is often known as “the great imitator” because it has many different symptoms that can occur that can look like a variety of different diseases.
The disease can be separated into three different stages: the primary stage, the secondary stage, and the latent/late stage. The first symptom that occurs, the start of the primary stage, is a painless sore in one or multiple areas that are mentioned above. These sores are normally painless and can appear to be an ingrown hair or zipper cut, therefore are overlooked quite frequently. These sores are the locations where the disease first entered the body. They normally last anywhere from three to six weeks, and they will heal regardless of whether or not treatment is received. Without treatment of the primary stage, the disease will then progress on to the secondary stage.
The secondary stage of syphilis has similar symptoms to the primary stage. The sores that are prominent in the primary stage can progress to possible skin rashes and more sores in the mouth, vagina, or anus. These are also called mucous membrane lesions. This rash can be in just one place on the body or can be in multiple places. These rashes may show up on the body whenever the primary sore is healing, or they can show up several weeks after that sore has healed. The rashes that occur during this stage can look rough, red, or even like reddish brown spots on the palms of the hands and/or on the bottoms of the affected individual’s feet. These rashes normally do not itch and are sometimes so faint that the individual will not notice them. During the secondary stage, other symptoms can also arise. These may include a fever, swollen lymph glands, a sore throat, patchy hair loss, headaches, weight loss, muscle aches, and even fatigue. Like the primary stage sores, these symptoms will go away over time regardless of if the individual receives treatment for them or not.
Not many people move on to the last stage of syphilis, or the latent/late stage. However, if treatment is not received during the first two stages, around fifteen to thirty percent of people who are infected with syphilis will develop tertiary, or the latent/late stage. Although most people who have untreated syphilis do not go on to develop this late stage of the disease, when this stage does occur it is very serious. This stage also does not show any symptoms until around ten to thirty years after the initial infection. During this stage, symptoms are more severe and debilitating than symptoms during the first two stages. Symptoms during this stage can include difficulty coordinating muscle movements, paralysis, numbness, blindness, and even dementia. As this stage progresses, the disease can then damage internal organs and can result in death. Along with these symptoms, the disease can cause stroke, meningitis, hearing loss, visual problems, dementia, loss of pain and temperature sensations, sexual dysfunction in men, bladder incontinence, and sudden, lightning-like pains. It can also cause aneurysm and inflammation of the aorta and other blood vessels surrounding the heart.
Syphilis was once a very common disease in the United States, but since the discovery of penicillin in the mid-20th century, the spread of the disease has been largely controlled for the most part. However, syphilis has not been able to be eradicated completely. The disease has also been on an upswing in the United States. In 2014, the CDC reported that cases for primary and secondary syphilis had risen from 2013 by 15.1 percent. This averages out to around six cases per 100,000 people. The CDC also reported that congenital syphilis, or syphilis passed from mother to baby, had also risen by 27.5 percent averaging around 11 cases per 100,000 live births. The disease is still not as prominent as it was during the early 1990’s, however, officials at the CDC believe that it is still a threat because individuals are not taking the disease as seriously now that HIV/AIDS is not as much of a risk factor as it was during the same time period in the 1990’s. Technology is also being said to blame for part of the rise in syphilis because of apps such as Tinder. With apps such as these, people are meeting without any knowledge of the other person’s sexual history or background and often do not think of STD testing after being with other sexual partners. Statistics also point to this because syphilis was not the only STD that had risen over the past few years. Syphilis, chlamydia, and gonorrhea all rose in numbers around the same exact time. The CDC reports that syphilis is still extremely prominent in many parts of the global South.
Syphilis is most easily spread during “early” syphilis. “Early” syphilis is when the patient has been infected for a year or less with the disease. If a patient is suspected to have syphilis, a physician can order several different tests in order to diagnose the patient with the disease. A simple blood test can diagnose the disease, but some physicians may also order a fluid test to test the fluid from the syphilis sore. If the patient is suspected to have nervous system complications from syphilis, a provider may suggest to collect a sample of cerebrospinal fluid through a lumbar puncture, also known as a spinal tap. Once diagnosed with syphilis, the disease can be treated with antibiotics. Normally, a physician will order penicillin to treat the disease unless the individual is allergic to any form of penicillin. If that is the case, then other antibiotics can be prescribed to the individual. If you suspect that you may have syphilis, it is suggested to seek treatment for the disease. Untreated syphilis that reaches the final latent/late stages has a mortality rate of 8-58%, with a larger death rate in males.
Syphilis has many manifestations and is often confused for other diseases. Sir William Osler remarked, “The physician who knows syphilis, knows medicine.” Many famous individuals are also believed to have had the disease before penicillin had controlled the majority of the cases. These individuals include Bram Stoker, Henry VIII, and Vincent Van Gogh. Although the disease can now be controlled and cured by antibiotics, it is still important to remain vigilant to diagnose and treat the disease. Even if you have been treated for syphilis beforehand, it is still possible to be re-infected after treatment. It is also important to remain vigilant in treatment in order to receive treatment before the disease can develop into something else. Syphilis increases the chances of getting and/or spreading HIV, which can then lead to AIDS. Also, if treatment is received after the disease has caused debilitating symptoms, the treatment cannot reverse the damage that has already been caused by the disease. For the best results, it is best to catch the disease in its early stages when the symptoms are not as severe.
Although syphilis is not considered to be deadly in very many cases, it can be quite a devastating disease. Without treatment an individual’s life can be cut short without them even realizing what is really going on. Since syphilis can mimic so many diseases and common illnesses, it is important to practice safe sexual practices along with making sure partners are practicing the same way. Without knowing for sure, it is best to get tested to be absolutely sure that you are not infected with the disease, or another STD that could have similar debilitating effects. Hopefully with more research, and with the disease becoming more prominent in the United States, the disease will gain more recognition so that others can be more aware in order to practice safer sex methods. With more research into the disease, it may even be able to be eradicated within the near future.