It is a sexually transmitted disease caused by a bacterium called Treponema pallidum. It is a disease with so many signs and symptoms that it cannot be distinguished from other diseases.
It is transmitted through direct human-to-human contact of the syphilis wound. The wound usually occurs on the external genitalia. Like inside the vagina, anus or rectum. It can also occur in the mouth and lips. It is transmitted during vaginal, anal or oral sex. It also infects the baby of a pregnant woman. Syphilis is not transmitted from toilets, doorknobs, swimming pools, hot water boilers, bath tubs, used clothing and dishes.
Signs and symptoms
People infected with syphilis may not have symptoms for years, and if they are not treated, the risk of late complications increases. Although it can be transmitted from person to person through wounds, these wounds may not be recognized. Thus, the person may not be aware of his infection.
The first phase of syphilis is usually characterized by a single wound. This wound is called a chancre. It could be more than one. Between the onset of syphilis infection and the appearance of the first symptoms, there is 10-90 days (mean 21 days). The chancre is usually firm, round, small and painless. Syphilis begins at the point where the germ enters. The chancre lasts 3-6 weeks and heals without treatment. People who are not treated adequately pass into the second phase of the disease.
The second cycle is characterized by skin and mucous rashes. It typically begins as a rash on one or more areas of the body. There is usually no itching. This rash begins immediately or a few weeks after the chancre has healed. Typically, it appears as rough, red or red-brown patches on the soles of the feet and palms. Sometimes there are different rashes that resemble the rashes of other diseases. Some are so faint that they cannot be noticed. In addition to skin rashes, fever, swollen lymph nodes, sore throat, regional hair loss, headache, weight loss, muscle pain and weakness are seen. It disappears with or without treatment. If untreated, the disease goes into a silent period and may even progress towards the late stage.
3rd Cycle and Silent Cycle
The silent cycle of syphilis begins when symptoms of the 1st and 2nd cycles disappear. If the person is not treated, he carries the infection without signs and symptoms. The disease remains in the body. This quiet period can last for years. It develops in 15% of the 3rd cycle, that is, late stage patients. It occurs 10-20 years after infection. In this late stage of syphilis, the disease begins to cause damage to the internal organs. The brain, nerves, eyes, heart, blood vessels, liver, bones, joints become sick. In late stage syphilis, incoordination of muscle movements, paralysis, blindness and dementia are seen. Internal organ damage can be fatal.
Effect on the pregnant woman and her baby
During pregnancy, the baby can become infected with this bacteria. Depending on how long the mother has been infected, stillbirth or postpartum infant death occurs. An infected baby may be born without signs or symptoms. If not treated immediately, serious problems develop within a few weeks. Growth retardation or death occurs in the untreated infant.
Bacteria are searched in the swab taken from the wound with the method called dark field microscopy.
Diagnosis is made with blood tests. Antibodies against syphilis are formed shortly after infection. These are effective, reliable and inexpensive tests. Even if the disease is completely cured, low levels of antibodies may remain in the blood for months or years. Since untreated pregnant women with syphilis will infect their babies and cause death, all pregnant women should be tested for syphilis.
The relationship between syphilis and HIV
With the genital wound caused by syphilis, the contagiousness of HIV increases. In the presence of syphilis, the risk of HIV transmission increases 2-5 times.
Like syphilis, the protective mechanism of the skin is impaired in sexually transmitted diseases that cause wounds and ulcers, or with ulcerative lesions that disrupt the integrity of the skin and mucous membranes. The tendency to infections increases. Genital ulcers due to syphilis bleed easily. The risk of HIV transmission increases when it comes into contact with the oral or rectal mucosa during sexual intercourse. The presence of other sexually transmitted diseases also facilitates the transmission of HIV.
In the early stages of syphilis, treatment is easy. Antibiotic treatment is applied to the causative agent. With treatment, the syphilis germ dies and it is prevented from causing further destruction. But if it has already caused havoc, it cannot cure it.
Since it has an effective treatment, people who are at risk of sexually transmitted diseases should be investigated from time to time in terms of syphilis.
The person who is treated for syphilis is prohibited from having sexual intercourse until the wound is completely healed. These people should warn other people they are with and ensure that tests related to syphilis are carried out and that they receive treatment if necessary.
Will syphilis recur?
Having syphilis does not prevent the disease from reoccurring. Even after successful treatment, the disease can be re-infected.
Tests reveal that a person has syphilis. Because syphilis sores can be hidden in the vagina, rectum and mouth. Thus, the person cannot clearly see that the person with whom he has sexual intercourse is sick. Therefore, in doubtful cases, retesting may be required after treatment.
The safest form of protection against sexually transmitted diseases, including syphilis, is abstinence from sexual contact or a long-term relationship with a single tested and known uninfected partner.
Avoiding alcohol and drug use is also important in preventing the transmission of syphilis. Because, in such cases, it becomes easier to participate in risky sexual acts. Spouses who are in sexual contact tell each other their own HIV status and the story of other sexually transmitted diseases, if any, and it makes it easier to take preventive measures from these diseases.
Diseases with genital ulcers such as syphilis can occur in the genital areas of both women and men, as well as in areas that can be covered with a condom, as well as in areas that the condom cannot cover. Correct and continuous use of condoms reduces the risk of transmission of syphilis, genital herpes and chancroid, as long as it prevents contact with the infected area.
Condoms lubricated with spermicides (especially N-9) have no advantage over other lubricated condoms. Condoms lubricated with N-9 are not recommended for protection from sexually transmitted diseases and HIV.
The transmission of sexually transmitted diseases, including syphilis, cannot be prevented by washing the genital area, urinating or showering after sexual intercourse.
When any unusual discharge, wound or rash is noticed, especially in the genital area, sexual intercourse should be terminated and a specialist physician should be consulted urgently.