Syphilis, the Queen of Sexually Transmitted Diseases

Syphilis, the Queen of Sexually Transmitted Diseases

Syphilis is a sexually transmitted disease (hence the acronym STD ), which is transmitted through sexual intercourse.

It is a long-standing disease, even linked to the past centuries, with maximum diffusion in Europe between the seventeenth and the first half of the nineteenth century. In the early sixteenth century, it was the European settlers returning from the American continent who imported it into Europe; but with the advent of antibiotics, its incidence dropped considerably, until it nearly disappeared in the years following the Second World War.

Recently, however, the trend of those infected with syphilis appears to be on the rise again , especially in less industrialized countries, and even if a few precious precautions would be enough to avoid syphilis, it is estimated that around 12 million new patients are diagnosed every year.

In Europe, cases of syphilis have increased by 70% in the last decade.

Syphilis is a totally curable disease but which, if not treated adequately, can become lethal. It is currently the sexually transmitted disease with the highest mortality rate after AIDS.

How to recognize it?

It can take several months for the first symptoms to appear following the infection . After this period, the so-called syphiloma appears, a small graze at the injection point of the bacterium. In general, syphiloma occurs near the genital organs , is small, more or less round in shape and completely painless. Diagnosis at this stage is difficult, as syphilis can be confused with various sexually transmitted diseases. However, starting from the third month of incubation, the two pathogenic microorganisms responsible for the disease, Treponema pallidum and Herpes simplex , can cause further inflammation andmucous ulcers.

“In China it’s a huge problem: it has had an almost 400% growth in pregnant women in the last decade and, until 2016, it was considered a real health emergency.”

 Syphiloma, on the other hand, is visible for a period between 3 and 6 weeks, after which it tends to heal spontaneously. Although the patient is convinced that he is cured, the main bacterium is still active and, without adequate treatment, allows the pathology to evolve towards the second stage. This stage is characterized by the rapid spread of Treponema pallidum, causing widespread lesions all over the body . After a few weeks, a rash appears which mainly affects the hands and feet. This may be accompanied by additional symptoms, such as fever , bone and muscle pain , swollen lymph nodes , sore throat, enlarged liver,patchy alopecia , labyrinthitis and, in severe cases, even widespread infections affecting the brain, including meningitis .

In the more advanced stage, the disease reaches all parts of the body, with the risk that the bacteria compromise the internal organs up to causing the death of the patient .

How do you get Syphilis?

The disease is transmitted from one subject to another through contact with ulcers and wounds; that is why the use of condoms protects against infection. In addition to being sexually transmitted, it can also be trans-placental, i.e. the mother can infect the fetus during pregnancy. It cannot be transmitted through objects.

The infection is usually transmitted through sexual intercourse:

  • genital,
  • orogenital,
  • anogenital
  • oral sex

A good percentage of syphilis cases (both primary and secondary)  are attributable to transmission by oral sex . A  survey has revealed that about 13.7 percent of syphilis cases could reasonably be attributed to an infection that occurred during oral sex without a condom, especially among male homosexuals , among whom the percentage rises to 20.3 percent. 

How is the diagnosis made?

It is possible to resort to serological tests , carried out by taking a blood sample. In this way it is possible to trace the presence of antibodies, which tend to multiply as soon as the bacterium appears. Antibodies are also present in the blood in the initial phase of the disease, the one characterized by the absence of obvious symptoms. The test should be requested by anyone who detects the typical skin lesions of the disease.

What are the treatments?

The main therapy consists in taking antibiotics . Among these, penicillin is the drug of choice and can also be prescribed to pregnant women. If the presence of the bacterium is detected, any partners of the patient must also undergo treatment. The second option is represented by ceftriaxone , which can also be taken by people with intolerances or allergies to penicillin. 

The best weapon is Prevention

As with all sexually transmitted infections, prevention passes from the use of a condom to every occasional encounter.

But be careful to let your guard down: wounds and skin ulcers can transmit the infection – as seen above – even during oral sex or any other skin contact with infected areas. 

Also pay attention to pregnancy: despite its low incidence, all women are screened in our country, before conception or at the beginning of pregnancy, for the prevention of congenital infection. Depending on the mother’s infection status, the infection can be transmitted to the fetus causing stillbirth or the birth of a child with congenital syphilis.