Syphilis is Back with a Bang. Here’s How You Can Protect Yourself.

<blockquote> <p>“If I were asked which is the most destructive of all diseases I should unhesitatingly reply, it is that which for some years has been raging with impunity…what contagion does thus invade the whole body, so much resist medical art, becomes inoculated so readily, and so cruelly tortures the patient?”</p> <p>— Desiderius Erasmus, 1520.</p> </blockquote> <p>Syphilis is one of the oldest names in the world of sexually transmitted infections (STIs). We used to believe it was in decline, but now it’s coming back with a vengeance. Since the case numbers are getting out of control, you must protect yourself and be aware of any signs or symptoms.</p> <h2>Syphilis is a disease of many faces</h2> <p>Since its first recording in the 1490s, syphilis has gone by many names (most of them not so friendly), with the “French disease” and the “Polish disease” among them. </p> <p>One nickname has stuck more than any other: “the great imitator”. This echoes syphilis’s masterful ability to imitate other infections and the difficulty in catching early signs. Genital herpes, thrush, chancroid, chlamydia, and gonorrhea are among the conditions that syphilis may be confused for.</p> <h3>Effect on militaries throughout history</h3> <p>Militaries throughout the centuries were plagued by it, taking many soldiers out of action in a less than dignified manner. The symptoms were repulsive on top of being painful; unsightly genital sores preceded abscesses and ulcers scattered over the rest of the body. Death quickly followed.</p> <figure><img alt="" height="474" src="https://cdn.storymd.com/optimized/6qyKRnS5o1/original.jpg" width="500" /> <figcaption>Cutaneous Secondary Syphilis <em>Source: CDC/ Robert Sumpter</em></figcaption> </figure> <p>Penicillin wasn’t around in the 16th century, and remedies were few and not very effective. There were treatments like mercury inunctions and suffumigation that were not only painful but dangerous; many died from mercury poisoning in the process.</p> <h3>Back in fashion</h3> <p>Over the centuries, syphilis evolved into a less virulent form that more closely resembles the disease we know today. It was only in the early 1900s that the cause was discovered, and we didn’t have a proper cure for it until penicillin stepped in in 1943.</p> <p>Nowadays, cases of syphilis are soaring in the US to levels not seen in 70 years, according to the CDC. More than 200,000 cases were recorded in 2022, almost double what we saw in 2018 and an increase of 17% over 2021. Left untreated, syphilis can cause serious organ damage or even death.</p> <h2>Overview of a syphilis infection</h2> <h3>How it spreads</h3> <p>Syphilis is a bacterial infection that most commonly spreads through sexual contact. It begins as a typically painless sore that shows up on the genitals, rectum, or mouth. The sores are extremely contagious, so direct contact is the main way syphilis spreads. It can also pass from mother to child during pregnancy and childbirth, and sometimes even through breastfeeding.</p> <figure><img alt="" height="252" src="https://cdn.storymd.com/optimized/vAQPm7I7q8/original.png" width="758" /> <figcaption>Congenital Syphilis – CDC Fact Sheet <em>Source: CDC</em></figcaption> </figure> <p>Syphilis is especially contagious in the primary and secondary stages when sores, ulcers, and rashes appear. The infection can spread even if no penetration or ejaculation occurs during sex; direct contact with a rash or sore is sufficient.</p> <p>You cannot get syphilis by coming into contact with objects like toilet seats, utensils, and doorknobs. The bacteria behind syphilis cannot survive on objects. </p> <h3>In the shadows</h3> <p>Following infection, the bacteria can remain in the body for many years without you noticing. But the infection can be reignited down the line, and without treatment, syphilis can spread to other organs and cause damage, including the heart and brain. </p> <h3>Progression of the disease</h3> <p>Syphilis has different stages, each with its own set of symptoms and risks:</p> <ul> <li><strong><strong>Primary syphilis. </strong></strong>This stage is characterized by painless sores or ulcers at the site of infection.<br/>  </li> </ul> <ul> <li><strong>Secondary syphilis. </strong>Marked by a rash, fever, swollen lymph nodes, and other issues.<br/>  </li> </ul> <ul> <li><strong>Latent stage</strong>. This refers to when the infection is dormant but could reactivate down the line. There are no obvious signs, though some people experience the odd flare-up. The infection can damage organs and bones at this point, and this stage may last up to 20 years.<br/>  </li> <li><strong>Tertiary syphilis. </strong>This stage can lead to serious complications, including cardiovascular damage, neurosyphilis (affecting the central nervous system), and organ failure.</li> </ul> <h3>Increased risk of HIV</h3> <p>A syphilis infection increases your risk of contracting or transmitting HIV. Syphilis sores are like a gate for HIV, giving the virus easier access for invasion, and the inflammation caused by syphilis facilitates the spread of HIV. </p> <h3>Long-term health issues</h3> <p>Among the worst of syphilis’s long-term complications (if left untreated) are:</p> <ul> <li><strong>Neurological problems</strong>. Neurosyphilis affects the brain and spinal cord, leading to symptoms like headaches, bizarre behavior, paralysis, and possibly dementia.<br/>  </li> <li><strong>Cardiovascular issues</strong>. Damage to the heart and blood vessels can occur, resulting in conditions such as aortic aneurysm and aortic regurgitation.<br/>  </li> <li><strong>Vision and hearing loss.</strong> Syphilis can spread to the eyes and ears, leading to vision problems, blindness, and hearing loss.</li> </ul> <h3>Treatment of syphilis</h3> <p>Syphilis is treatable and curable. With the right antibiotics, you can eliminate the infection from your system. However, this treatment might not be able to undo the damage caused by syphilis while it was lurking inside, including irreversible neurological and cardiovascular complications. Catching it early and nipping it in the bud is vital.</p> <h2>Prevention of syphilis</h2> <p>Stopping syphilis from infecting you follows the same protocols we apply to other STIs. To prevent syphilis, you should:</p> <ul> <li><strong><strong>Use condoms. </strong></strong>This is paramount. People can carry syphilis without signs or symptoms, so don’t mess around, and make sure you’re using condoms correctly and consistently.<strong> </strong><br/>  </li> </ul> <ul> <li><strong>Communicate with partners. </strong>An open conversation with sexual partners about history, checkups, health, and safe sex practices allows you to make informed decisions.<br/>  </li> </ul> <ul> <li><strong>Limit partners. </strong>With more people comes more risks. Having fewer sexual partners decreases the likelihood of encountering someone with syphilis or another STI.<br/>  </li> </ul> <ul> <li><strong>Screen regularly. </strong>Routine screening is essential for sexual health and early detection. The more sexually active you are and the more partners you engage with, the more frequently you should get checked.</li> </ul> <figure><img alt="" height="378" src="https://cdn.storymd.com/optimized/lqL3eXfKdX/original.jpg" width="568" /> <figcaption>Stop Syphilis <em>Source: Fanny Schertzer/Wikimedia</em></figcaption> </figure> <p>You should not:</p> <ul> <li><strong><strong>Engage in unprotected sex. </strong></strong>It might seem like something you can get away with, but even with the best of intentions and transparency from both partners, unexpected issues can arise, including sneaky STIs like syphilis. This goes for vaginal, anal, and oral sex, all of which carry risks of varying degrees with different infections.<br/>  </li> </ul> <ul> <li><strong>Sharing needles. </strong>This is another route by which syphilis can transfer to another person. Seek help for drug abuse disorders and ensure you’re using a sterile, fresh needle if you are using.</li> </ul> <h3>Know the early warning signs of syphilis</h3> <p>In the primary stage (10 to 90 days after infection):</p> <ul> <li><strong>Chancre</strong>. The #1 symptom of syphilis is the development of a painless sore or ulcer called a chancre at the site of infection, typically the genitals, anus, or mouth, but it can happen elsewhere. Chancres can go unnoticed because of their painless nature. They may also go away on their own, tricking you into believing the infection has resolved.</li> </ul> <p>In the secondary stage (in the weeks and months after the chancre has healed):</p> <ul> <li><strong><strong>Rash. </strong></strong>A non-itchy rash may develop on different parts of the body, such as the palms or soles. Reddish-brown spots may characterize the rash, or rough, wart-like lesions.<br/>  </li> </ul> <ul> <li><strong>Flu. </strong>Some people get symptoms resembling the flu, e.g., fever, sore throat, muscle aches, headaches, and swollen lymph nodes.<br/>  </li> </ul> <ul> <li><strong>Hidden lesions. </strong>Mucous membrane lesions can appear in the mouth, throat, and genital area. They may be painless and often go unnoticed.<br/>  </li> <li><strong>Hair loss</strong>. Patchy hair loss may occur (alopecia).</li> </ul> <h2>More on Syphilis</h2><ul><li><a href="https://soulivity.storymd.com/journal/4m8ggn5hpw-syphilis" target="_blank">Syphilis: Symptoms, Testing, Prevention, Treatment</a></li><li><a href="https://soulivity.storymd.com/journal/lw2zxbdh8w-syphilis-and-women" target="_blank">Syphilis and Women: Transmission, Symptoms, Treatment</a></li><li><a href="https://soulivity.storymd.com/journal/pwgrrxo14j-sexually-transmitted-diseases" target="_blank">Sexually Transmitted Diseases (STDs): Types, Symptoms, Treatment</a></li></ul>