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Sexually Transmitted Diseases 101

February 2001

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Syphilis is a highly treatable disease in which a single painless lesion (chancre) will develop over three to four weeks at the site of entry into the body. As the lesion may be painless and occur in the rectum, it can go unnoticed, and be easily spread.

Infection is detected by blood test, examining fluid produced by the lesions, and spinal fluid testing. Antibiotics are successful in treating syphilis. Damage caused by untreated syphilis, however, cannot be undone.

Even without treatment, the lesion will heal in about three weeks. The patient will then develop secondary syphilis, often characterized by a body rash. Without treatment, the rash will remain for about four weeks and will also eventually disappear.

Because of a relatively long incubation period, the spread of syphilis can be stopped by testing individuals who suspect they may be infected, and then treating them before the infection can be spread to others.

For people living with HIV, co-infection with HIV and syphilis may complicate the treatment of both diseases. The risk of syphilis treatment failure increases in the presence of HIV. People with HIV may also be at higher risk for neurosyphilis.

STDs also may increase the risk of HIV transmission since there is a two- to five-fold increased risk of acquiring HIV infection when syphilis is present. A person already infected with syphilis, who has sexual contact with another infected person, also infected runs the risk of an additional syphilis infection. Testing for syphilis at least every four to six months is suggested for sexually active people.

Symptoms of Syphilis

Diagnosing syphilis and treating the disease is especially complex among people with HIV. Untreated, the syphilis organism, called "spirochete," can remain in the body for life and lead to disfigurement, neurologic disorder or death.

Syphilis occurs in phases that may overlap, and do not always follow in the same sequence. Symptoms vary with each phase. In the primary phase, painless sores or open, wet chancres appear, often from three weeks to 90 days after infection. They last three to six weeks. They appear on the genitals, in the vagina, on the cervix, lips, mouth, or anus. Swollen glands may also occur during the primary phase.

Other symptoms occur in the secondary phase, which begins between three and six weeks after the sores appear. These symptoms include body rashes that last from two to six weeks, often on the palms of the hands and the soles of the feet. Other symptoms include mild fever, fatigue, sore throat, hair loss, weight loss, swollen glands, headache and muscle pains.

Latent phases of syphilis are characterized by no symptoms. This phase may occur between other phases or at the same time. When syphilis is untreated, it can reach a late phase. Serious damage to the nervous system, heart, brain, or other organs occur, and death may result.

How Syphilis Is Spread

Syphilis may be contracted through vaginal, anal or oral intercourse, kissing, and by a fetus from its mother. When sores are present early in the disease, syphilis is especially contagious. Liquid that oozes from the chancres is very infectious.

People are usually not contagious during the latent phases of the first four years of syphilis infections. Untreated syphilis remains latent for many years or a lifetime, but can be spread from a pregnant woman to her fetus.

If untreated, the risks of stillbirth or serious birth defects from syphilis infection are high. Birth defects include damage to the heart and brain as well as blindness. It is very important for pregnant women to consider testing for syphilis early, and, sometimes, throughout their pregnancies. Pregnant women with syphilis can be treated to prevent damage to the fetus.

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This article was provided by AIDS Project Los Angeles. It is a part of the publication Positive Living.
See Also
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