Not-So-Sexy Syphilis

In Australia and many other developed countries, Syphilis is back on the increase.

This is due, in part, to both heterosexual and same-sex couples not using condoms. In same-sex couples, HIV prophylaxis PrEP and post exposure PEP is another contributing factor.

Read on to learn some off-the-beaten stats and details about the disease.

HISTORY

Syphilis has been around for a long time. From mummified ancient Egyptian royalty, through to the Greeks and Romans, the New World, the Americas and movie stars of today, syphilis is unfortunately an omni-present disease throughout history.  In fact, syphilis - and a few other STI’s - were the second most common reason for disability and absence from duty during World War I, II and the Vietnam War.  So devastating was syphilis in the pre-penicillin years that it effectively halted several large conflicts in Europe, including the first of the Italian Wars where Charles VIII of France invaded Naples, but was essentially thwarted by his own troops of painful and repulsive sores.

CLASSES OF SYPHILIS

Primary syphilis classically presents itself on the genitals between 3 weeks and 3 months post-exposure and most often looks like a single firm, painless, non-itchy skin lump called a gumma (this is different to that of herpes and other STI’s that are painful and or itchy). 

At this stage of the disease, it is relatively easy to treat primary syphilis with a course of antibiotics, undetected, it can often evolve quickly from a lump to something resembling a pustule, and from there to a painless ulcer.

Latent and Tertiary syphilis carry the greatest health risks. 

Latent syphilis is defined as having syphilis in your blood, but without showing any symptoms. Latent syphilis can change at anytime to tertiary, with some cases reported of people getting tertiary symptoms 40+ years later.

Tertiary syphilis infection is divided into three classes:

Gummatous - characterized by chronic soft tumour-like gummas affecting the skin, bone and liver;

Neurosyphilis - referring to when the infection involves the brain and central nervous system.  It can cause problems from loss of sensation, poor balance, to lightening pains in the lower extremities, dementia, seizures and death.  Not the kind of syphilis that you want nor is it easy to treat or reverse.

Cardiovascular - causes the formation of aneurysms, and sometimes death, if a large one were to burst. Yikes.

MIS-DIAGNOSIS

HIV, herpes and other STIs not only make it easier to catch syphilis, but also to mis-diagnose and under treat the disease.  Many people with secondary syphilis report never having been aware of any primary symptoms at all: though once it has reached this stage, up to 30% of people will have a re-occurrence, even after what is considered effective treatment.  Secondary syphilis is widespread, often affecting the palms and soles with bacteria filled wart-like lesions that are contagious and only appear weeks or months after that initial lump or ulcer.

INFANTS & SYPHILIS

Infants born with congenital syphilis have a much higher chance of organomegaly (enlarged organs such as the liver and spleen). If untreated late, congenital syphilis results in facial and body deformations.  Syphilis is transmitted to children during pregnancy or birth, and whilst many children are born without recognizable symptoms, they are often latent carriers with issues developing later in life.  Mothers are screened for syphilis in both the first and third trimester to try and prevent the problems with congenital transmission though this is still an ongoing issue in developing nations.

NON-SEXUAL TRANSMISSION

Whilst syphilis is preventable through the use of safe sex, there have been several cases of transmission through heavy petting and other body contact where one of the two partners has an open sore.

HOW TO TEST FOR SYPHILIS

You need regular sexual health testing so that doctors can halt the disease in its primary stage, rather than have it carry on undetected through stages 2-4 where there can be fatal consequences. Visit your doctor to schedule regular health checkups, regardless of whether you are single or in a relationship.

THE VERDICT

So whatever your sexual orientation, slip on a condom, as there is no vaccine for syphilis, and barrier protection is the best way to prevent the vast majority of its spread and other STIs.  This does not completely eliminate the risk - even if you never have unprotected sex, you still need to get STI tested every 6-12 months to ensure you’re not a carrier, as the downstream effects can be devastating.