Syphilis

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SYPHILIS is caused by a spiral-like bacteria called Treponema pallidum. If syphilis is left undiagnosed and untreated it can cause very serious long term health consequences, including heart conditions, nervoussystem breakdown, brain function impacts, and death.

Syphilis can affect anyone regardless of their sexuality. Higher rates of syphilis notifications have occurred in young Indigenous people and among HIV-negative and HIV-positive gay men.

TRANSMISSION

Syphilis is easy to catch through oral sex or from skin-to-skin contact if there is a skin rash or syphilis sores (chancre) which may go unnoticed. Therefore, even if you use condoms, sexual foreplay (skin-to-skin body contact) and oral sex are still a high risk for contracting syphilis – your sexual partner may be unaware of their infection if they haven’t been tested.

Sexual transmission usually occurs during the primary (2-3 months) and secondary stages (2-6 months). Syphilis is highly contagious during these times, but transmission may also occur within 2 years of infection (during early latency, even without any symptoms).

SYMPTOMS

Chancre sores are generally small reddish open lesions and can occur just about anywhere, inside the mouth, on the lips, or in the genital or anal areas (and in the rectum) – making them sometimes hard to see and sometimes they are painful but can also be painless. These will often heal and disappear within a few weeks, even if untreated, and a person can still pass on syphilis without these. A rash may also occur on your palms and soles of feet or other parts of your body.

Other symptoms may also emerge such as swollen glands, fever, headaches, fatigue, muscle and joint aches and pains, weight loss and hair loss.

In the early stages of infection symptoms may not always occur, this is why it’s important to test regularly for syphilis if you are sexually active.

The progression of syphilis can occur more quickly if you also have HIV, which can make syphilis harder to treat. Like all STIs it is best to diagnose and treat them early, before they progress to more serious stages.

TESTING

Ask your doctor or sexual health clinic for a test if you think you’ve been exposed to syphilis.

There is a period of 2-3 weeks before an infection can be detected on a test, though this period can be up to 3 months. Rapid syphilis tests are also available from QPP’s RAPID clinics in Brisbane and the Gold Coast – results are provided in 15 minutes and no appointment is required (www.rapid.org.au).

Rapid syphilis tests are only reliable if you have never had a previous syphilis infection (because antibodies can persist for life), so if you have had syphilis before you are best to test for a current new infection at your medical or sexual health clinic. If you are having any sex get a yearly test, and whenever you change sex partners. If you are having any condom-less sex, or sex with multiple partners (>10 within 6 months) or group sex, or using recreational drugs during sex – get a test every 3 months (4 times a year).

If you are HIV-positive, consider the above testing recommendations as it is best to test every 3 months due to the added impact of having HIV and syphilis.

PREVENTION

If you have been diagnosed with syphilis, it is safest not to have sex, even with a condom, until 1 week after the first treatment and all symptoms have gone.

You can get syphilis again even if you had it before. If you have previously been treated for syphilis, it is still very easy to catch again. There is no vaccine against syphilis.

Condoms provide partial protection, but may not prevent all risks of syphilis. Syphilis can occur in the mouth, so oral sex without a condom can also be a risk. A skin rash may also occur (which can be hard to see) so any skin-to-skin body contact is also a risk. However, condoms will provide genital and anal protection, so it’s still important to use condoms to assist in the prevention of syphilis.

SYPHILIS & HIV

Your risk of getting HIV increases when you or you partner have syphilis. Having a syphilis infection may also increase your chances of passing on HIV, as it may increase HIV viral load in semen and pre-cum (even with an undetectable HIV viral load in blood).

CONTACT TRACING

It is important to inform sexual partners to prevent transmission and reinfection. Contact tracing (or partner notification) is where any sexual partners you have had since you may have become infected with an STI should also go for a sexual health test check, as they may also need to be treated. Not all STIs need contact tracing (such as herpes or genital warts), but the more serious and health impacting conditions do (such as chlamydia, gonorrhoea, syphilis, hepatitis, etc.). Your diagnosing doctor can discuss partner notification needs with you. If contact tracing is recommended, there are ways to let your partners know they may have been exposed to an STIs without disclosing your identity (i.e. anonymously).

The following websites can assist you to anonymously notify your sexual partners:

www.letthemknow.org.au

www.bettertoknow.org.au/notify

www.thedramadownunder.info

TREATMENT

Syphilis is easy to treat (and cure) with penicillin injections. The length of treatment depends upon the stage the infection. If left untreated the condition enters a period of latent infection, with no obvious symptoms. At this stage, even without symptoms, the infection may cause serious damage to

internal organs such as the heart, brain, liver, nerves and eyes. This latent stage may persist for years, or decades, and it may lead to tertiary (end stage) syphilis, resulting in conditions such as blindness, difficulty walking, talking and eating. Tertiary syphilis is very difficult to treat and is life threatening.

READ MORE ABOUT SYPHILIS

www.tinyurl.com/ja25j7t

www.healthdirect.gov.au/syphilis

www.tinyurl.com/gnb3c8z