Lecture Notes

In the U.S. more than 45,000 cases of syphilis were reported in 2010. Syphilis is a genital ulcerative disease. It is spread by direct contact with a syphilis sore during vaginal, anal, and oral sexual behavior. The syphilis bacterium of an infected mother can infect the baby during the pregnancy. Many of its signs and symptoms of syphilis are indistinguishable from those of other diseases. Yet, many infected people stay asymptomatic for years but they remain at risk for complications if not treated. Further, they may unknowingly infect others. Syphilis progresses through three discrete stages:

During the primary stage symptoms appear from 10 to 90 days after exposure with an average of 21 days in appearance. This is marked by the appearance of a single sore or multiple sores. The sore will be firm, round, small, and a painless chancre on the labia, the shaft of the penis, testicles or rectum, within the vagina, mouth, or lips. Without treatment it will heal in three to six weeks, but bacterium remains in the body and the person is still highly contagious. Infection also progresses to the secondary stage. The secondary stage develops six weeks after this appearance of the chancre. Its symptoms include a skin rash and mucus membrane lesions that do not itch or hurt on the palms of the hands, sole of the feet, or other areas of the body. They are often rough, red, and a reddish brown in color. A person can also experience a fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. Symptoms may be mild or unnoticeable but still contagious. This will resolve with or without treatment but will progress to the next stage. The latency stage develops two to six weeks after the disappearance of the symptoms for untreated secondary syphilis. An infected person can experience no further symptoms or can appear 10 to 20 years after initial infection, and the stage can last for years. After one year, bacterium can no longer be transmitted to sex partners, but women can still transmit the disease to their fetus. Damage can also occur later in the internal organs including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Also, this includes difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia, and even death.

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