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What Is Syphilis? And Why Are Rates Rising?

Jack Smith woke up one morning to discover a small hard sore on his penis. When it didn't go away…

Jack Smith woke up one morning to discover a small hard sore on his penis. When it didn't go away within a couple of days, he went to a clinic where he was examined, was asked about his sex life and was given a blood test, which registered positive for syphilis. He was lucky that the clinic had been made aware, through public service health campaigns, to be on the lookout for the infection.

Smith was shocked and immediately regretted not speaking with his sexual partners about their sexual habits. He also regretted that he'd been careless and wasn't always using a condom during sexual intercourse. Fortunately, the infection was found at an early stage, and Smith was treated with a dose of penicillin. Had he waited longer, he may have had to have more than one treatment and could have suffered lasting complications.

Smith is not a real person, but stories like this are playing out daily across the country. Syphilis is rising at alarming rates in the United States. It's affecting all age groups in all regions of the country. Since 2000, the number of syphilis cases has been steadily increasing. Between 2018 and 2022, cases of the disease increased by almost 80% to 207,000 cases, the highest number recorded since the 1950s. In 2022, the number of babies born with syphilis (congenital syphilis) was about 3,755, an increase of 93% in ten years.

"Syphilis is curable in all stages, but there's a lack of awareness about the causes of the disease, the symptoms of the disease and the availability of testing and treatment," says Dr. Michael Angarone, an infectious disease specialist at Northwestern Feinberg School of Medicine.

[READ: Guide to Sexually Transmitted Diseases.]

What Is Syphilis?

Syphilis is a common curable sexually transmitted infection caused by the bacteria Treponema pallidum. Syphilis can cause serious health problems if not treated early. It's transmitted through anal, genital or oral sexual contact, or from a mother with syphilis to a fetus.

Without treatment, which consists primarily of penicillin shots, syphilis can cause serious problems, including damage to the brain, the heart and other organs. It can also cause blindness, deafness, paralysis and sometimes death. About 10% of patients who are not treated for syphilis end up dying from this infection.

Syphilis starts as a painless sore that can go unnoticed. It typically appears on the genitals, rectum and mouth. It is spread through direct contact with sores.

It can be transmitted sexually only in its early stages, but syphilis can stay in the body for many years without symptoms. A pregnant woman can pass it on to a fetus at any stage.

[Read: Living With an HPV Infection.]

The Stages and Symptoms of Syphilis

The syphilis bacterial infection develops in stages, each of which has specific signs and symptoms. While it can be cured at any stage, damage that has occurred before treatment is usually not reversible.

Syphilis is known as "the great mimicker" because of the way it manifests itself — liver inflammation, cardiac issues, rashes and swollen lymph nodes — can be chalked up to so many other causes. Its symptoms and consequences mostly depend on its stage. However, patients can develop neurosyphilis and ocular syphilis — or syphilis that has spread to the nervous system or brain — at any stage of the disease. If that happens, it can lead to serious, irreversible conditions including blindness and dementia.

4 stages of syphilis:

Primary Syphilis. In the first stage of syphilis, sores called chancres appear in the spot where bacteria entered the body. Most people develop one chancre, but some develop more than one. Sores may go unnoticed, as they are firm, round and painless and may be hidden in or around the penis, vagina, anus, rectum, lip or mouth.

A sore usually lasts for about 3 to 6 weeks and heals on its own whether it's treated or not. Treatment stops the infection from moving to the secondary stage.

Secondary Syphilis. In the second stage of syphilis, while a chancre is healing or a few weeks after it has healed, a rash may appear first on the trunk of your body (chest, stomach, pelvis, back) and can spread to your arms and legs, the palms of your hand and the soles of your feet.

The rash is usually not itchy and may look red, reddish brown and rough. Sometimes, the rash is so faint it's barely visible.

In addition to a rash, symptoms of secondary syphilis include the following:

— Wart-like sores in your mouth or genital areas

— Hair loss

— Muscle aches

— Fever

— Sore throat

— Headaches

— Fatigue

— Weight loss

— Swollen lymph nodes

These symptoms will usually go away on their own, but without treatment, the infection will move to the next stage, the latent stage — and maybe to the tertiary stage of syphilis. Symptoms could come and go for months or years.

Latent Syphilis. The latent stage of syphilis is also called the hidden stage because there are no visible signs or symptoms of the disease. They may never come back, but without treatment, the infection can remain in your body for years and you may have serious problems, including brain and cardiovascular disease.

Tertiary Syphilis. Tertiary syphilis is very serious. After latent syphilis, up to 30% to 40% of those who don't get treatment will progress to the tertiary stage. It usually appears about 10 to 30 years after the original untreated primary infection.

Complications of tertiary syphilis can include the following:

— Brain damage

— Nerve damage

— Eye damage

— Heart damage

— Blood vessel damage

— Liver damage

— Brain and joint damage

— Death

[Related:Health Screening Tests Every Woman Should Have]

What Is Congenital Syphilis?

Congenital syphilis is a severe and often life-threatening infection seen in infants whose mothers were infected and not treated. It can be passed to a baby thorough the placenta or during birth.

When syphilis is transmitted during pregnancy, the result can be miscarriage, infant death or lifelong medical problems. Up to 40% of babies born to a mother with untreated syphilis die from the infection.

At birth, infants with syphilis who survive may have no signs of the disease, but if a baby is not treated right away, serious problems can develop within a few weeks. Those problems include:

— Sores and rashes on the skin

— Fever

— Jaundice or discoloration of the skin and eyes

— Anemia or not enough red blood cells

— Swollen spleen and liver

— Rhinitis or sneezing or stuffed and drippy nose

— Bone change

Later symptoms can include deafness, vision problems, problems with teeth, collapsed nose bridge and impaired brain development.

[READ: How to Cope With Common Sex Problems.]

Who Is at Risk for Syphilis?

Anyone who is sexually active and having vaginal, anal or oral sex without a condom with one or more partners is at risk for contracting the disease.

Due to health inequities like a lack of sex and public health education, inadequate access to health care and cultural barriers to care, syphilis tends to be more common in some racial/ethnic and sexual minority groups.

Dr. Matthew Hamill, a specialist in sexually transmitted infections at Johns Hopkins School of Medicine, says that there have been changes in services for sexually transmitted infections in public health clinics. Since 2003, there has been a 40% reduction in investment in sexual health services with fewer clinics operating.

Increased substance abuse linked to risky sexual behavior is also contributing to the rise of syphilis.

Jessica Leston, a public health professional who has been doing educational outreach work with Native tribes for more than 20 years, says that many Native people get their health care through the Indian Health System, which she says is funded at less than 20% of need. American Indian and Alaska Native people are experiencing the highest rates of syphilis in the U.S., comparable to rates recorded from the pre-penicillin era when syphilis was difficult to cure.

Gay and bisexual men are also disproportionately impacted by syphilis.

Who should get tested for syphilis?

If you think you're at risk for syphilis, you should seek out a health care provider who can test you for the disease. The following are good reasons to ask to be tested:

— You are regularly having sex with more than one partner.

— You are having unprotected sex (without a condom).

— You've had sex with someone who has syphilis.

— You have a partner who has tested positive for syphilis.

— You have another sexually transmitted disease like HIV.

— You are gay or bisexual.

— You live in a community that has high rates of syphilis.

— You are pregnant.

"All pregnant women should be tested for the disease at least twice during pregnancy and at labor and delivery in high prevalence areas," says Dr. Peter Leone, an infectious disease specialist at the University of North Carolina at Chapel Hill. "The only way to know for sure if you have syphilis is to be tested."

Proper diagnosis of syphilis involves a discussion of sexual history, a physical exam and blood tests, he adds.

Although not all are highly accurate, home tests for syphilis are now available online, so that you can test yourself in the privacy of your own home.

How Is Syphilis Treated?

Syphilis is curable at any stage when treated with an antibiotic, usually penicillin. The duration and dose of medication needed depends upon the stage of the disease. Damage caused by the infection prior to treatment may not be reversible.

You should also contact anyone with whom you've had sex in the last three months to help limit the spread of disease.

After you've been treated for syphilis, your healthcare provider will test your blood again to be sure the infection is gone. Be sure to practice safe sex after you've been treated, as you can get syphilis again. If you think you're at risk, get tested again.

"Syphilis is generally very easy and straightforward to treat and responds to one or more injections of penicillin," says Hamill. "For late syphilis or for syphilis you've had for a year or more, you'll need to get one shot a week for three weeks."

In addition, Hamill says there is now an antibiotic to take after having sex for people who are at high risk.

If syphilis is so curable, why are the numbers of cases rising?

Although screening and treatment for syphilis is easy, highly accurate and effective, rates of the disease are continuing to rise. Much of the public continues to have limited understanding and knowledge of what syphilis is, how it's spread, how to recognize it and what to do about it.

"We need to do a better job of letting the public know that syphilis is still around, how to recognize the signs and symptoms of the disease and that screening and treatment is available," says Hamill.

In addition to better educating patients to be open and honest with healthcare providers about their sexual activity, healthcare providers need to learn how to speak with patients about STIs.

"People should feel empowered to ask their health care providers for tests that are usually covered by insurance," says Hamill, "and clinicians should be comfortable asking patients about their sex lives."

Here's Why You Should Call A Doctor If You See Green Discharge

Seeing green discharge when you wipe is enough to send even the most chill person into a full-on freak out. After all, you likely have an idea of what your vaginal discharge looks like on a regular basis — and a green or even green-ish shade definitely isn't it. While doctors say you shouldn't panic, this is one of those situations that definitely warrants a call to your ob-gyn.

The bottom line: Green discharge (no matter whether it's just slightly mossy or full-on Kermit the Frog) is most often a sign of something fairly serious, making it imperative to be seen by a doctor ASAP. But to help give you some idea of what could possibly be behind that grassy hue while you wait for your appointment, keep reading for a breakdown of the most common causes of green discharge, according to ob-gyns.

Experts Featured in This Article

Christine Greves, MD, is an ob-gyn at Orlando Health Women's Institute Center for Obstetrics & Gynecology and obstetrical and gynecological surgeon at Winnie Palmer Hospital for Women & Babies.

Jennifer Wider, MD, is a women's health expert, author, and podcast host.

What Causes Green Discharge?

The high-level summary: "Green discharge isn't normal," says Christine Greves, MD, an ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida. There are a few different culprits that could be responsible, although this color usually signals some kind of infection.

It's an STI.

Some sexually transmitted infections (STIs) including gonorrhea, chlamydia, and trichomonas can also cause a green discharge, says Dr. Greves. "Usually gonorrhea discharge is thicker and heavier than usual," she says. "The trichomoniasis discharge may be thin, foamy, and foul smelling." In both cases, the discharge typically is a yellow-green color.

Gonorrhea can also cause symptoms like pain or a burning sensation when you pee, increased vaginal discharge, and vaginal bleeding between periods, according to the Centers for Disease Control and Prevention (CDC). If you're dealing with trichomonas, you may also have irritation in your vulva, per the CDC.

On the other hand, "Chlamydia sometimes presents with symptoms and sometimes does not, but it can also have a green discharge," Dr. Greves says. If chlamydia is behind your green discharge, you'll likely also have a burning sensation when you pee, pelvic pain, and possibly bleeding after sex, Dr. Greves says.

You have bacterial vaginosis.

Bacterial vaginosis, or BV, occurs when there is too much of a certain bacteria in the vagina. (Not so fun fact: It's the most common vaginal condition in women between the ages of 15 and 44, according to the CDC.)

BV can cause pain, itching, or burning in the vagina, a burning feeling when you pee, a fishy odor, and itching around the outside of the vagina. It can also cause green discharge, because the underlying pathology is from a bacterial infection, explains women's health expert and ob-gyn Jennifer Wider, MD. A number of triggers can cause BV, including hormonal changes, unprotected sex, and even stress, Dr. Greves says.

You forgot about a tampon.

A lost or forgotten tampon can also lead to green discharge. Why? Any retained blood in the tampon is a haven for bacteria to thrive and cause inflammation, and possibly an infection, Dr. Greves explains. As a result, you can end up with green discharge and, usually, an intense odor as well.

If you suspect that you forgot to remove a tampon, you can try to fish it out yourself. (Try squatting and bearing down like you're about to use the bathroom, while inserting two fingers to reach it.) But if you're unsuccessful, it's a good idea to contact a healthcare provider. You'll also want to monitor yourself for signs of toxic shock syndrome (TSS), which include a sudden high fever, rash, and vomiting or diarrhea, according to the Cleveland Clinic.

There's toilet paper stuck in there.

"Even bits of stuck toilet paper can result in a greenish yellow discharge," Dr. Greves says. The concept is similar to what can happen with a tampon—the toilet paper gets trapped in your vagina and turns into a breeding ground for bacteria. It's worth noting that this can happen with nearly anything that gets stuck in your vagina, including broken portions of condoms or other objects that were inserted into the vagina, Dr. Greves notes. Just like with a lost tampon, you can try to remove the debris yourself, but again, if you're unsuccessful, seek medical attention.

When to See a Doctor About Green Discharge

In case it's not yet clear, call a doctor anytime you have any kind of green discharge; getting properly diagnosed and treated ASAP is imperative. Treatment can vary, but typically includes antibiotics, given that an infection is usually present. And make sure you push for immediate medical care if your discolored discharge is also accompanied by pain (during urination or otherwise), fever, or chills, Dr. Greeves notes.

Korin Miller is a writer specializing in general wellness, health, and lifestyle trends. Her work has appeared in Women's Health, Self, Health, Forbes, and more.

Bacteria Involved In Gum Disease Linked To Increased Risk Of Head And Neck Cancer

More than a dozen bacterial species among the hundreds that live in people's mouths have been linked to a collective 50% increased chance of developing head and neck squamous cell carcinoma (HNSCC), a new study shows. Some of these microbes had previously been shown to contribute to periodontal disease, serious gum infections that can eat away at the jawbone and the soft tissues that surround teeth.

Experts have long observed that those with poor oral health are statistically more vulnerable than those with healthier mouths to HNSCC, a group that includes the most common cancers of the mouth and throat. While small studies have tied some bacteria in these regions (the oral microbiome) to the cancers, the exact bacterial types most involved had until now remained unclear.

Led by researchers at NYU Langone Health and its Perlmutter Cancer Center, the new analyses looked at the genetic makeup of oral microbes collected from healthy men and women. Of the hundreds of different bacteria that are routinely found in the mouth, 13 species were shown to either raise or lower risk of HNSCC.

Overall, this group was linked to a 30% greater likelihood of developing the cancers. In combination with five other species that are often seen in gum disease, the overall risk was increased by 50%.

"Our findings offer new insight into the relationship between the oral microbiome and head and neck cancers," said study lead author Soyoung Kwak, Ph.D. "These bacteria may serve as biomarkers for experts to flag those at high risk," added Kwak, a postdoctoral fellow in the Department of Population Health at NYU Grossman School of Medicine.

Previous investigations had uncovered certain bacteria in tumor samples of people already diagnosed with these cancers, says Kwak. Then, in a small 2018 assessment, the current research team explored how microbes in healthy participants may over time contribute to future risk of HNSCC.

Their latest report, published online Sept. 26 in the journal JAMA Oncology, is the largest and most detailed analysis of its kind to date, says Kwak. It is also among the first to examine whether common fungi, organisms like yeast and mold that, along with bacteria, make up the oral microbiome, might play a role in HNSCC. The new experiments found no such role for fungal organisms.

For the research, the team analyzed data from three ongoing investigations tracking 159,840 Americans from across the country to better understand how diet, lifestyle, medical history, and many other factors are involved in cancer. The data were gathered for the American Cancer Society Cancer Prevention Study II; the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial; and the Southern Community Cohort Study.

Shortly after enrolling, participants rinsed with mouthwash, providing saliva samples that preserved the numbers and species of microbes for testing. Researchers then followed up for roughly 10 to 15 years to record any presence of tumors.

In the current study, the investigators analyzed bacterial and fungal DNA from the spit samples. Then, they identified 236 patients who were diagnosed with HNSCC and compared the DNA of their oral microbes with that of 458 randomly selected study subjects who had remained cancer-free. In their research, the team accounted for factors known to play a role, such as age, race, and how often they smoked cigarettes or drank alcohol.

"Our results offer yet another reason to keep up good oral-hygiene habits," said study co-senior author Richard Hayes, DDS, MPH, Ph.D.

"Brushing your teeth and flossing may not only help prevent periodontal disease, but also may protect against head and neck cancer," added Hayes, a professor in the Department of Population Health at NYU Grossman School of Medicine and a member of its Perlmutter Cancer Center.

The researchers emphasized that their study was designed to identify correlations between the risk of cancer and certain bacteria in the mouth, but not to establish a direct cause-and-effect link. That will require further research.

"Now that we have identified key bacteria that may contribute to this disease, we next plan to explore the mechanisms that allow them to do so and in what ways we can best intervene," said study co-senior author Jiyoung Ahn, Ph.D. Ahn is a professor in the Departments of Population Health and Medicine at NYU Grossman School of Medicine and is the associate director for population research at its Perlmutter Cancer Center.

Ahn cautions that while the added risks from bacteria are concerning, overall cases of head and neck cancer remain fairly uncommon.

More information: Oral Microbiome and Subsequent Risk of Head and Neck Squamous Cell Cancer, JAMA Oncology (2024). DOI: 10.1001/jamaoncol.2024.4006

Citation: Bacteria involved in gum disease linked to increased risk of head and neck cancer (2024, September 26) retrieved 29 September 2024 from https://medicalxpress.Com/news/2024-09-bacteria-involved-gum-disease-linked.Html

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