April 2024 - Syphilis and Congenital Syphilis
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."
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What Is Syphilis? And Why Are Rates Rising? Originally appeared on usnews.Com
Update 09/17/24: This story was previously published at an earlier date and has been updated with new information.
Trump Refuses To Release Medical Records To Conceal Years-old Illness, Claims Senior Democrat
A senior Democratic strategist, James Carville, has sparked controversy by claiming that former President Donald Trump is concealing a syphilis diagnosis by refusing to release his medical records. Carville's allegation comes after a photo emerged in January showing Trump with red markings on his hands, which some believe may be a sign of the sexually transmitted disease. According to Radar Online, Carville suggested that Trump's long-standing secrecy around his health could be linked to the infection.
Carville further alleged that medical records stolen from a Manhattan facility in 2017 by one of Trump's bodyguards contained evidence of the syphilis diagnosis. The incident reportedly occurred shortly after Trump's physician, Dr. Harold Bornstein, disclosed that Trump had been taking medication for hair growth.
Carville's comments echo earlier speculation by infectious disease specialist Steven Beutler, who wrote an article for The New Republic in 2017, proposing that Trump's behavior could be linked to neurosyphilis—a severe form of syphilis that affects the nervous system. Beutler explained that syphilis is known as "The Great Imposter" because it can mimic a variety of conditions as it progresses. If left untreated, it can enter a latent phase and later lead to serious neurological issues, including dementia, delusional thinking, and memory problems.
Beutler detailed how syphilis develops, starting with primary syphilis, which usually presents as a genital ulcer. If untreated, the infection can spread throughout the body, leading to secondary syphilis with symptoms like fever, rash, and fatigue. Over time, the disease can enter a prolonged dormant phase, which can last for years or even decades without symptoms. The most severe stage, known as tertiary syphilis, can result in neurosyphilis, affecting brain function and leading to symptoms such as irritability, insomnia, and impaired judgment.
Beutler pointed out that several symptoms of neurosyphilis, including memory issues, grandiosity, and irritability, have been observed in Trump. He cautioned, however, that without full access to Trump's medical records, it's difficult to confirm a diagnosis.
Despite Trump's public claims of robust health, the lack of transparency regarding his medical history continues to fuel speculation. Beutler concluded that while there are numerous potential explanations for Trump's behavior, the absence of detailed medical information leaves many questions unanswered.
Genital Herpes Symptoms: What To Watch Out For
Genital herpes causes painful sores on your genitals (sex organs). It is one of the most common sexually transmitted infections (STIs) in the U.S. It's caused by the herpes simplex virus (HSV).
Most cases of genital herpes are due to the herpes simplex virus type 2 (HSV-2).
Herpes simplex virus type 1 (HSV-1) mostly causes cold sores or fever blisters. But it can also cause genital herpes.
A lot of people with genital herpes don't know they have it. If you do, you might not have any symptoms or only have very mild ones. But because treatment can help prevent complications and make it less likely that you'll spread this STI to others, it's a good idea to be aware of genital herpes symptoms.
Genital herpes virus is passed from one person to another through sexual contact. This happens even if the person with the virus doesn't have symptoms or signs of infection.
Once the virus enters through your skin, it travels along your nerve paths. It can then become dormant (inactive) in your nerves and remain there.
From time to time, the virus can become active again. It travels back along the nerve path to the surface of your skin, where more virus is shed. At this point, it may cause an outbreak of symptoms, or what's called an outbreak or flare. But not everybody has noticeable symptoms.
In either case, the active virus can easily be passed from you to your partner through sexual contact. Even wearing a condom may not be enough protection, as the virus can be present on the skin that remains uncovered.
When you're first infected, you're likely to have an outbreak within 2 days to 3 weeks after contact. But it could also take years.
The first outbreak is usually the longest and most uncomfortable. It could last 2-4 weeks. After that, herpes outbreaks tend to become shorter and less intense.
The number of outbreaks you can have varies. Some people have many flare-ups in the first year after being diagnosed, but these may decrease over time.
Genital herpes can show up on your:
If you have a mild case, you can easily mistake herpes sores for a patch of ingrown hairs or pimples on your genitals.
They may start as small blisters that eventually break open and ooze fluid. Over time, they'll turn into raw sores that may be painful. Then, they'll scab over and heal up within a few weeks.
First signs of genital herpes
About half of all people with genital herpes can tell when an outbreak is about to happen. A few days or hours before, you could notice any of the following in the areas where sores will form:
You could also feel like you're coming down with the flu, with symptoms such as fever, headache, swollen lymph nodes, and feeling tired for no reason.
When symptoms occur soon after you're infected, they tend to be severe.
You could have:
Genital herpes is not the only condition that can cause these symptoms. Sometimes, HSV is mistaken for vaginal yeast infections, bacterial infections, or bladder infections. The only way to know for sure whether you have herpes or another condition is to be checked by a doctor.
At your visit, the doctor may take a tiny sample of the fluid from one of your blisters, which is then analyzed at a lab. Or they could do a blood test to look for HSV antibodies. Either way, these tests can confirm if you have genital herpes, but they can't show how you got it or how long you've had it.
All of the symptoms mentioned above can happen in women and people assigned female at birth. You might also be more likely to have pain when you pee. You could have a feeling of pressure below your stomach. And you could notice a discharge from your vagina.
You're at higher risk of getting herpes. That's because the virus spreads more easily from men to women.
The list of symptoms above also apply to you if you're a man or assigned male at birth. Having a partner who's also a man raises your risk of being diagnosed with herpes.
There is no cure for genital herpes. But your doctor can prescribe antiviral medication, which can help:
How often you take medication will depend on how often you get outbreaks and how severe they are. In some cases, your doctor may suggest you take your medication every day. Doctors call this "chronic suppressive therapy."
Some people decide not to get treatment for genital herpes. For instance, you might put it off if your symptoms are very mild or if you're not currently having sex, so you're not worried about spreading the virus to a partner. But because genital herpes raises your risk for other health issues, talk to your doctor about whether this is a safe option for you.
During an outbreak, here's what you can do at home to relieve some of your symptoms:
Try over-the-counter pain relief. If you're not sure whether it's safer for you to take acetaminophenor ibuprofen, check with your doctor.
Bathe sore areas with a warm saltwater solution. Twice a day, mix 1/2 teaspoon salt with 1/2 pint of warm water.
Wear loose-fitting clothes. Letting air around the sores and keeping them dry will help them heal faster. Choose cotton underwear, which will pull moisture away from your skin.
Cool off. Put an ice pack on the affected area. Make sure to wrap the ice pack in a towel first.
Take a sitz bath. Sitting in a warm, shallow bath could make you more comfortable. Air-dry afterward, instead of using a towel.
Make peeing less painful. Peeing while you're in a bath or while your penis is submerged in a bowl of water sounds strange, but it could stop your urine from stinging your sores.
Reduce your triggers. Stress can cause a herpes outbreak, so do what you can to keep calm and stay healthy. Get enough rest, for instance. Try to eat healthy foods. Talk to a counselor if you need tips on managing challenges in your daily life.
To avoid passing the virus to other people, take these steps:
Before you have sex with a new partner, it's important to let them know you have herpes. You can share with them that this virus is really common and unlikely to cause any lasting health issues. You can also lay out the steps you'll take to keep them from getting it.
Once you have an initial outbreak following a genital HSV infection, you can expect to have four to five outbreaks within a year.
As time goes on, your body builds up more immunity to the virus, and your outbreaks may become less frequent. Some people see them stop altogether.
Genital herpes symptoms usually flare up during periods of physical or emotional stress. That's because, during these times, your body's immune system may be less able to suppress the virus and keep it from becoming active.
Common symptom triggers can include:
You may find it helpful to keep track of how you're feeling and anything going on in your life when an outbreak starts. Over time, that can help you understand what activates your infection. Then, you and your doctor can talk about how to avoid these specific triggers or reduce their effect on you.
Most of the time, genital herpes isn't a major threat to your health. Aside from discomfort during outbreaks, an HSV infection is more of an emotional stressor. It can:
In some cases, though, complications from genital herpes can be extremely serious. They include:
Infecting your newborn. If you're pregnant and have genital herpes, you can pass the virus on to your child. This can result in developmental issues and serious physical issues, which can sometimes be life-threatening. So, it's advised to take steps to prevent an outbreak at the time of your delivery, starting at 34 weeks into your pregnancy. If you have signs of an active viral infection when it's time to deliver, your doctor will likely recommend a C-section for delivery to protect your baby's health.
HIV and AIDS. If you've been diagnosed with genital herpes, you have a higher risk of an HIV infection. One reason is that cracks and breaks in the skin that result from an outbreak create openings through which HIV can enter your body. If left untreated, HIV can progress into AIDS.
Infections in other parts of your body. Although it's rare, the HSV virus could lead to severe infections in other parts of your body, such as your eyes or brain.
If you have any reason to think that you have an HSV infection, either genital or oral, contact your doctor.
Once you're infected with genital herpes, you will have this condition for life. Genital herpes symptoms, such as painful, fluid-filled sores on your genitals, will come and go. Antiviral medication can manage your symptoms and prevent you from infecting others. If you're pregnant, it's very important to tell your doctor and get treated. The virus that causes genital herpes can be fatal to your baby.
Is herpes contagious all the time?
Yes, you can be contagious even if you don't have any sores. That's why it's so important to get tested for genital herpes. Once you know you have it, you can take steps to avoid spreading to others.
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