Hello patients and friends!
Here at Capitol Hill Medical we have noticed an uptick in the number of cases of syphilis cases, and we’ve just received an update from Dr. Joanne Stekler at the Public Health department confirming our fears that we are still in the midst of a worrisome, and worsening, outbreak. Yikes!
For the year, the county is double where it was in terms of new syphilis cases as compared to last year, and we have no indications that it’s going to slow down anytime soon.
So, let me recap some of the most important points about syphilis for all of you, so that you know what we’re up against:
What is syphilis?
Syphilis is a sexually transmitted disease caused by the spirochete Treponema Pallidum. There are various stages of syphilis that occur after someone is infected, mostly dependent on how long someone has been infected.
What are the various stages of syphilis?
Primary syphilis - the first stage, is characterized by a small, painless nodule or ulcer which typically occurs on the genitals but may appear anywhere on the body. This nodule or ulcer may appear anywhere from a week to a few months after someone is infected, but usually within a few weeks
Secondary - after the initial ulcer resolves, a patient enters the second stage, which can last up to several months. Patients with secondary syphilis may exhibit fevers, a generalized rash (it can look like small reddish or brown spots that appear all over your body and, in a telltale fashion, on the palms of your hands and soles of your feet), enlarged lymph nodes, weird patches on the skin of your oral cavity, generalized fatigue or general aches/pains, like from a flu.
Latent - the symptoms of a syphilis infection may seem to disappear, but unless someone is treated, the infection becomes more “hidden” in that the symptoms from the secondary stage disappear, but the infection is still active, and can be for up to decades! This smoldering infection can eventually cause severe damage to your vital organs and anatomy: your heart, your blood vessels, bones, liver, and especially your brain! (this is called “neurosyphilis” and may be characterized by odd numbness/tingling of the skin, or visual disturbances, and even confusion and dementia)
How is syphilis transmitted?
Syphilis is transmitted simply by contact with a syphilis ulcer or infected mucous membranes. Keep in mind that the ulcer is typically painless and can occur anywhere! So if it’s high up on the inside of your cheek, or hidden inside the anal cavity, you may never see it! Thus, syphilis can be transmitted through both oral or anal sex, or even kissing. We’ve even seen cases in the literature of primary syphilis ulcers on fingers. Condom use can reduce the risk of transmission, but you can see how even condoms may not prevent syphilis transmission completely.
How is syphilis diagnosed?
Syphilis is diagnosed with a simple blood test. However, because the blood test looks for antibodies that your body makes against syphilis, and it takes your body weeks to make antibodies, there are often many false negatives on screening tests in early syphilis infections. That’s why it’s so important to go to your provider or an STD clinic if you suspect an infection - someone needs to evaluate you!
What is the treatment for syphilis?
Thankfully, the bacteria that causes syphilis is still exquisitely sensitive to penicillin, but you need a lot of it, so it needs to be given as an injection. Early infections require only one shot! Later infections (over a year, or unknown duration, or late stages) need more than one shot, and in some cases, IV therapy for several days in the worst cases. Our truly penicillin-allergic patients have oral medication options that may suffice. So you can see why we at Capitol Hill Medical insist that you get a syphilis screen AT LEAST once a year. It can save you a couple shots in the butt or more!
A special word to our pregnant, or planning-to-be pregnant patients:
Syphilis can be incredibly, catastrophically dangerous to an unborn child if untreated. Early perinatal care involves a syphilis screen, but please be aggressive about being safe and about screening if you are sexually active while pregnant.
SO, here’s the bottom-line, folks:
Syphilis is out there as we speak, infections seem to be accelerating, and only through education, safe sexual practices, aggressive screening, and appropriate treatment can we hope to stamp out this current outbreak.
Call any of us at Capitol Hill Medical to make an appointment for screening!
(206) 568-6320, or go to www.capitolhillmedical.com and click on “Make an appointment.”
More information is available from our friends at Public Health, who have created the "Syphilis Rising" campaign to spread awareness. Check it out HERE.
-- Vy Chu, MD
