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Syphilis, an STD that returns to the forefront
With its contamination peak in the 19th century and having almost disappeared in the 20th century (the cases recorded in Montreal were almost zero between the 1990s and the 2000s). Syphilis, also called “the disease of Naples” or more commonly the pox, is a sexually transmitted infection (STI) affecting all the sexually active people, an infection caused by a bacterium, the Treponema pallidum or Treponema pallidum. Unfortunately, it has become famous for having infected some famous authors such as Guy de Maupassant, Charles Baudelaire and Alphonse Daudet. We can see that it is on the rise particularly in Quebec (about 500 cases per year) in recent years having affected the male population with homosexual activity more than others. It is mainly due to an increase in risky practices. Since the beginning of 2016 the increasing cases have raised concerns to the medical community, especially in Quebec, where there has been a drug shortage for the treatment of syphilis. Therefore, vigilance is required. This microbe is mainly transmitted by:- oral sex (cunnilingus, anilingus and fellatio), vaginal and anal sex with a person carrying the bacterium
- blood contact with infected material (needle sharing particularly in drug use)
- contact with the symptomatic syphilitic sores of the infected person (i.e. a characteristic canker of this type of infection, i.e. a lesion in the penis, vagina or anus), which explains the fact that syphilis can be transmitted from mother to child before birth but especially during childbirth. (Congenital syphilis)
- by kiss with exchange of saliva
- by the use of sex toys that have been used and have been contaminated by an infected person
Symptoms of syphilis
The incubation period is estimated between 10 and 90 days between the starting point of contamination following a risky practice, for example and the onset of the first symptoms. It is a progressive infection which is why it is often complicated to confirm a diagnosis. In addition, it is a malicious disease because in some patients, the symptoms are completely absent. The risk of transmitting syphilis to your partner, without knowing you have it, is very high, hence the need to be regularly screened, especially for people with multiple sexual partners or those who want to give up using condoms. Three stages in the evolution of the symptoms can be distinguished:Primary Stage
The first symptom (not always present in all patients) that appears in general during this incubation period is this characteristic painless sore called syphilitic chancre which takes the form of ulceration of 1 cm in diameter on the initially infected mucosa (mouth, penis, testicles, vagina, anus, vulva) lesion that is highly contagious. This lesion is also associated with the swelling of the lymph nodes in the groin. The disappearance of the chancre after 3-8 weeks without leaving any trace or its location in areas that are less visible by the patient (e.g. rectum) explains why many patients remain carriers of the bacterium without knowing it. The healing of the lesion is not in fact a sign of the disappearance of this STI, but quite the contrary.Secondary Stage
This is the stage which makes diagnosis difficult especially if the primary stage went unnoticed. In fact, between 6 weeks to 6 months after the beginning of the infection, syphilis evolves due to the absence of its treatment; infection then becoming widespread. Several symptoms can be listed:- Severe fatigue with pain in joints
- Rash (papular syphilis) that can occur on all the areas of the body (palms, back … mucosa in the genital organs, tongue …) and which can be easily confused with a roseola, psoriasis, acne or chickenpox.
- Fever
- Characteristic inflammation of the lymph nodes
- Hair loss
- A more serious attack with loss in hearing and vision with characteristic headaches associated with ringing in the ears; it is called neurosyphilis Without treatment, all these symptoms disappear. This is called latent syphilis (which can last for many decades). This STI is therefore still in the shadows and still very contagious.
The tertiary stage (or late syphilis), serious complications
Without diagnosis and treatment of the first two stages, the infection continues to spread over a very long period. Syphilis can cause very serious complications 30 years after the patient has been infected. Damage then occurs in all the organs of the body including vital organs which may sometimes result in the death of the patient. Here are some serious complications:- Brain damage through vision and hearing issues, meningitis, memory loss, epileptic seizures …
- Serious liver lesions (hepatitis)
- Heart failure (stroke risk …)
- Bone lesions
- Risk of infection transmission from mother to child
Protect yourself against syphilis
Prevention remains essential because in fact there is no vaccine against syphilis. A responsible attitude is paramount:- Use a condom during intercourse. It remains the most effective way to prevent the infection transmission between partners. Protect yourself even during oral sex (vaginal, anal) namely during fellatio but also during cunnilingus (oral intercourse man / woman) and anilingus using a dental dam (small square pieces of latex )
- Get tested regularly if you change sexual partners often
- Any injections for drug use should be done with sterile equipment without needle exchange.
- All lesions on your partner or on yourself should automatically alert you (no contact with those sores; seek medical advice as soon as possible with sexual abstinence while these symptoms are diagnosed)