​Tackling Syphilis

​Tackling Syphilis

Dr . Sylvester Ikhisemojie

There is nothing esoteric about this disease . It is an old condition that men primarily have suffered from for many centuries. Women have also had their fair share of the disease because it is sexually transmitted and highly contagious. So whether it is oral sex , anal sex or vaginal penetration that is involved , all of the receptacles are at risk of getting invaded by the bacteria once such contact has been made . Therefore, the mouth, lips , anus and genital regions of people of either sex are usually involved .

For many years after the discovery of penicillin , this disease seemed to be in decline. However , in the wake of the HIV/AIDS pandemic, it has assumed an increased significance in sub – Saharan Africa , in particular , because of the rising incidence of co -infection with that disease . The rates appear to be on the rise elsewhere in the world and even in the high -income countries that had seen significant declines in overall numbers for several decades , an increase in the incident numbers has also been seen .

Today , more than 10 million people around the world are estimated to be suffering from syphilis. The disease is caused by a tiny bacterium called Treponema pallidum . The first sign of the disease is a small , painless sore or ulcer called a Chancre that can appear in the mouth , rectum or on any of the sexual organs . And because it causes no pain, many people fail to observe its presence when it appears . It is primarily because of this failure to observe it that syphilis can be a very challenging condition to diagnose. As a result, it is entirely possible to have the infection and not show any features of the disease for many years . When this disease is noted early and treated properly , resolution is the normal result. If it is not , it can ultimately lead to blindness, stroke , dementia and deafness.

Syphilis has four major stages in the body before it degenerates to cause any of the terminal events mentioned above . These are the primary , secondary, latent phase and tertiary stages of the disease . In the primary stage, a person who has recently become infected with the bacteria develops a chancre as described above . It is usually one in number , small , round and firm. It usually lasts for about three to six weeks before disappearing on its own with or without treatment . When no treatment has been received , this stage then gives rise to a secondary stage of the disease . During this phase , rashes appear all over the body that may resemble other skin rashes seen in other disease conditions. They also appear on the palms and soles of the feet which help to distinguish it from other rashes seen in other conditions. In virtually all of them, rashes would not appear on such surfaces . The rashes also do not itch , which is another significant difference from other common skin conditions. In this stage also, the infection has spread all over the body and there may now be fever , weight loss, muscle pains , fatigue , sore throat and loss of body hair. There may also be enlargement of the various lymph nodes and headaches. Eventually , these features will subside even without treatment . The disease then will progress to the tertiary phase , but this stage is reached in less than 30 per cent of untreated people who suffer secondary syphilis. This period – the latent stage – before the tertiary stage of the disease develops can last 10 to 20 years .

Several organs within the body can be damaged during this critical phase of the illness. The brain , nerves , eyes , blood vessels , heart , liver, bones and joints can all be damaged . Paralysis and difficulties with movement can result . Gradual loss of vision , numbness and personality changes can also follow, not to mention death from any combination of the above complications . Untreated syphilis in pregnant women will often result in the bacteria being able to cross the placenta to the unborn baby and will cause as many as 40 per cent of all such babies to either die in the womb or soon after birth . As a result of this information , it is mandatory that all women attending the antenatal clinic for the first time should be tested for syphilis.

The diagnosis of this condition was already difficult enough ; its latter association with HIV/AIDS has made that task a lot more difficult . However , if efforts to treat the condition do not continue, in a manner backed up with a robust sense of suspicion, it may yet reach epidemic proportions once again . Current tests such as the Venereal Disease Research Laboratory are useful but may be misleading in that false positive results can sometimes be obtained. More specific tests involve the use of blood to determine if there is a current or past infection. This is confirmed when antibodies to the bacteria causing syphilis are present in the sample . Similarly , a specimen can be obtained from the chancre during the primary or secondary stage of the disease or by a lumbar puncture when the central nervous system is suspected of involvement . In either of these situations , the bacteria can indeed be recovered from the specimens , thus confirming the presence of the disease .

The mainstay of treatment involves the use of penicillin . It is available either alone or in a combination that can potentiate its effect . The duration of such treatment depends on the stage at which the diagnosis has been made . Any kind of sexual intercourse can lead to the development of this disease once one party has got it. In the United States for example , there has been a decline among women sufferers of this disease but there has been an increase among males especially within the gay community. Many people have developed some barriers against worry about this disease . It is seen as a relic of another era and unable to cripple and kill . Such people are sadly mistaken . Syphilis is alive and well and the number of new cases is increasing every year . Every suspicious lump on the genital area especially when it is painless must be taken to a doctor for examination and diagnosis .
Source: The Punch


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