The STD syphilis, often called "the great imitator," is a sexually transmitted infection (STI) that can have serious health consequences if left untreated. Testing for early detection with an at home syphilis test and treatment with antibiotics are crucial for preventing long-term complications.
Syphilis is an infection caused by corkscrew-shaped bacteria called Treponema pallidum (from it's shape of 'pale turning thread').
It often spreads through sexual contact. But a mother with infection may transfer it to the baby during pregnancy (a form called congenital syphilis).
The word syphilis has no specific meaning (although it has been called the 'French Disease'). It's the name of a 1530 Italian poem's hero who was infected by the dreaded disease when he insulted the sun god.
Because symptoms of syphilis can mimic those of other diseases, syphilis often goes undiagnosed and untreated.
Symptoms of skin rashes, headache, fever, sore throat, muscle aches, and fatigue are common to 'almost every disease known to humans' and therefore syphilis has been called 'the Great Imitator'.
That's why it's so important of regularly test, especially for sexually active individuals.
A syphilis blood test is readily available and highly reliable at home syphilis tests can be ordered from the privacy and comfort of home.
Figure 1: Images of the syphilis bacteria Treponema pallidum. (Source: National STD Curriculum)
Syphilis progresses through several stages, each with distinct characteristics.
Figure 2. Syphilis stages and natural progress of the infection with symptoms. (Sources: National STD Curriculum and CDC.)
Understanding these stages of syphilis is key for effective management of the disease.
Primary Syphilis
A key characteristic of this stage is appearance of a painless skin sore (called chancre) at the point of infection.
You may not notice it but it's usually round, firm, and doesn't emit any fluid.
The syphilis skin rash normally appears 10-90 days after exposure.
The chancre usually heals on its own within a few weeks (3 to 6 weeks), even without treatment, but this does not mean the infection is gone.
Secondary Syphilis
A few weeks or months after the syphilis skin rash, chancre, disappears, secondary syphilis develops.
Symptoms include new skin rashes, swollen lymph nodes, fever, sore throat, and muscle aches.
These new rashes normally appear on palms, bottom of the feet, mouth, vagina or anus. They are often faint rough, red or red-brown patches that don't itch.
These symptoms can also resolve without treatment, but the infection persists.
Latent Syphilis
If left untreated, syphilis enters a latent (hidden or dormant) phase where there are no noticeable symptoms.
This stage can last for years, and the infection remains transmissible, particularly during early stage of latency.
Tertiary Syphilis
Several years after the initial infection, untreated syphilis can progress to tertiary syphilis.
It may take as many as 10 to 30 years from first infection of reach this stage.
About 15 percent or one-in-seven people reach tertiary stage of syphilis
At this highly dangerous stage, it starts affecting various organ systems, including the heart, brain, blood vessels, and nervous system.
Often bones and soft tissues such as gums are also affected.
This stage can lead to severe complications such as blindness, paralysis, and even death.
It has been very rare to see such symptoms over past several decades.
Depending on the affected organ, there are a few specific forms that have different symptoms. They can appear at any stage.
Neurosyphilis - when the infection reaches brain and nervous system. This can cause severe headaches, muscle pain and weakness. Infection of the brain can change mental health issues, including difficulty focusing, dementia, personality change, and confusion.
Ocular syphilis - infection of the eye. This can cause red eye, vision loss and blindness.
Otosyphilis - infection of the ear. One might face dizziness, vertigo, tinnitus with ringing and buzzing in the ears or even hear loss.
Syphilis is only found in human being. It has been around for about 500 years.
Until 2000 AD, cases were very low and it was not a serious concern.
Symptoms in men often follow the typical stage progression, with chancres appearing on the penis, scrotum, or anus at first infection (primary stage).
Secondary syphilis can manifest with rashes on the palms of the hands and soles of the feet.
Other symptoms at this stage include:
Fever
Headache
Swollen lymph
Muscle aches
Fatigue
Sore throat
Some hair loss in patches
There are no symptoms at third step of latent stage. However, tertiary stage may have serious life-threatening organ failures, if the disease is not treated in time.
You can see some images of syphilis infection at this page: https://www.std.uw.edu/go/comprehensive-study/syphilis/core-concept/all.
Women may experience similar symptoms as in men, with red skin sores or chancres appearing on the vulva, vagina, or cervix.
Secondary syphilis can also present with rashes and other flu-like symptoms.
Syphilis spreads by direct sexual contact with penis, vagina and anus.
But it can NOT spread from toilet sheets, doors, showers, baths, hot tubs, food, pools, cloths or sleeping in same bed.
Washing or bathing after contact with an infected person may NOT reduce your risk of infection.
Open sores and risky sexual behavior with syphilis can also increase the risk of HIV.
Syphilis is called a "New World Disease". Some people believe it was brought back to Europe by Columbus and the sailors from the newly discovered North America. Others believe it originated in East Africa & was transported to Asia & Europe through the slave trade.
It is easy to test for syphilis.
You will need a blood sample to check the antibodies produced against the bacteria.
An at home syphilis test, with a sample collected with a finger prick, is easy, convenient, and offers the privacy of home.
Sometimes fluids from the syphilis skin rash can also be used to detect the bacteria.
Syphilis is typically treated with penicillin injections.
The dosage and duration of treatment depend on the stage of the infection.
Early treatment is crucial to prevent long-term damage.
1906, T. pallidum was first identified as the cause of syphilis.
First treatment appeared in 1910 as Salvarsan or arsphenamine, an arsenic based product.
Practicing safe sex, including using condoms consistently and correctly, is the most effective way to prevent syphilis transmission.
However, condoms are not effective if infection occurs from contact with other parts of the body.
Regular testing for STIs is recommended for sexually active individuals, especially because one can get re-infected at any stage.
Being in a long term monogamous relation is another way to reduce the risk of syphilis infection.
Congenital syphilis occurs when a pregnant woman with syphilis transmits the infection to her baby.
This can lead to serious health problems for the infant, including miscarriage, premature birth, stillbirth and developmental delays.
Because syphilis had such a low prevalence, doctors often have very little experience in diagnosing congenital syphilis.
Pregnant women should be tested for syphilis during prenatal care. American College of Obstetricians and Gynecologists recommend testing three times during pregnancy:
during first prenatal visit.
at 28 weeks.
at the time of delivery.
After treatment for syphilis, follow-up testing is important to ensure the infection has been cleared.
Individuals diagnosed with syphilis should inform their sexual partners so they can also be tested and treated.
Some of the most famous people to die from syphilis include Al Capone, Scott Joplin (The Ragtime King), the French painter Henri de Toulouse-Lautrec, and the master of short story, Guy de Maupassant.
Syphilis is a serious but treatable STI. Early detection and treatment are essential to prevent long-term health complications.
If you are experiencing any symptoms of syphilis or are concerned about your risk, consult a healthcare professional or consider at-home testing options for a comprehensive sexual health assessment.
Remember, open communication with your partner and consistent safe sex practices are crucial for preventing the spread of syphilis and other STIs.
For individuals who are sexually active, regular STI screenings, including testing for syphilis, are a vital part of maintaining good sexual health.
Order a Syphilis STD test kit that checks for an array of different STDs.
What are the Most Common Sexually Transmitted Infections? - a concise list and short summary.
Trichomoniasis - About Trich STD, Symptoms and Treatment - learn about this most common sexually transmitted infection.
Gonorrhea - STD Symptoms, Testing and Treatment - learn about the most common STD in teens and young adults.
The Most Challenging STD - Genital Herpes and HSV - learn about the most widespread STD across the world.
Chlamydia - STD Symptoms, At Home Testing and Treatment - learn about chlam symptoms, testing and treatment.
References:
National STD Curriculum - University of Washington.
Revisiting the Great Imitator: The Origin and History of Syphilis, American Society of Microbiology, Jun 17, 2019.
Letter: The great imitator - E Meyerhoff, Can Med Assoc J, Mar 20, 1976.
Science Diction: The Origin Of The Word 'Syphilis' - Science Talk on NPR, May 27, 2011.
