Syphilis: Why its dormancy is dangerous

Symptoms of many a disease usually last the infection until they are treated. The patient can die with them. But there are exception, such as in syphilis, where the symptoms are progressive according to the stage at which the disease is and will disappear at some stage. That is, when a patient remains untreated throughout the infection. Make no mistake, this is what makes syphilis as dangerous as any other STI might come, according to medics. Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore — typically on your genitals, rectum or mouth. Syphilis can also spread from person to person via skin or mucous membrane contact with these sores. However, there is also congenital syphilis, where an infected mother can pass on the disease to the foetus through the placenta. After the initial infection, the syphilis bacteria can lie dormant in your body for decades before becoming active again. Early syphilis can be cured, sometimes with a single injection of penicillin. Without treatment, syphilis can severely damage your heart, brain or other organs, and can be life-threatening. According to Dr Ivan Rukundo, a general practitioner at Rwanda Military Hospital, Kanombe, the disease is caused by a bacterium. The most common route of transmission is through contact with an infected person’s sore during sexual intercourse. Syphilis is a highly contagious disease spread primarily by sexual activity, including oral and anal sex. Occasionally, the disease can be passed to another person through prolonged kissing or close bodily contact, according to to WEBMD, an online medical journal. The infected person is often unaware of the disease and unknowingly passes it on to his or her sexual partner. “The bacteria enter your body through minor cuts or abrasions in the skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes in the early latent period,” says WEBMD. Less commonly, syphilis may spread through direct unprotected close contact with an active lesion (such as during kissing) or through an infected mother to her baby during pregnancy or childbirth (congenital syphilis). Like many other sexually transmitted infections that come with myths about the nature of their spread, syphilis cannot be spread by using the same toilet, bathtub, clothing or eating utensils, or from doorknobs, swimming pools or hot tubs. Dr Rukundo syphilis develops in stages, and symptoms vary with each stage. But the stages may overlap, and symptoms don’t always occur in the same order. Primary syphilis. The first sign of syphilis is a small sore, called a chancre. The sore appears at the spot where the bacteria entered your body. While most people infected with syphilis develop only one chancre, some people develop several of them. The chancre usually develops about three weeks after exposure. Many people who have syphilis do not notice the chancre because it is usually painless, and it may be hidden within the vagina or rectum. The chancre will heal on its own within six weeks. Secondary syphilis. Within a few weeks of the original chancre healing, you may experience a rash that begins on your trunk but eventually covers your entire body — even the palms of your hands and the soles of your feet. This rash is usually not itchy and may be accompanied by wart-like sores in the mouth or genital area. In some individuals, muscle ache, fever, sore throat and swollen lymph nodes might be experienced. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year. Latent syphilis. When a patient is not treated for syphilis, the disease moves from the secondary to the latent (hidden) stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the tertiary stage. Tertiary (late) syphilis. About 15 to 30 per cent of people infected with syphilis who do not get treatment will develop complications known as tertiary (late) syphilis. In the late stages, the disease may damage your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur years after the original, untreated infection. How is syphilis treated? Dr Florence Mutesi, a general practitioner at Rwanda Military Hospital, Kanombe, says when diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic that can kill the organism that causes syphilis. But then again, some individuals are allergic to penicillin. Dr Mutesi says for such persons, they can talk to their doctors for alternative treatment. A single injection of penicillin can stop the disease from progressing if you’ve been infected for less than a year. If you’ve had syphilis for longer than a year, you may need additional doses. Penicillin is the only recommended treatment for pregnant women with syphilis. Women who are allergic to penicillin can undergo a desensitisation process that may allow them to take penicillin. Even if you’re treated for syphilis during your pregnancy, your newborn child should also receive antibiotic treatment. Justine Bagirisano, a midwife at Rwamagana School of Nursing and Midwifery, says pregnant women should attend antenatal care, especially before the fourth month of pregnancy. During antenatal care, expectant mothers are screened for various infections, including syphilis.

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Syphilis: Why its dormancy is dangerous