Spotlight on Syphilis
With COVID-19 vaccine distribution in full swing, we’re all excited to be seeing a light at the end of the tunnel. Businesses are beginning to re-open and people are emerging from a long dark winter of isolation to consider dating again; the timing couldn’t be better for Sexually Transmitted Infection Awareness Month.
This year, the nation’s health care providers are focusing on educating patients about syphilis. Once near elimination, syphilis was surging in the United States again just before the COVID-19 pandemic hit. In 2018, the United States experienced the highest number and rate of reported syphilis cases in 20 years. From 2014-2018, syphilis rates increased among both males and females, in every region, and among every race/ethnicity. Rates of syphilis went up 71% overall, 61% among men, and 172.7% among women. Men in general, and gay and bisexual men specifically, continue to face the highest levels of syphilis. In recent years, syphilis has also risen among women.
What is Syphilis Again?
Syphilis is an STD that can have very serious complications, thankfully it is often simple to cure. Diagnosing syphilis in the early stages makes treatment easier and reduces the likelihood that it will be spread to anyone else.
Syphilis is divided into four stages (primary, secondary, latent, and tertiary), with different signs and symptoms associated with each stage. A person with primary syphilis generally has a sore or sores at the original site of infection. But calling them “sores” is a little misleading because they are typically painless, making them easy to miss. These sores, also called “chancres,” can usually be found on or around the genitals, around the anus or in the rectum, or in or around the mouth. Chancres are usually (but not always) firm, round, shiny and look like open wounds.
Symptoms of secondary syphilis include a body rash, swollen lymph nodes, and fever. The signs and symptoms of primary and secondary syphilis can be mild, and they might not even be noticed. During the latent stage, there are often no signs or symptoms. It could seem like you’re all better; making the final stage a big surprise for those who go undiagnosed. The final stage is Tertiary syphilis. Tertiary syphilis is associated with severe medical problems. It can affect the heart, brain, and other organs of the body. It can cause skeletal deformity, severe headaches, paralysis and dementia. Neurologic or ocular (eye) syphilis are very serious can occur at any stage. Having syphilis also makes it easier to get HIV.
How is syphilis spread?
You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. YES oral sex too! You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth. Syphilis can also spread from an infected mother to their unborn baby.
What You Can Do to Prevent Syphilis
If you are sexually active, here are some ways to lower your chances of getting syphilis:
- Use latex barriers or condoms for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish). Condoms prevent the spread of syphilis by preventing contact with a syphilis chancre. Sometimes sores can occur in areas not covered by a condom, so you could still get syphilis from contact with these sores, even if you are wearing a condom.
- Check for sores, bumps, chancres; any apparent wound on your genitals and keep an eye out for anything that could be a chancre on your sex partner(s). If you see something: say something and delay sexual activity until you can both see a doctor.
- Get tested – it’s the only way to know if you have syphilis. CDC recommends all sexually active people be tested for specific STDs, including syphilis, at least once a year, and more frequently for those who have multiple or anonymous partners (i.e., at 3- to 6-month intervals).
- Talk about it! Silence helps to fuel the spread of STDs.
- Have an honest and open talk with your healthcare provider about your sexual history and ask whether you should be tested for syphilis or other STDs.
- Talk with your partner about sex and STDs BEFORE you have sex.
If you test positive, syphilis can be cured with the right medicine from your healthcare provider.
Kate Wojnicki, ARNP, Unity Care NW
I’m a Family Nurse Practitioner and HIV Specialist at Unity Care NW. I hold a Bachelor of Science from the University of Washington and a Master of Science in Nursing/ Nurse Practitioner degree from Seattle Pacific University. After spending 6 years in the Neonatal Intensive Care Unit at UW and volunteering in Uganda, it became my personal belief that access to high quality primary care was the answer to many of the problems we see in medicine. I later completed a Community Health Residency in Tacoma with a focus on caring for persons living with HIV. I joined Unity Care NW in 2014 as an opportunity to serve the community where I spent much of my childhood. I earned my HIV credential through the American Academy of HIV Medicine in 2016.
Content source: Centers for Disease Control Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention