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Syphilis was first found in Europe at the end of the fifteenth century, when it showed up in the Mediterranean area and spread rapidly, becoming a great problem. Some people say that syphilis was from the New World and was brought to Europe by Columbus' crew. Syphilis might also have been in Africa for centuries and brought to Europe at that time by armies or other migrating people. At first syphilis was called the "Italian Disease," the "French Disease," and "the great pox." They didn't realize it was sexually transmitted until the eighteenth century. In 1767, John Hunter, an English doctor, vaccinated himself from a patient with gonorrhea. Unfortunately, the patient also had syphilis, and then so did Hunter, which showed that syphilis was a venereal disease, but also convinced people for a long time that syphilis and gonorrhea where the same thing. Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. When a person gets syphilis, it is because the spirochete, usually during sexual intercourse, entered their body through broken skin or a mucous membrane. Syphilis is not an extremely highly contagious disease, a person who has sex with an infected person has about a 30% chance of getting syphilis. The use of condoms offers some protection, but they are not fail-safe. A fetus can also get syphilis from its mother, via the placenta, after the tenth week of pregnancy. If the fetus gets syphilis from its mother, it can cause the fetus to be stillborn. The effects of syphilis are neither pleasant nor pretty. During the first stage of infection, which happens between one week and six weeks after the disease is transmitted, the infected person gets a sore, usually on their private parts where the bacteria entered their body. It looks like a pimple, or a blister, and it doesn't hurt. While the infected person has that sore, which is called a chancre, it is very infectious. After a while the sore goes away again. But the person has still got syphilis. A week or maybe even a year after the end of the first stage, the second stage starts. The second stage can last for a couple weeks, or it can last a year. The secondary stage is basically like having the flu. (Imagine having the flu for a year!) Also, the second stage doesn't happen just once, people who have syphilis can go through the second stage many times. Most people get a rash, all over their entire body and often on their hands and feet as well, which is a bit different than most STDs. The rash can look like a lot of different diseases, and because of this syphilis is also called "the great impostor," or "the great pretender." People also get sores in their mouths, aching bones, painful joints, mild fever and headache. During the secondary stage the disease can be spread through the lesions of the rash, and it very contagious. After the secondary stage, or between bouts of the secondary stage, the disease is latent. At least, it doesn't manifest itself in any outward symptoms, but the bacteria are very busy inside the person's body, reproducing themselves and causing damage to internal organs. During the latent stage, which can last for up to twenty years, one third of people will get better by themselves, one third will stabilize, and one third will move on to the third stage of syphilis. Third stage syphilis can damage a person's body permanently and lead to death. The third stage happens when the disease has been working away at the body for so long that it starts to have very serious effects, such as heart disease, blindness, central nervous system disorders and mental incapacity as well. When syphilis starts to destroy the central nervous system it causes a neurological disease called neurosyphilis. Neurosyphilis happens to fifteen or twenty percent of all the people who reach the third stage of syphilis. Two blood tests are used to diagnose syphilis in a patient. One is called a VDRL test, the other a CSF VDRL test. There are also several other tests which doctors can use to check the patients nervous system during advanced cases of syphilis. These tests include examining cranial nerves, puncturing the lumbar (vertebrae between the rib and pelvis levels) and then doing tests on the patient's spinal fluid, a cranial CT scan, an MRI, and a cerebral angiogram. Once the doctors know a patient has syphilis, they can treat it. Syphilis is treated with penicillin, by injection or an oral substitute, taking doses for one to four weeks. The treatment depends on how long the patient has had syphilis. Different drugs are also given to pregnant women. Patients who have had syphilis for less than a year can get a shot of 2.4 million units of Benzathine penicillin into muscle, as a single dose, take smaller shots of another drug daily for ten days, or take one of three drugs orally two to four times a day, for fourteen or fifteen days. For patients who have had syphilis for more than a year, they can take that big shot of Benzathine once a week for three weeks, or take one of two drugs orally, twice a day, for thirty days. The treatment for neurosyphilis is much the same, but a bit more complicated, as it requires both oral drugs and shots, and also takes longer. Pregnant women are only given penicillin because the penicillin substitutes are either not effective enough or may be toxic to the fetus. After getting treatment, patients must take follow up blood tests three, six, twelve and twenty-four months later, to make sure that they no longer have syphilis, and they must also abstain from sex until two of the follow up tests have showed that the infection has been cured. More than 100,000 cases of syphilis occur each year in the U.S, and it is the third most commonly reported infectious disease. However, because it is easily treatable with penicillin, the number of deaths caused by syphilis are decreasing. Young people between the ages of fifteen and twenty-five are the highest risk age group. The National Sexually Transmitted Disease (STD) Hot Line at (800) 227- 8922 is one number that a person could call if they think they might have syphilis, or any other STD.
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