Syphilis

Definition

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Transmission occurs through direct contact with an infected person, usually during sexual intercourse. The genital and anal areas are usually affected, but in rare cases the oral cavity can also be affected.
In modern times, “syphilis” (short for lues venerea) was spoken of more often than “syphilis”. The Latin word luēs means “plague”, “disaster”; Venereus comes from humanistic Latin, derives from venus, love-lust, love-enjoyment and means “relating to sexual intercourse”.

Infection/transmission

Syphilis is easily transmittable. The pathogens are found everywhere where the skin or mucous membrane changes due to the disease and secretes fluid, as well as in the blood.
The bacteria can enter another person’s body through the smallest injuries in the skin or mucous membrane (for example in the mouth, anal area, penis or vagina). This usually happens during unprotected vaginal or anal sex. But syphilis can also be transmitted through oral sex. Transmission from shared syringes during drug use is particularly easy.
Even people who don’t feel any symptoms can infect others.
Congenital syphilis is rare in the EU. People who frequently change sexual partners, men who have sex with men (MSM) and HIV-positive people are at increased risk of syphilis infection. It is not uncommon for repeated infections to occur.

Symptoms

Syphilis causes very different symptoms and courses. That’s why it is often overlooked or confused with other diseases.
If left untreated, syphilis progresses in 3 different stages.

• Primary syphilis

The first symptoms appear 10-90 days after infection and on average after three weeks. Initially, a dark red spot appears, which develops into a reddened ulcer with hardened edges. It secretes a colorless liquid that contains a particularly large number of pathogens and is extremely infectious. The ulcer occurs on the penis, labia or vagina during vaginal intercourse. It is also found in the mouth or throat during oral sex and in the rectum during anal sex. One to two weeks later, the neighboring lymph nodes swell. The symptoms of the first stage can go undetected and usually disappear after four to six weeks, even without treatment. However, the disease and its transmissibility remain.

• Secondary syphilis

The second stage begins after around four to ten weeks. Syphilis has now spread almost throughout the entire body via the blood and lymphatic system, accompanied by symptoms such as fever, fatigue and headache. A non-itchy, measles-like rash appears about ten weeks after infection. The rash can occur anywhere on the body, but usually on the soles of the hands and feet. All of these symptoms disappear after about four months, but can recur again if left untreated. The disease and its transmissibility remain.

• Tertiary syphilis

If the stage of secondary syphilis remains untreated, after a phase without symptoms (latent syphilis) lasting up to several years, the third stage of the disease can occur, in which various organ systems (brain, nervous system, eyes, heart, blood vessels, liver, bones, joints). ) can be affected and serious health problems can occur over many years. In the case of tertiary neurosyphilis, there is progressive breakdown of nerve tissue in the brain or spinal cord. Possible consequences of the loss of tissue in the brain include personality changes and even dementia. However, antibiotic treatments have made this stage rare.
If transmission from mother to unborn child occurs during pregnancy, miscarriage, stillbirth or premature birth can occur. Many children are normal after birth but become ill within 8 months. With this congenital (congenital) syphilis, a number of different clinical pictures can occur, for example skin rashes, meningitis, and later also deformities or blindness.
Syphilis can be easily treated and cured with antibiotics, especially if the infection is detected early.

Protection / Duration / Healing

The risk of syphilis cannot be completely eliminated during sex, but it can be reduced by using condoms. You should avoid contact with your partner’s weeping skin. If sex toys are used, you should put a new condom on each partner and then clean it thoroughly.
Particularly important: People who frequently change sexual partners should be tested for syphilis once a year in order to be able to treat the disease in a timely manner and not pass it on.
If syphilis is suspected, a blood test is performed.
Syphilis infections are reported by the practice or laboratory in which they are detected to the Robert Koch Institute, which monitors the spread of infectious diseases in Germany. However, the name of the patient is not mentioned.
Syphilis is treated with antibiotics, most often penicillin. The medication is injected into a muscle or – in severe cases – given via infusion into a vein. If the disease is treated in the first two stages, therapy lasts two to three weeks. Treatment is still possible in later phases of the disease, although therapy usually takes longer.
People with syphilis should avoid sex until treatment is complete. If possible, they should inform their sexual partners that they may have become infected. They should also definitely get checked for syphilis.