Can You Come in Contact With Syphilis and Not Catch It

February 17, 2022 Post a Comment

Basic Fact Sail | Detailed Version | View Images of Symptoms

Detailed fact sheets are intended for physicians and individuals with specific questions about sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well as citations so the reader can research the topic more than in depth.

What is syphilis?

Syphilis is a sexually transmitted illness (STD) caused by the bacterium Treponema pallidum. Syphilis can crusade serious health sequelae if not adequately treated.

How common is syphilis?

During 2019, there were 129,813 reported new diagnoses of syphilis (all stages), compared to 37,968 new diagnoses of HIV infection in 2022 and 616,392 cases of gonorrhea in 2019.^{one, 2} Of syphilis cases, 38,992 were chief and secondary (P&S) syphilis, the earliest and virtually transmissible stages of syphilis. In 2019, the majority of P&S syphilis cases occurred among gay, bisexual, and other men who have sex with men (MSM). Specifically, MSM simply and men who accept sexual activity with men and women (MSMW) accounted for 47% of all P&S syphilis cases, as well as 56% of all male P&S syphilis cases. Even so, in recent years, the rate of P&S syphilis has been mostly increasing among MSM as well as heterosexual men and women.

Congenital syphilis (syphilis passed from meaning women to their babies) continues to be a concern in the United states. According to preliminary 2022 data, more than than two,000 cases of congenital syphilis were reported, compared to 65 cases of perinatal HIV infection during 2018.^{1, 9} Preliminary information also showed rates of congenital syphilis are highest among mothers who were non-Hispanic American Indian or Alaska Native (180.2 per 100,000 live births), followed past mothers who were non-Hispanic Native Hawaiian or other Pacific Islander (167.seven per 100,000 live births) and mothers who were non-Hispanic Black or African American (125.3 per 100,000 live births).^nine

How exercise people become syphilis?

Syphilis is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres tin can occur on or around the external genitals, in the vagina, around the anus , or in the rectum, or in or around the mouth. Manual of syphilis tin occur during vaginal, anal, or oral sex activity. In add-on, pregnant women with syphilis tin transmit the infection to their unborn child.

How quickly exercise symptoms appear after infection?

The average time betwixt acquisition of syphilis and the start of the start symptom is 21 days, but tin can range from 10 to ninety days.

What are the signs and symptoms in adults?

Syphilis has been called "The Nifty Pretender", as its symptoms tin look similar many other diseases. However, syphilis typically follows a progression of stages that can last for weeks, months, or even years:

Primary Stage

The appearance of a single chancre marks the primary (first) stage of syphilis symptoms, only there may be multiple sores. The chancre is usually (but not always) house, round, and painless. It appears at the location where syphilis entered the trunk. These painless chancres can occur in locations that brand them difficult to notice (e.g., the vagina or anus). The chancre lasts 3 to 6 weeks and heals regardless of whether a person is treated or not. However, if the infected person does not receive adequate handling, the infection progresses to the secondary stage.

Secondary Stage

Pare rashes and/or mucous membrane lesions (sores in the oral fissure, vagina, or anus) mark the second stage of symptoms. This phase typically starts with the development of a rash on one or more areas of the trunk. Rashes associated with secondary syphilis tin announced when the primary chancre is healing or several weeks after the chancre has healed. The rash ordinarily does non crusade itching. The characteristic rash of secondary syphilis may appear as rough, red, or reddish chocolate-brown spots both on the palms of the hands and the bottoms of the feet. Yet, rashes with a different advent may occur on other parts of the body, sometimes resembling rashes caused by other diseases. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. Big, raised, gray or white lesions, known as condyloma lata, may develop in warm, moist areas such as the rima oris, underarm or groin region. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy pilus loss, headaches, weight loss, muscle aches, and fatigue. The symptoms of secondary syphilis volition go abroad with or without treatment. However, without handling, the infection volition progress to the latent and possibly 3rd stage of illness.

Latent Stage

The latent (hidden) phase of syphilis is a catamenia of time when there are no visible signs or symptoms of syphilis. Without treatment, the infected person will proceed to have syphilis in their torso fifty-fifty though at that place are no signs or symptoms. Early on latent syphilis is latent syphilis where infection occurred within the past 12 months. Tardily latent syphilis is latent syphilis where infection occurred more than 12 months ago. Latent syphilis tin last for years.

Third Syphilis

Tertiary syphilis is rare and develops in a subset of untreated syphilis infections;, information technology tin appear 10–30 years later infection was commencement caused, and information technology can be fatal. Tertiary syphilis tin can affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Symptoms of tertiary syphilis vary depending on the organ system afflicted.

Neurosyphilis and Ocular Syphilis

Syphilis can invade the nervous organisation (neurosyphilis), visual system (ocular syphilis), or auditory system (otosyphilis) at whatsoever stage of infection. These infections tin can cause a wide range of symptoms.³ Clinicians should be aware of neurosyphilis, ocular syphilis, and otosyphilis, as well every bit the diagnostic and management considerations.

How does syphilis bear on a pregnant woman and her baby?

When a pregnant adult female has syphilis, the infection can exist transmitted to her unborn baby. All pregnant women should be tested for syphilis at the showtime prenatal visit. Some women need to be tested again during the third trimester (28 weeks gestation) and at delivery. This includes women who alive in areas of loftier syphilis morbidity, are previously untested, had a positive screening test in the outset trimester, or are at higher risk for syphilis (i.due east., multiple sex partners, drug use, transactional sex, late entry into prenatal care or no prenatal care, meth or heroin use, incarceration themselves or of sex partners, unstable housing, or homelessness).³ There should also be a discussion about ongoing risk behavior and treatment of sexual practice partners to assess the run a risk for reinfection. Any adult female who delivers a stillborn baby after 20 week'southward gestation should also be tested for syphilis.

Depending on how long a pregnant adult female has been infected, she may take a high adventure of having a stillbirth or of giving birth to a baby who dies before long after birth. Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases.

An infected baby born alive may not take whatever signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may get developmentally delayed, have seizures, or die. All babies born to mothers who test positive for syphilis during pregnancy should be screened for syphilis and examined thoroughly for show of congenital syphilis. ^three

For meaning women only penicillin therapy can be used to treat syphilis and forbid passing the disease to her baby; treatment with penicillin is extremely effective (success rate of 98%) in preventing mother-to-child manual. ⁴ Pregnant women who are allergic to penicillin should be referred to a specialist for desensitization to penicillin.

How is syphilis diagnosed?

Treponemal tests (east.grand., TP-PA, various EIAs, chemiluminescence immunoassays, immunoblots, and rapid treponemal assays) detect antibodies that are specific for syphilis. Treponemal antibodies appear earlier than nontreponemal antibodies and unremarkably remain detectable for life, even after successful treatment. If a treponemal test is used for screening and the results are positive, a nontreponemal exam with titer should be performed to confirm diagnosis and guide patient management decisions. Based on the results, farther treponemal testing may be indicated. For further guidance, please refer to the 2022 STI Treatment Guidelines. This sequence of testing (treponemal, then nontreponemal, test) is considered the "contrary" sequence testing algorithm. Reverse sequence testing can identify persons previously treated for syphilis and those with untreated syphilis. False-positive results can occur in those with depression likelihood of infection with reverse sequence testing as well.^five

Special note: Because untreated syphilis in a pregnant woman can infect her developing baby, every pregnant woman should have a blood exam for syphilis. All women should be screened at their first prenatal visit. Some patients should receive a second test during the third trimester (at 28 weeks) and once more at delivery. For further information on screening guidelines, please refer to the 2022 STI Handling Guidelines.

All infants born to mothers who accept reactive nontreponemal and treponemal exam results should exist evaluated for built syphilis. A quantitative nontreponemal examination should be performed on babe serum and, if reactive, the infant should exist examined thoroughly for prove of congenital syphilis. Suspicious lesions, body fluids, or tissues (e.k., umbilical cord, placenta) should be examined by darkfield microscopy, PCR testing, and/or special stains. Other recommended evaluations may include analysis of cerebrospinal fluid by VDRL, prison cell count and poly peptide, CBC with differential and platelet count, and long-bone radiographs. For further guidance on evaluation of infants for congenital syphilis, please refer to the 2022 STI Treatment Guidelines.

What is the link betwixt syphilis and HIV?

In the United States, approximately half of men who have sex activity with men (MSM) with primary and secondary (P&S) syphilis were likewise living with HIV.^two In addition, MSM who are HIV-negative and diagnosed with P&S syphilis are more likely to be infected with HIV in the futurity. ^half-dozen Genital sores caused by syphilis make information technology easier to transmit and larn HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. ⁷ Furthermore, syphilis and certain other STDs might be indicators of ongoing behaviors and exposures that place a person at greater hazard for acquiring HIV.

What is the treatment for syphilis?

For detailed handling recommendations, please refer to the 2022 CDC STI Treatment Guidelines. The recommended handling for adults and adolescents with main, secondary, or early latent syphilis is Benzathine penicillin G 2.four million units administered intramuscularly in a single dose. The recommended treatment for adults and adolescents with late latent syphilis or latent syphilis of unknown elapsing is Benzathine penicillin Thou 7.2 million units total, administered as 3 doses of 2.iv million units administered intramuscularly each at weekly intervals. The recommended treatment for neurosyphilis, ocular syphilis, or otosyphilis is Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-iv one thousand thousand units intravenously every 4 hours or continuous infusion, for 10-14 days. Treatment will prevent disease progression, only information technology might not repair damage already done.

Option of the advisable penicillin preparation is important to properly treat and cure syphilis.Combinations of some penicillin preparations (eastward.m., Bicillin C-R, a combination of benzathine penicillin and procaine penicillin) are not appropriate replacements for benzathine penicillin, equally these combinations provide inadequate doses of penicillin. ⁸

Although information to back up the use of alternatives to penicillin is limited, options for non-pregnant patients who are allergic to penicillin may include doxycycline, tetracycline, and for neurosyphilis, potentially ceftriaxone. These therapies should be used only in conjunction with shut clinical and laboratory follow-up to ensure appropriate serological response and cure. ³

Persons who receive syphilis handling must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sexual activity partners and so that they also can be tested and receive treatment if necessary.

Who should be tested for syphilis?

Whatever person with signs or symptoms suggestive of syphilis should be tested for syphilis. Likewise, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with syphilis should be tested for syphilis.

Some people should be tested (screened) for syphilis even if they practise non have symptoms or know of a sex partner who has syphilis. Anyone who is sexually active should discuss his or her take chances factors with a wellness care provider and enquire whether he or she should be tested for syphilis or other STDs.

In addition, providers should routinely examination for syphilis in persons who

are pregnant;
are sexually active men who take sex with men (MSM);
are living with HIV and are sexually active;
are taking PrEP for HIV prevention.

Will syphilis recur?

After appropriate treatment, clinical and serologic response to treatment will be followed. Nevertheless, fifty-fifty following successful treatment, reinfection can occur. Persons with signs or symptoms that persist or recur or who have a sustained fourfold increase in nontreponemal test titer likely were reinfected or experienced treatment failure. For further details on the management of persistent syphilis or reinfection, refer to the 2022 STI Treatment Guidelines

Considering asymptomatic chancres can be present in the vagina, rectum, or oral fissure, it may not be obvious that a sexual activity partner has syphilis. Unless a person knows that their sex partners have been tested and treated, they may be at risk of being reinfected past an untreated partner. For further details on the management of sex partners, refer to the 2022 STI Treatment Guidelines.

How can syphilis be prevented?

Correct and consistent use of latex condoms can reduce the risk of syphilis when the infected area or site of potential exposure is protected. Even so, syphilis transmission can occur with lesions not covered past a latex condom.

The surest way to avert manual of sexually transmitted infections, including syphilis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to not take an infection.

Partner-based interventions include partner notification – a critical component in preventing the spread of syphilis. Sexual partners of patients with syphilis should exist considered at run a risk and provided treatment per the 2022 STI Treatment Guidelines.

National Network of STD Clinical Prevention Training Centers, STD Clinical Consultation Network external icon

Wellness care providers with STD consultation requests tin can contact the STD Clinical Consultation Network (STDCCN). This service is provided past the National Network of STD Clinical Prevention Preparation Centers and operates v days a week. STDCCN is convenient, simple, and free to wellness care providers and clinicians. More information is bachelor at www.stdccn.orgexternal icon.

Sources

1. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2022 (Updated). HIV Surveillance Study 2018;31.pdf icon HIV Surveillance Written report 2018;31.

2. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2019. Atlanta, GA: Department of Health and Human being Services; April 2021.

3. Workowski, KA, Bachmann, LH, Chang, PA, et. al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70(No. 4): one-187.

4. Alexander, J.M., et al., Efficacy of handling for syphilis in pregnancy. Obstet Gynecol, 1999. 93(i): p. 5-eight.

5. Centers for Disease Control and Prevention. Discordant results from contrary sequence syphilis screening–five laboratories, United states, 2006-2010. MMWR Morb Mortal Wkly Rep, 2011. 60(v): p. 133-7.

6. Pathela P et al. The loftier risk of an HIV diagnosis following diagnosis of syphilis: a population-level analysis of New York City men. Clinical Infectious Diseases 2015;61:281-287.

seven. HIV prevention through early detection and handling of other sexually transmitted diseases–The states. Recommendations of the Advisory Committee for HIV and STD prevention. MMWR Recomm Rep, 1998. 47(RR-12): p. 1-24.

8. Centers for Affliction Command and Prevention. Inadvertent use of Bicillin C-R to care for syphilis infection–Los Angeles, California, 1999-2004. MMWR Morb Mortal Wkly Rep, 2005. 54(9): p. 217-ix

9. Centers for Disease Control and Prevention. Built Syphilis: Preliminary 2022 Data. Atlanta, GA: Department of Health and Human Services; September sixteen, 2021.

Varela Pardow