Syphilis, a Bacterial Disease

What is the difference between a disease and a bacterial disease? – A bacterial disease doesn’t need a host, it is able to reproduce without outside influence. Virii can’t do this, they require a host. Virii also target specific cells, unlike bacteria. [1]

Specifics about Syphilis: Syphilis is a bacterium spread by intercourse, making it a STD. [3]Syphilis is specifically is a spirochete bacteria, Teponema pallidum. T. pallidum is a fragile spiral bacterium 6-15 micrometer long by 0.25 micrometers in diameter. Undetected by light microscopy, it can only be ifentified by a distinctive undulating movement on a darkfield microscopy. T.pallidum can only survive ina short period on the body. The infection of syphilis is classified into 4 stages: primary , secondary, latent, and tertiary [3]. T. pallidum is transmited through the mucous membranes or open skin-to-skin contact, primily sexual intercourse. It can also be transferred through blood transfusion.

After infection, it begins an incubation period, entering the lymphatic system, bloodstream, and soon after disseminates from the point of contact. A chancre ( A painless ulcer, particularly one developing on the genitals as result of a veneral disease. [2]) forms at the site of inoculation. This chancre spontaneously heals in a two to eight week period, but then then the infected enters the secondary stage of syphilis. If the infected has an intact immune system the disease will enter a period of latency. After the period of latency, which can last four or more years in someone un(der)treated individual, gummas are formed that cause dysfunction in any organ system. Gummas are what also account for the dysfunction found in tertiary syphilis. If left untreated, it can cause dysfunction of the central nervous and cardiovascular system which can lead to progressive dementia and death.

The History of Syphilis: Studies have foung that syphilis is a disease of early time, and could have been prevalent among the indigenous peoples of the Americas before Europeans travelled to and from the New World. The “Pre-Columbian Theory” holds that syphilis was present in Europe before discovery of the Americas, and was described by Hippocrates in it’s venereal/tertiary form. The introduction of syphilis to Europe is thought to be caused by its continual arrival of sailors from distant places. Historians also believe that the disease first appeared in the French troops when besieging Naples, it’s name at the time was ‘French disease’. In 1913, Hideyo Noguchi, demonstrated the presence of Syphilis in the brain of a progressive paralysis patient. Dementia at the time was largely contributed to syphilis. In the years of 1932-1972 the Tuskegee Study was conducted. In this study 400 men with syphilis were denied effective treatment so that the disease could be researched, this caused changes to the system that controls how patients are protected in clinical studies.

The eariliest tests for Syphilis were the Wassermann test, found in 1906, which caused a few false positives, but led a major advance in the prevention of syphilis; the Hinton test was the next test to be developed, based on the principle of flocculation, it was shown to cause fewer false positives. Both have been superseded by newer methods. The two most common treatments for syphilis in the earlier times was the use of mercury, and the use of an arsenic-containing drug called Salvarsan. Both were rendered obsolete by the discovery of penicillin. Al Capone, Vincent Can Gogh, and Henry VIII, are a few of the most famous people diagnosed with syphilis. [4] Where Can Syphilis Be Found?: All over the world! In the United States of America it is most commonly found in parts of the south. [5] What are the current treatments for syphilis?: Treatment of syphilis involves systemic IV or IM penicillin, alternative include doxycycline, tetracycle, ceftriaxone, and chloramphenicol. Neurosyphilis can only be treated by penicillin. [6] Is antibiotic resistance applicable to syphilis?: Yes, it has already developed a form that is resistant to the second best treatment, macrolides. Although it has only developed a resistance to macrolides, it has the potential to develop additional antibiotic resistance. [7]

How has treatment of syphilis changed?: When syphilis was first treated, the two harmful substances mercury and arsenic were used, since then we have developed antibiotics that are not harmful to the body, and if an allergy is apparent for one antibiotic, there are many others available. This does not apply to neurosyphilis. These advancements in treatments are attributed the discovery of penicillin. [8] What is the outlook for someone diagnosed with syphilis?: If stopped early enough, no damages are caused. This is because the chancres that are formed in the primary stage of syphilis heal with little to no scarring, the treatment of syphilis is able to prevent further damage, but it cannot cure damage already done. When being treated for syphilis, patients are to abstain from sexual contact to prevent the spread of syphilis. [8] How can the spread of syphilis be prevented?

Like any other STD, the most effective form of prevention is routine tests to be sure that a sexually-active person is not a carrier of the disease. If they are infected with syphilis, a treatment is needed as soon as possible to prevent damage to the body. While being treated, the patient is to contact all recent sexual partners to inform them that they may have the disease, and that they are to get tested. In order not to contract syphilis, persons are to use a male or female condom. Besides the transmission of syphilis through sexual contact, congenital spread is also a risk. Congenital spread can be prevented by having a blood test for syphilis before birth, otherwise, syphilis could be spread from mother to fetus. [9] In the future will syphilis be more or less important to humans?: Syphilis can never be eliminated, but “the absence of sustained transmission”

References:

[2] http://dictionary.reference.com/browse/chancre

[3] http://emedicine.medscape.com/article/229461-overview#a0104 [4] http://www.news-medical.net/health/Syphilis-History.aspx [5] http://www.health.ny.gov/diseases/communicable/std/syphilis.htm [6] http://cms.revoptom.com/handbook/sect7f.htm

[7] http://www.ncbi.nlm.nih.gov/pubmed/19805553
[8] http://www.cdc.gov/std/syphilis/stdfact-syphilis.htm
[9] http://www.health.ny.gov/diseases/communicable/syphilis/fact_sheet.htm