How Does Syphilis Differ
Syphilis has been a major global public health problem worldwide and in all healthcare organizations for the past decades. Despite numerous prevention and intervention efforts, the overall rates of the case of syphilis in the CDC have not decreased significantly over time. In fact, according to the article, Syphilis: using modern approaches to understand an old disease, “the CDC reported that 25% of primary and secondary syphilis cases occurred in person coinfected with HIV, and the incidence rate of syphilis in HIV-infected persons was 77 times greater than the general population” (Ho & Lukehart 2011). Also, according to the article, Nevada is experiencing the highest rate of syphilis in the Western U.S. following an outbreak in Las Vegas,
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“the latest available data, from 2014, showed a 15 percent increase in cases overall, the Centers for Diseases Control and Prevention said. A majority of cases involved men having sex with men” (Ho 2016). Syphilis is transmitted from person to person through chancre contact in the mouth or through an infected external genital touching a non-infected external genital.
Syphilis by nature is fatal and devastating not only to the patient, family and friends, but to the professional staff, community and nation at large. The doctors and health care providers are aware of the increase of syphilis cases over the past decades and are blaming social media because of “anonymous sex through social media, particularly with an increase in the use of smartphone apps…Young people dependent on their iPhones can find quick, easy access to hookups” (Ho 2016). Due to these challenges, it is imperative that everyone, especially adolescents, early adults, and gay men, should be proficient in avoiding syphilis and identifying those at risk to avoid much contact. Thereby, implementing safe practices of abstinence, the use of condom during sexual activities and avoidance of skin contact to areas susceptible to syphilis can reduce the spread of syphilis.
How the Disease is Originated Syphilis is a type of sexually transmitted disease, or an STD, caused by a spirochete bacteria called Treponema pallidum or T. pallidum. It is a gram-negative bacteria where it has an “outer and inner membranes and a periplasmic space, lacks lipopolysaccharide, a potent proinflammatory glycolipid, and does not produce any known toxic proteins” (Ho & Lukehart 2011). Because the bug is a gram-negative bacteria, it can lead to the most common infections such as pneumonia, skin infection, blood infection, etc. It is usually resistant to the most common types of antibiotics such as penicillin, cephalosporin, aminoglycoside, etc. especially when being treated at the later phase when the disease has already progressed in the body. The origin of syphilis is unknown but stems from a country in the Caribbean Islands where Christopher Columbus, and his crew, visited. Upon their arrival to Europe, there were a major outbreak where thousands of people died of unknown causes. However, according to the article, Syphilis Then and Now, “there continues to be disagreement about where syphilis is originated. Much evidence seems to point the finger at Christopher Columbus and his crew, who may have picked up the pathogen on their legendary first time to the New World” (Harper, Zuckerman, and Armelagos 2014). During the 1500s, scientists and archaeologists began collecting skeletons of people who have died from the unknown disease that was being passed around. The goal was to observe any special characteristics and testing. “The skeleton, genetic, and ecological information, scientists are now uncovering could inform our understanding of how T. pallidum has evolved and how we can best control it today” (Harper, Zuckerman, and Armelagos 2014). In 1905, the name “syphilis” was derived when scientists used skeletons collected in Europe since the 1500s and discovered a pale, corkscrew-shaped bacterium on them. Hence, scientists called the disease the “syphilis” which means “the French Disease.”
Four Stages The first stage of syphilis is called the “primary syphilis” known as the transmission, adhesion, and local host immune response. Anyone who gets the disease through sexual activities or skin-to-skin contact in the infected site goes through this stage. The bacteria is first transmitted through the mucosal membranes or skin and immediately enters the bloodstream. It targets the first tissue it reaches in site and penetrates in nearby tissues. “T. pallidum replicates at the site of initial inoculation, dividing once every 30-33 hours, inducing a local inflammatory response that results in a painless chancre approximately 3-6 weeks after initial infection” (Ho & Lukehart 2011). As soon as the person gets the syphilis, symptoms such as chancres or ulcers begin to develop at the site of infection within the first four weeks, or month. This stage lasts up to six weeks and progress to the second stage if not seek any medical attention immediately. The second stage of syphilis is called the “secondary syphilis” known as the motility, systemic host immune response, diagnosis, and systemic spread. The bacteria is formed in a corkscrew-like mechanism where it penetrates through tight junctions of the epithelial cells. In the meantime, there is a humoral response in which it produces antibodies like IgG and IgM. These antibodies, along with macrophages, goes to the infection site to phagocytize the bacteria. While this is occurring, symptoms such as weight loss, malaise, meningitis, and muscle aches will occur within the three months of infection because “most of the symptoms and tissue damage related to syphilis are due to activation of the host inflammatory and immune response” (Ho & Lukehart 2011). At this stage, it becomes obvious to the person that he or she have contracted a contagious disease due to signs of rapid weight loss, tiredness, weakness etc. If this stage is ignored and not received any medical attention, it will progress to the third stage. The third stage of syphilis is called the “latent syphilis” known as asymptomatic.
At this stage, the bacteria is latent, or asleep, and persist in many tissues without causing any signs or symptoms. According to the article, Syphilis & Stages of Syphilis, “the bacteria remain inactive inn the lymph nodes and the spleen. Latency can last 3-30 years and may or may not progress to the final, or tertiary, syphilis. About 30 percent of infected people persist in a latent state” (Swierzewski 2015). Within the first year of infection, after going through stage 1 and stage 2, the bacteria goes to sleep and remain dormant, or noninfectious, for up to 30 years. However, it does not mean that the person is considered free from the infection because it is still present in the body and can still be passed on to another person. For instance, a pregnant woman, at this stage, is likely to pass the infection on to the unborn because the disease is present in the blood. “T. pallidum may seed the bloodstream intermittently during the latent stage and thus infect a developing fetus during pregnancy” (Ho & Lukehart 2011). Babies who are born to a mother tested positive for syphilis are likely to get the disease also. In this case scenario, the baby either have a short life span or may live a full life style with the precaution of taking proper medically prescribed antibiotics on the daily basis. While growing up, the person still remains a carrier of the disease and must restrict from skin-to-skin contact to prevent the spread of
syphilis. The fourth or final stage of syphilis is called the “tertiary syphilis” known as antigenic variation. Not everyone with the syphilis reach this stage because the disease is still at a “latent” stage. However, people come to this final stage of syphilis when it somehow decides to wake up and continue attacking other organs at any time after the first year of infection. What makes this stage different from the previous stages is that the disease start attacking and penetrating into the nervous system. The invasion of the nervous system causes abnormalities in the cerebrospinal fluid, elevated white blood cells, etc. Also, the invasion of the nervous systems, following the primary or secondary stage of syphilis, include symptoms such as meningitis, visual changes, hearing loss, and facial weakness and are thus signs of an HIV infection. “Some studies indicate that HIV-infected individuals may have more significant symptoms of neurosyphilis, and HIV-infected individuals who have symptomatic neurosyphilis have more severe CSF abnormalities” (Ho & Lukehart 2011). Following the invasion of the nervous system and the production of problematic symptoms, the T. pallidum are capable of escaping the immune detecting due to “antigenic variation of bacterial surface proteins, consistent with the resistance to phagocytosis of those select treponemes that survive bacterial clearance of the primary lesion” (Ho & Lukehart 2011). The bacteria is capable of sneaking out of the supervision of the immune system because it is capable of disguising itself as a “good bacteria” due the outer membrane proteins. Once the bacteria successfully escapes, the person enters the new and uppermost level of STD infection, known as HIV/AIDS, the hard-to-treat level of disease where death is granted and irreversible.
“the latest available data, from 2014, showed a 15 percent increase in cases overall, the Centers for Diseases Control and Prevention said. A majority of cases involved men having sex with men” (Ho 2016). Syphilis is transmitted from person to person through chancre contact in the mouth or through an infected external genital touching a non-infected external genital.
Syphilis by nature is fatal and devastating not only to the patient, family and friends, but to the professional staff, community and nation at large. The doctors and health care providers are aware of the increase of syphilis cases over the past decades and are blaming social media because of “anonymous sex through social media, particularly with an increase in the use of smartphone apps…Young people dependent on their iPhones can find quick, easy access to hookups” (Ho 2016). Due to these challenges, it is imperative that everyone, especially adolescents, early adults, and gay men, should be proficient in avoiding syphilis and identifying those at risk to avoid much contact. Thereby, implementing safe practices of abstinence, the use of condom during sexual activities and avoidance of skin contact to areas susceptible to syphilis can reduce the spread of syphilis.
How the Disease is Originated Syphilis is a type of sexually transmitted disease, or an STD, caused by a spirochete bacteria called Treponema pallidum or T. pallidum. It is a gram-negative bacteria where it has an “outer and inner membranes and a periplasmic space, lacks lipopolysaccharide, a potent proinflammatory glycolipid, and does not produce any known toxic proteins” (Ho & Lukehart 2011). Because the bug is a gram-negative bacteria, it can lead to the most common infections such as pneumonia, skin infection, blood infection, etc. It is usually resistant to the most common types of antibiotics such as penicillin, cephalosporin, aminoglycoside, etc. especially when being treated at the later phase when the disease has already progressed in the body. The origin of syphilis is unknown but stems from a country in the Caribbean Islands where Christopher Columbus, and his crew, visited. Upon their arrival to Europe, there were a major outbreak where thousands of people died of unknown causes. However, according to the article, Syphilis Then and Now, “there continues to be disagreement about where syphilis is originated. Much evidence seems to point the finger at Christopher Columbus and his crew, who may have picked up the pathogen on their legendary first time to the New World” (Harper, Zuckerman, and Armelagos 2014). During the 1500s, scientists and archaeologists began collecting skeletons of people who have died from the unknown disease that was being passed around. The goal was to observe any special characteristics and testing. “The skeleton, genetic, and ecological information, scientists are now uncovering could inform our understanding of how T. pallidum has evolved and how we can best control it today” (Harper, Zuckerman, and Armelagos 2014). In 1905, the name “syphilis” was derived when scientists used skeletons collected in Europe since the 1500s and discovered a pale, corkscrew-shaped bacterium on them. Hence, scientists called the disease the “syphilis” which means “the French Disease.”
Four Stages The first stage of syphilis is called the “primary syphilis” known as the transmission, adhesion, and local host immune response. Anyone who gets the disease through sexual activities or skin-to-skin contact in the infected site goes through this stage. The bacteria is first transmitted through the mucosal membranes or skin and immediately enters the bloodstream. It targets the first tissue it reaches in site and penetrates in nearby tissues. “T. pallidum replicates at the site of initial inoculation, dividing once every 30-33 hours, inducing a local inflammatory response that results in a painless chancre approximately 3-6 weeks after initial infection” (Ho & Lukehart 2011). As soon as the person gets the syphilis, symptoms such as chancres or ulcers begin to develop at the site of infection within the first four weeks, or month. This stage lasts up to six weeks and progress to the second stage if not seek any medical attention immediately. The second stage of syphilis is called the “secondary syphilis” known as the motility, systemic host immune response, diagnosis, and systemic spread. The bacteria is formed in a corkscrew-like mechanism where it penetrates through tight junctions of the epithelial cells. In the meantime, there is a humoral response in which it produces antibodies like IgG and IgM. These antibodies, along with macrophages, goes to the infection site to phagocytize the bacteria. While this is occurring, symptoms such as weight loss, malaise, meningitis, and muscle aches will occur within the three months of infection because “most of the symptoms and tissue damage related to syphilis are due to activation of the host inflammatory and immune response” (Ho & Lukehart 2011). At this stage, it becomes obvious to the person that he or she have contracted a contagious disease due to signs of rapid weight loss, tiredness, weakness etc. If this stage is ignored and not received any medical attention, it will progress to the third stage. The third stage of syphilis is called the “latent syphilis” known as asymptomatic.
At this stage, the bacteria is latent, or asleep, and persist in many tissues without causing any signs or symptoms. According to the article, Syphilis & Stages of Syphilis, “the bacteria remain inactive inn the lymph nodes and the spleen. Latency can last 3-30 years and may or may not progress to the final, or tertiary, syphilis. About 30 percent of infected people persist in a latent state” (Swierzewski 2015). Within the first year of infection, after going through stage 1 and stage 2, the bacteria goes to sleep and remain dormant, or noninfectious, for up to 30 years. However, it does not mean that the person is considered free from the infection because it is still present in the body and can still be passed on to another person. For instance, a pregnant woman, at this stage, is likely to pass the infection on to the unborn because the disease is present in the blood. “T. pallidum may seed the bloodstream intermittently during the latent stage and thus infect a developing fetus during pregnancy” (Ho & Lukehart 2011). Babies who are born to a mother tested positive for syphilis are likely to get the disease also. In this case scenario, the baby either have a short life span or may live a full life style with the precaution of taking proper medically prescribed antibiotics on the daily basis. While growing up, the person still remains a carrier of the disease and must restrict from skin-to-skin contact to prevent the spread of
syphilis. The fourth or final stage of syphilis is called the “tertiary syphilis” known as antigenic variation. Not everyone with the syphilis reach this stage because the disease is still at a “latent” stage. However, people come to this final stage of syphilis when it somehow decides to wake up and continue attacking other organs at any time after the first year of infection. What makes this stage different from the previous stages is that the disease start attacking and penetrating into the nervous system. The invasion of the nervous system causes abnormalities in the cerebrospinal fluid, elevated white blood cells, etc. Also, the invasion of the nervous systems, following the primary or secondary stage of syphilis, include symptoms such as meningitis, visual changes, hearing loss, and facial weakness and are thus signs of an HIV infection. “Some studies indicate that HIV-infected individuals may have more significant symptoms of neurosyphilis, and HIV-infected individuals who have symptomatic neurosyphilis have more severe CSF abnormalities” (Ho & Lukehart 2011). Following the invasion of the nervous system and the production of problematic symptoms, the T. pallidum are capable of escaping the immune detecting due to “antigenic variation of bacterial surface proteins, consistent with the resistance to phagocytosis of those select treponemes that survive bacterial clearance of the primary lesion” (Ho & Lukehart 2011). The bacteria is capable of sneaking out of the supervision of the immune system because it is capable of disguising itself as a “good bacteria” due the outer membrane proteins. Once the bacteria successfully escapes, the person enters the new and uppermost level of STD infection, known as HIV/AIDS, the hard-to-treat level of disease where death is granted and irreversible.