These Are The Early Warning Signs Of Syphilis
Cases of syphilis have hit the highest rate of new infections since the 1950s, according to a new report from the Centers for Disease Control and Prevention. From 2018 to 2022, cases skyrocketed by nearly 80%, totaling more than 207,000.
“We have long known that these infections are common, but we have not faced such severe effects of syphilis in decades,” Dr. Laura Bachmann, acting director of the CDC’s division of sexually transmitted disease prevention, said in the statement released with the report. “It has emerged as a unique public health challenge.”
Rates of the most infectious stages of syphilis ― called primary and secondary ― rose in all age groups and in all regions across the country, but the CDC noted that Black and Latino communities were disproportionately affected due to longstanding social inequities “that often lead to health inequalities.”
Another troubling finding? Among the cases reported, more than 3,700 were congenital syphilis, which is transmitted to a baby during pregnancy. That’s a 937% increase over a decade.
Congenital syphilis can be fatal to newborns and if left untreated can cause health issues later in life, said Dr. Kenosha Gleaton, a board-certified OB-GYN and medical adviser at Natalist, a women’s health company that focuses on pregnancy and conception.
“It’s important to treat syphilis immediately, especially if you’re pregnant, because it can lead to a number of issues during your pregnancy, birth and postpartum state,” she told HuffPost.
Syphilis can also lead to an increased risk of miscarriage, premature birth and stillbirth, Gleaton said.
As for why syphilis is increasing in general, the CDC pointed to a number of reasons: lax condom use; an increase in substance abuse, which is often tied to risky sexual behavior; and people facing “tremendous barriers” to sexually transmitted infection prevention and health services, such as screenings. The COVID-19 pandemic and lockdown strained public health programs even further.
This 1966 microscope photo shows a tissue sample with the presence of numerous corkscrew-shaped, darkly-stained Treponema pallidum spirochetes, the bacterium responsible for syphilis.
And unfortunately with syphilis, the symptoms aren’t always easy to notice; the STI is often referred to as “the great imitator,” because of its ability to mimic other diseases. The elusive nature of its symptoms is why it’s best to go and get tested if you’re concerned you may have contracted it. In its beginning stages, syphilis is easily curable with the right antibiotics.
There are four stages of syphilis, some of which tend to overlap, but it’s most infectious during the primary and secondary stages.
The Signs Of Primary Syphilis
When you come in contact with syphilis ― usually through sex with a person who has a sore ― the bacteria can live in your body for years without producing any symptoms, but that’s not the norm, Gleaton said.
You generally see one or multiple small sores (which doctors call “chancres”) within three weeks of being exposed to the syphilis bacteria, Gleaton added.
Chancres are highly contagious and tend to show up around the penis, vagina, rectum and, less commonly, the mouth. The sores are often hard to identify because they may be hidden inside your vagina or under the foreskin. They can even be mistaken for pimples or an ingrown hair.
“The sore is often painless and goes away on its own, but the syphilis bacteria will live in your body and progress over time if it’s left untreated,” Gleaton told HuffPost.
“The way your body reacts to syphilis bacteria can really vary, so I always recommend that my patients stay up to date on their STI testing, especially if they are pregnant,” she said.
Hearing about the signs of syphilis may be unnerving if you suspect you might have it, but the good news is that syphilis is typically treated easily with antibiotics.
The Signs Of Secondary Syphilis
If syphilis is left untreated, some (but not all) people develop the secondary stage, which includes a rash, said Dr. Philip A. Chan, an associate professor at Brown University and the medical director of the Rhode Island Department of Health.
“The rash can be anywhere on the body but classically involves the palms of your hands and the soles of your feet,” he said. “People may also experience fevers, chills, enlarged lymph nodes, malaise and other symptoms.”
If your rash and those mild flu-like symptoms go away, you’re not out of the woods, so you should still go get tested.
“No matter how progressive the symptoms are, they will actually clear on their own without treatment, but the syphilis bacteria will continue to live in your body and can lead to health issues later in life,” Gleaton said.
If left untreated, late stages of syphilis can cause blood vessel and heart problems, tumors, blindness, paralysis and even death.
How To Treat Syphilis In The Early Stages
Hearing about those early signs of syphilis ― chancres, a rash and flu-like symptoms ― may be unnerving, but the good news is that syphilis is easily treated with antibiotics, Gleaton said.
If you’re in any way concerned, talk to your primary care doctor or another medical provider who specializes in sexual health.
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“Testing for syphilis generally includes a blood test,” Chan said. “Syphilis continues to be highly susceptible to penicillin, and treatment typically includes between one and three shots of a long-acting penicillin formulation.”
While you’re there, you should also be tested for other STIs, including HIV. Bottom line: There’s no shame in addressing any issues you have with your sexual health, and there’s treatment that can help.
“As an OB-GYN, I’ve seen an uptick of STI cases at my private practice in Charleston, South Carolina, from millennials to women over 45,” Gleaton said. “I’ve seen the fear and shame patients feel when they receive a positive STI diagnosis, but it’s so important that we educate and destigmatize this scenario.”
How A Morning-After-Style Pill Could Help Rising STD Cases
NEW YORK (AP) — U.S. health officials released data Tuesday showing how chlamydia, gonorrhea and syphilis cases have been accelerating, but doctors are hoping an old drug will help fight the sexually transmitted infections.
Experts believe STDs have been rising because of declining condom use, inadequate sex education and reduced testing during the COVID-19 pandemic.
Millions of Americans are infected each year. Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans.
“Sexually transmitted infections are an enormous, low-priority public health problem. And they’ve been a low-priority problem for decades, in spite of the fact that they are the most commonly reported kind of infectious disease,” said Dr. John M. Douglas Jr., a retired health official who lectures at the Colorado School of Public Health.
To try to turn the tide, many doctors see promise in doxycycline, a cheap antibiotic that has been sold for more than 50 years.
The Centers for Disease Control and Prevention is drafting recommendations for using it as a kind of morning-after pill for preventing STDs, said Dr. Leandro Mena, director of the agency’s STD prevention division.
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The drug is already used to treat a range of infections. A study published last week in the New England Journal of Medicine showed its potential to prevent sexually transmitted infections.
In the study, about 500 gay men, bisexual men and transgender women in Seattle and San Francisco with previous STD infections took one doxycycline pill within 72 hours of unprotected sex. Those who took the pills were about 90 percent less likely to get chlamydia, about 80 percent less likely to get syphilis, and more than 50 percent less likely to get gonorrhea compared with people who did not take the pills after sex, the researchers found.
The study was led by researchers at the University of California, San Francisco and built on a similar French study that saw promise in the idea.
“We do need new approaches, new innovations” to help bring sexually transmitted infections under control, said Dr. Philip Andrew Chan, who is consulting with the CDC on the doxycycline recommendations.
Mena, of the CDC, said there is no sign the STD trend is slowing.
Mississippi had the highest rate of gonorrhea cases, according to 2021 CDC data released Tuesday. Alaska saw a sharp increase in its chlamydia case rate that allowed it to overtake Mississippi at the top of that list. South Dakota had the highest rate of early-stage syphilis.
And Arizona had the tragic distinction of having the highest rate of cases in which infected moms pass syphilis on to their babies, potentially leading to death of the child or health problems like deafness and blindness.
Using an antibiotic to prevent these kinds of infections won’t “be a magic bullet. but it will be another tool,” said Chan, who teaches at Brown University and is chief medical officer of Open Door Health, a health center for gay, lesbian and transgender patients in Providence, Rhode Island.
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Experts noted the CDC will have many factors to weigh as it develops the recommendations.
Among them: The drug can cause side effects like stomach problems and rashes after sun exposure. Some research has found it ineffective in heterosexual women. And widespread use of doxycycline as a preventive measure could contribute to mutations that make bacteria impervious to the drug, as has happened with antibiotics before.
Nevertheless, the San Francisco Department of Public Health in October became the first U.S. health department to issue guidance about doxycycline as an infection-prevention measure. And some other clinics have been been recommending the antibiotic to patients who may be at higher risk.
Derrick Woods-Morrow, a 33-year-old artist and an assistant professor at the Rhode Island School of Design, is an early adopter. Woods-Morrow, said he isn’t a fan of condoms — they can break and sometimes people slip them off during sex. But he wants to stay healthy.
About a decade ago, he started taking an anti-viral medication before sex to protect himself from HIV infection. Five years ago, a doctor told him about research into whether doxycycline might protect people from other diseases.
“I thought it was probably in my best interest to protect myself, and my partners as well,” he said. He said it’s been a positive experience and that he hasn’t tested positive for chlamydia, gonorrhea or syphilis while using it.
“I feel like it’s a tool to sort of take back the sexual freedoms that someone may have lost and to really enjoy sex and interactions with people with a piece of mind,” he said.
