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Material elaborado en Médicos
del Mundo Canarias (Tenerife)
SEXUALLY TRANSMITTED DISEASES (STD’S)
SYPHILIS
WHAT IS SYPHILIS?



Syphilis is a sexually transmitted
disease (STD).
It’s caused by the Treponema Pallidum
bacteria.
It is called “the great imitator”.
SYPHILIS
SYPHILIS
HOW IS SYPHILIS TRANSMITTED?

Syphilis IS TRANSMITTED by:
 Direct
contact with a syphilitic ulcer.
 The ulcers mainly appear on the external genitals,
the vagina, the anus or the rectum.
 They can also appear on the lips and in the mouth.
 The transmission of the bacteria occurs during
vaginal, anal and oral sex.
 Pregnant women that have this disease can
transmit it to their babies.
HOW IS SYPHILIS NOT TRANSMITTED?
Syphilis IS NOT TRANSMITTED by:
 Contact with toilets.
 Door
handles.
 Sharing
pools, normal or whirlpool baths.
 Sharing
clothes or cutlery.
WHICH ARE ITS SIGNS AND SYMPTOMS?

Syphilis presents 3 stages according to its signs and
symptoms:






Primary syphilis
Secondary syphilis
Latent and late syphilis
Many people that have syphilis don’t present any
symptoms for years.
Many people who are in the primary or secondary stages
of the disease can transmit it to their partners even
though in many cases syphilitic ulcers cannot be
recognized.
People who do not know they have been infected can
transmit the disease.
PRIMARY SYPHILIS

The primary stage is mostly marked by the
appearance of a single sore (called a chancre).

The time that passes between the infection of syphilis
and the appearance of the first symptom can be from
10 to 90 days (with an average of 21 days).

The chancre is firm, round, small and painless. It
appears in the place where the syphilis entered the
organism.

The chancre lasts from 3 to 6 weeks and disappears
without being treated.
PRIMARY SYPHILIS
PRIMARY SYPHILIS
Open sore or
chancre
Treponema pallidum
bacteria
PRIMARY SYPHILIS
PRIMARY SYPHILIS
PRIMARY SYPHILIS
PRIMARY SYPHILIS
PRIMARY SYPHILIS
PRIMARY SYPHILIS
PRIMARY SYPHILIS
SECONDARY SYPHILIS 1
 Skin
rashes and mucous membrane lesions
appear.
 This
stage usually begins with a rash in one or
more areas of the body.
 The
 The
rashes generally aren’t itchy.
rashes associated with secondary syphilis
can appear when the chancre is healing or
weeks after it has healed.
SECONDARY SYPHILIS 2

The characteristic rash of this stage may appear as rough, red or reddish
brown spots, both on the palms of the hands and the bottoms of the feet.

Rashes with a different appearance may occur on other parts of the body,
sometimes resembling rashes caused by other diseases.

Sometimes, they are so faint that they are not noticed.

In addition to rashes, symptoms of secondary syphilis may include fever,
swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss,
muscle aches, and fatigue.

The signs and symptoms of secondary syphilis will resolve with or without
treatment, but without treatment, the infection will progress to the latent
and possibly late stages of disease.
SECONDARY SYPHILIS
SECONDARY SYPHILIS
SECONDARY SYPHILIS
SECONDARY SYPHILIS
SECONDARY SYPHILIS
SECONDARY SYPHILIS
SÍFILIS SECUNDARIA
SÍFILIS SECUNDARIA
SECONDARY SYPHILIS
LATENT & LATE SYPHILIS 1

It’s also called the hidden stage of syphilis.

It begins with the disappearance of the symptoms of the first and secondary
stages.

Without treatment, the infected person will continue to have syphilis even
when they no longer present signs or symptoms, as the infection remains in
the body.

This latent stage can last for years.

The late stages of syphilis can develop in about 15% of people who have not
been treated for the primary stages, the disease can advance and appear
10–20 years after infection was first acquired.
LATENT & LATE SYPHILIS 2

In this advanced stage syphilis may
subsequently damage the internal organs
including:
 The brain
 The nerves
 The eyes
 The heart
 Blood vessels
 The liver
 Bones
 The joints
LATENT & LATE SYPHILIS 3


The damage caused in this stage can be serious and
cause death.
The signs and symptoms of this latent stage of
syphilis include:
 Difficulty
coordinating muscle movements
 Paralysis
 Numbness
 Gradual
blindness and dementia.
LATENT & LATE SYPHILIS
Liver
Bone
Heart
Brain
The bacteria spreads to
various organs and causes
lesions.
LATENT & LATE SYPHILIS
HOW IS SYPHILIS DIAGNOSED? 1

There are two ways of diagnosing a syphilis
infection:

Via a blood test:
Shortly after a person is infected they begin to produce
antibodies against the syphilis that can be detected by
an accurate, safe and inexpensive blood test.
 A low level of antibodies will likely stay in the blood for
months or years even after the disease has been
successfully treated.
 Because untreated syphilis in a pregnant woman can
infect and possibly kill her developing baby, every
pregnant woman should have a blood test for syphilis.

HOW IS SYPHILIS DIAGNOSED? 2

The other way to diagnose syphilis Is by
examining material from a chancre (infectious
sore) using a special microscope called a darkfield microscope.

If syphilis bacterium are present in the sore,
they will show up when observed through the
microscope.
WHICH EFECTS DOES SYPHILIS HAVE ON
PREGNANT WOMEN AND THEIR BABIES?

The syphilis bacteria can infect the baby during pregnancy.

Depending on the time in which a pregnant woman has been
infected, there could be a high risk of having a stillborn or of the
baby dying after birth.

An infected baby can be born without the signs and symptoms
of the disease. However, if it is not immediately treated, the
baby could present some serious symptoms after some weeks.

If these babies do not receive treatment, they may suffer
developmental delays, convulsions or death.
CONGENITAL SYPHILIS
CONGENITAL SYPHILIS
CONGENITAL SYPHILIS
CONGENITAL SYPHILIS
WHAT IS THE LINK BETWEEN
SYPHILIS AND HIV

The syphilitic genital ulcers (chancres) make it easier
to acquire and transmit the 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.

Ulcerative STDs that cause sores, ulcers, or breaks in
the skin or mucous membranes, such as syphilis,
disrupt barriers that provide protection against
infections.
WHAT IS THE TREATMENT FOR
SYPHILIS?






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Syphilis is easy to heal in its early stages.
A single intramuscular injection of penicillin, an antibiotic, will cure a
person who has had syphilis for less than a year.
Additional doses are needed to treat someone who has had syphilis
for longer than a year.
For people who are allergic to penicillin, other antibiotics are
available to treat syphilis.
Treatment will kill the syphilis bacterium and prevent further damage,
but it will not repair damage already done.
Persons who receive syphilis treatment must abstain from sexual
contact with new partners until the syphilis sores are completely
healed.
Persons with syphilis must notify their sex partners so that they also
can be tested and receive treatment if necessary.
WILL SYPHILIS RECUR?

Having syphilis once does not protect a person
from getting it again.

Following successful treatment, people can still be
susceptible to re-infection.

Because syphilitic sores can be hidden in the
vagina, rectum, or mouth, it may not be obvious
that a sex partner has syphilis.

Which is why it is necessary to be re-tested for
syphilis after being having finished the treatment.
HOW FREQUENT IS SYPHILIS
- “Experts recognize an increase in incidence of syphilis and tuberculosis in developed
countries.”
22nd of March (noticiadesalud.blogspot.com)
- “The Balearics is the region with the highest rate of syphilis with almost 100 cases in
2009”
22nd of March (noticiadesalud.blogspot.com)
- “Syphilis has duplicated in 10 years due to a relaxation in sexual protection”
19th of March 2008 (elpais.es)
- “20% rise in cases of syphilis, with a daily average of almost one patient”
The latest health data figures show that 355 were infected in the last year, 164 of those
had various partners.
3rd of May 2010 (levante-emv.com)
HOW FREQUENT IS SYPHILIS?
According to the Canarian government’s PUBLIC HEALTH
ADMINISTRATION DEPARTMENT:

The figures of sexually transmitted diseases in the
Canaries, including aids, are experiencing an increase in
frequent years as is everywhere in our surroundings ,
especially in the young population (between 15 & 35 years
old) in both heterosexuals and homosexuals.

The cause of this increment is due to the lack in use of
protection (barrier methods like the preservative) during
sexual relations.
HOW FREQUENT IS SYPHILIS?
According to the Canarian government’s PUBLIC HEALTH
ADMINISTRATION DEPARTMENT:



The incidence rates of syphilis and gonococcal infections
(gonorrhea) declared to the Public Health’s Administration
Department’s Epidemiological Register, there are 12.85 cases
of syphilis per 100.000 inhabitants and 8.93 gonococcal
infections per 100.000 inhabitants.
The incidence rates of these two pathologies are: 5.7 cases of
syphilis per 100.000 inhabitants, and 4.25 cases of
gonococcal infection per 100.000 inhabitants.
The incidence rates of cases of aids in the Canary Islands in
2008 is of 21.72 cases per 1.000.000 inhabitants.
HOW CAN SYPHILIS BE PREVENTED 1

The surest ways to avoid the transmission of syphilis are:
 Abstain from sexual contact.
 Be in a stable and mutually monogamous relationship with a partner
that has been tested and is known to be uninfected.

Avoiding alcohol and drug use may also help prevent transmission of
syphilis because these activities may lead to risky sexual behavior.

It is important that sex partners talk to each other about their HIV status
and history of other STDs so that preventive action can be taken.

The correct and frequent use of condoms can reduce the risk of contracting
syphilis, genital herpes and chancres, always and when the infected area or
the area of possible contact is covered.
HOW CAN SYPHILIS BE PREVENTED 2

Condoms lubricated with spermicides are no more effective than other
lubricated condoms in protecting against the transmission of syphilis and
other STDs.

The transmission of an STD, including syphilis, cannot be prevented by
washing the genitals, urinating and/or showering after sex.

Any unusual discharge, sore, or rash, particularly in the groin area, should
be a signal to refrain from having sex and to see a doctor immediately.
REVIEW
Cause
Transmission
via
Symptoms
Diagnosis
Treatment
Blood test from
15 days after
infection.
Treatment with
antibiotics which
requires
comprehensive
monitoring.
First stage: Primary Syphilis
(chancre)
Redish ulcer in the infected area
and infection of the lymph nodes of
the nearest areas to the lesion
(mouth, genitals or rectum). Heals
in 3 to 6 weeks.
Bacteria
-Anal & vaginal Secondary stage: Secondary
penetration
Syphilis (rashes, warty or mucous
(elevated risk) patches)
Rashes on the chest, extremities
and hands, lymph nodes of the
-Oral sex and neck, armpits and groin, fever, hair
kissing if a
loss and general malaise.
lesion is
present.
Third stage: Latent & late syphilis
Ulcers on the skin, arthritis, lesions
on the heart and blood vessels,
brain and spinal cord.
ANY QUESTIONS ABOUT SYPHILIS?
Thank you very much for you attention!
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