Definition of Syphilis

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Syphilis: A sexually transmitted disease caused by Treponema pallidum, a microscopic organism called a spirochete. This worm-like, spiral-shaped organism infects people by burrowing into the moist mucous membranes of the mouth or genitals. From there, the spirochete produces a non-painful ulcer known as a chancre. There are three stages of syphilis:

• The first (primary) stage: This involves the formation of the chancre. At this stage, syphilis is highly contagious. The primary stage can last one to five weeks. The disease can be transmitted from any contact with one of the ulcers, which are teeming with spirochetes. If the ulcer is outside of the vagina or on the scrotum, the use of condoms may not help in preventing transmission. Likewise, if the ulcer is in the mouth, merely kissing the infected individual can spread syphilis. Even without treatment, the early infection resolves on its own in most women.

• The second (secondary) stage: However, 25 percent of cases will proceed to the secondary stage of syphilis, which lasts four to six weeks. This phase can include hair loss; a sore throat; white patches in the nose, mouth, and vagina; fever; headaches; and a skin rash. There can be lesions on the genitals that look like genital warts, but are caused by spirochetes rather than the wart virus. These wart-like lesions, as well as the skin rash, are highly contagious. The rash can occur on the palms of the hands, and the infection can be transmitted by casual contact.

• The third (tertiary) stage: This final stage of the disease involves the brain and heart, and is usually no longer contagious. At this point, however, the infection can cause extensive damage to the internal organs and the brain, and can lead to death.

Diagnosis is by blood test, either the rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) test. Treatment is with antibiotics.

Syphilis remains a major health problem. About 12 million new cases of syphilis occur every year. More than 90% of them are in developing nations where congenital syphilis remains a leading cause of stillbirths and newborn deaths. In North America and Western Europe, syphilis is disproportionately common and rising among men who have sex with men and among persons who use cocaine or other illicit drugs.

The name "syphilis" was coined by Hieronymus Fracastorius (Girolamo Fracastoro). Fracastorius was a true Renaissance man; he wrote on the temperature of wines, the rise of the Nile, poetry, the mind, and the soul; he was an astronomer, geographer, botanist, mathematician, philosopher and, last but not least in the present context, a physician. In 1530 he published the poem "Syphilis sive morbus gallicus" (Syphilis or the French Disease) in which the name of the disease first appeared. Perhaps more importantly, Fracastorius went on in 1546 to write "On Contagion" ("De contagione et contagiosis morbis et curatione"), the first known discussion of the phenomenon of contagious infection: a landmark in the history of infectious disease.

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