Syphilis is often associated with diseases of the past, and according to NBC Universal Media, syphilis was “on the verge of elimination in 2000 in the U.S.” Yet, syphilis refuses to retreat to the shadows, and community health providers and STD-prevention measures need to understand how this resurgence is occurring, who it affects, where it is happening, and how it can be addressed.
Rates of Syphilis Return to Levels Not Seen Since Before the HIV Epidemic
On April 13, 2016, reports CNSNews.com, Gail Bolan, Director of the Center for Disease Control and Prevention’s (CDC) Division for STD Prevention, explained how syphilis has resurfaced with vengeance to return the disease to epidemic status at an event on Capitol Hill. Her words emphasized the seriousness of the situation:
We’re back to the level of the disease – burden of the disease – in gay men that we were seeing before HIV in this country.
In 2014, syphilis infections among men who have sex with men (MSM) made up 83 percent of all cases of the disease in men. However, Bolan’s testimony alludes to even higher numbers that have yet to be released, but some areas are experiencing record-shattering jumps in the incidence of syphilis.
Lubbock County stands out with a 267-percent increase in the number of confirmed cases of the disease from January 2016 to the present, explains KCBD (a local news station in the area). As a result, the Texas Department of State Health Services issued a “Syphilis Alert” for Lubbock Country, but the trend appears to continue across the state. Cities like Amarillo, Austin, San Antonio and Dallas have issued similar alerts in recent weeks as well.
Syphilis Threatens Everyone
Statistics on the disease seem to indicate the rise in syphilis is exclusive to men. Although the most significant data have focused on MSM, women and men who have sex with women (MSW) have an increased risk of contracting syphilis as prevalence grows. Moreover, syphilis can be transmitted during pregnancy, giving rise to congenital defects and complications. Fortunately, syphilis can be treated successfully with antibiotics.
Potential Causes of the Increase
The increase in the prevalence of syphilis cannot be pinned to any particular factor. Public perception toward the severity of sexually transmitted diseases (STDs) could be diminishing. Although pre-exposure (PrEP) treatment of HIV with Truvada, explains AIDS.gov, can curb reduce transmission rates of HIV, there is no absolute means of preventing syphilis besides abstinence.
Another factor in the rise of syphilis involves addiction. Risky sexual behaviors increase the likelihood of contracting syphilis. Moreover, injection drug users have the highest risk of contracting blood-borne infections, such as HIV or hepatitis B and C, asserts the National Institute on Drug Abuse (NIDA).
Preventing Complications From Syphilis: Early Recognition
In adults, syphilis occurs in multiple stages, explains the CDC. The key to preventing the advancement of the disease rests in recognizing the symptoms of syphilis as soon as possible. These stages include the following.
- Primary Stage – Development of one or more firm, round and painless sores at the place of entry, e.g., the mouth, vagina or anus. Although sores resolve within three to six weeks, syphilis will continue to grow worse with time.
- Secondary Stage – Skin rashes and sores may appear on mucus membranes. Other secondary symptoms include fever, swollen lymph glands, muscle pain, fatigue, unexplained hair or weight loss, headaches and sore throat.
- Latent and Late Stage – After secondary symptoms resolve, the disease may be asymptomatic for up to 30 years. Between 10 and 30 years after infection, muscle paralysis, numbness, blindness and dementia or other mental health disturbances may occur. At the far-end of the spectrum, internal organs may become damaged, resulting in death.
Preventative Measures Against Syphilis
Syphilis transmission occurs at any stage, but most often, contact with a syphilis-sore is the mode of transmission. However, certain actions can decrease risk for contracting syphilis or developing advanced symptoms of the disease.
- Use a condom during any form of sexual contact. This includes oral sexual contact as well. However, sores that present on “uncovered” areas are still capable of transmitting syphilis. For example, kissing when a sore is present in the mouth can result in transmission.
- Avoid promiscuity. Long-term, monogamous relationships lower the risk for contracting syphilis when both partners have negative test results for STDs.
- Do not abuse drugs or alcohol. Intoxication from drugs or alcohol increases the risk for engaging in unsafe sexual activity. It is important to define alcohol abuse for community health purposes as well.
Alcohol abuse is not having a few drinks on rare occasions; it involves recurrent heavy or binge drinking as defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
4. Get tested for STDs regularly. Blood tests are available for nearly all STDs. If you have engaged in unprotected sexual activity or sexual activity with multiple partners, get tested. Proactive testing greatly reduces the chances of complication from syphilis and all other STDs.
Final Thoughts on the Spike in Syphilis
Syphilis is completely curable, but even those who have had the disease previously can contract it again. Currently, the greatest danger of syphilis is among men who have sex with men, but everyone needs to know what syphilis looks like in its varying stages.
Community health centers can often connect those with an increased risk for syphilis with testing and treatment facilities, and no one should feel ashamed for such a diagnosis. Until syphilis retreats from society once more, pregnant women should consider being tested for syphilis as soon as pregnancy is confirmed.
By taking action now, we can do something about increased prevalence and incidence of syphilis. The battle against syphilis and its associated problems with physical and mental health starts and ends with raising awareness about the disease through communities in all possible settings, inside and outside of direct-care environments.