Syphilis

syphilis (sĬf´əlĬs), contagious sexually transmitted disease caused by the spirochete Treponema pallidum (described by Fritz Schaudinn and Erich Hoffmann in 1905). Syphilis was not widely recognized until an epidemic in Europe at the end of the 15th cent. Some medical historians have proposed that syphilis first appeared in Spain among sailors who had returned from the New World in 1493, while others have concluded from archaeological evidence that it probably originated in the Old World but may have been confused with leprosy. A study (pub. 2008) that examined the evolutionary relationships among Treponema bacteria supported the idea that the spirochete originated in the New World, with some researchers suggesting it may have mutated into a sexually transmitted disease in Europe.

Transmission

The most prevalent mode of transmission is by sexual contact; infection by other means is possible, but its occurrence depends upon an open wound or lesion to permit invasion of the organisms. A person with syphilitic sores has an increased chance of contracting AIDS from an infected partner. An infected mother can transmit the disease to her fetus; 25% of such pregnancies end in stillbirth or death of the infant, and another 40% to 70% will result in a baby with congenital syphilis, which, if untreated, can progress to late-stage syphilis and cause serious damage to the brain and other organs.

Symptoms

The development of syphilis occurs in four stages. The primary stage is the appearance of a painless chancre at the site of infection (often internal) about 10 days to 3 months after contact. There are no other symptoms, and the chancre disappears with or without treatment.

The secondary stage usually begins 3 to 6 weeks after the chancre with a rash over all or part of the body. Active bacteria are present in the sores of the rash. Headache, fever, fatigue, sore throat, patchy hair loss, and enlarged lymph nodes may be present. The signs of the secondary stage will disappear with or without treatment, but may reappear over the next 1 to 2 years.

Untreated syphilis then goes into a noncontagious latent period. Some people will have no more symptoms, but about one third will progress to tertiary syphilis, with widespread damage to the heart, brain, eyes, nervous system, bones, and joints. Late syphilis can result in mental illness, blindness, severe damage to the heart and aorta, and death.

Neurosyphilis, infection of the nervous system, frequently occurs in the early stages in untreated patients. There may be no symptoms, mild headache, or severe consequences such as seizures and stroke. Its treatment and course are complicated by concomitant HIV infection.

Diagnosis and Treatment

Diagnosis is made by symptoms, blood tests (required by many states before issuing marriage licenses), and microscopic identification of the bacterium. Until the advent of penicillin in the 1940s, treatment for syphilis was with mercury, arsenic, and bismuth. Penicillin is the antibiotic of choice for all stages of syphilis treatment, but penicillin-resistant organisms have complicated treatment of the disease. Even late-stage syphilis can be cured, but damage that has already occurred cannot be reversed. Despite available treatment, the incidence of syphilis in the United States was on the rise until 1990, when it began declining significantly; since 2000, it has risen again.

See also Ehrlich, Paul.

The Columbia Encyclopedia, 6th ed. Copyright© 2014, The Columbia University Press.

Selected full-text books and articles on this topic

Disease in the Popular American Press: The Case of Diphtheria, Typhoid Fever, and Syphilis, 1870-1920
Terra Ziporyn.
Greenwood Press, 1988
Librarian’s tip: Chap. 4 "Syphilis: A Disease of the Immoral"
Sex, Disease, and Society: A Comparative History of Sexually Transmitted Diseases and HIV/AIDS in Asia and the Pacific
Milton Lewis; Scott Bamber; Michael Waugh.
Greenwood Press, 1997
Librarian’s tip: Includes discussion of syphilis in multiple chapters
No Magic Bullet: A Social History of Venereal Disease in the United States since 1880
Allan M. Brandt.
Oxford University Press, 1987 (Expanded edition)
Librarian’s tip: Includes discussion of syphilis in multiple chapters
Syphilis: Epidemiology and Control
Romanowski, Barbara.
The Canadian Journal of Human Sexuality, Vol. 6, No. 2, Summer 1997
PEER-REVIEWED PERIODICAL
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Syphilis Elimination in Canada: If Now, When?
Wong, Thomas; Jordan, Robbi A.
The Canadian Journal of Human Sexuality, Vol. 9, No. 3, Fall 2000
PEER-REVIEWED PERIODICAL
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Pain and Shame-The Triumph of the Pox: Sars Is but the Latest Epidemic to Plague Mankind. Syphilis Has Been around for 500 Years, Has Claimed Famous Victims, and Now Threatens a Comeback
Hayden, Deborah.
New Statesman (1996), Vol. 132, No. 4637, May 12, 2003
Opera: Desire, Disease, Death
Linda Hutcheon; Michael Hutcheon.
University of Nebraska, 1996
Librarian’s tip: Chap. 3 "Syphilis, Suffering, and the Social Order: Richard Wagner's Parsifal"
The Colour of Disease: Syphilis and Racism in South Africa, 1880-1950
Karen Jochelson.
Palgrave, 2001
Contagion and the State in Europe, 1830-1930
Peter Baldwin.
Cambridge University Press, 1999
Librarian’s tip: Chap. 5 "Syphilis Between Prostitution and Promiscuity"
The Keys to Happiness: Sex and the Search for Modernity in Fin-de-Siècle Russia
Laura Engelstein.
Cornell University Press, 1992
Librarian’s tip: Chap. Five "Morality and the Wooden Spoon: Syphilis, Social Class, and Sexual Behavior"
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