I was surprised and concerned to receive a report this past week from the Department of Health in my home state (Maryland) on the national and statewide increase in the cases of syphilis reported in the past few years. This sexually transmitted disease, not often seen in recent decades, has made an unfortunate resurgence due to a number of factors which I will describe below. But first, let’s talk about the disease itself.
The condition, in its primary, secondary and tertiary forms, is caused by a cork-screw shaped microorganism called a spirochete, an ugly little bacterium that goes by the Latin name Treponema pallidum. Like its nasty cousins gonorrhea and chlamydia, syphilis is an STD—a sexually transmitted disease. With sexual contact, particularly that with men having unprotected sex with men and people who exchange sex for drugs, the incidence nationwide has increased a whopping 78% between 2012 and 2016. Sadly, the disease can be spread to newborns in the birthing process, where the incidence has increased 88% during this same time. This has been due to the alarming increase in the infection among young women. Clearly, we have a national problem.
- What does one look for in this condition? The primary and secondary disease reveals:
- Painless genital or oral ulcers (called chancres).
- A rash on the palms or soles of the feet (macabrely known as the “Hollywood Measles in the 1920s and 30s).
- Genital warts.
- Patchy hair loss and overall body rash.
The tertiary stage means central nervous system involvement (the stage Al Capone had when he died, as did Vladimir Lenin, Scott Joplin and Howard Hughes), with difficulty walking, mental and behavioral changes and other neuro/psychiatric manifestations.
There is a blood test for the disease, but up to 30% of patients can still have it and have a negative blood test.
The good news is that injected penicillin is a great cure. The bad news is many people have the disease and don’t know it. So may all their sexual partners.
Why the increase in incidence? Other than the factors mentioned above, be aware that online dating and hook-up sites are likely to blame. The population is letting its guard down, it seems, concerning safe-sex practices.
- What to do?
- Use common sense and discretion.
- Practice safe sex.
- Get tested if you have any signs or symptoms.
- Talk to your doctor.
Remember: Biology does not care if you are rich, famous or educated. Your bloodstream is still a great swimming pool for spirochetes!