Syphilis

Syphilis

Syphilis is a sexually transmitted disease that is caused by the bacterium Treponema pallidum. Diagnosis of syphilis is sometimes difficult for medical professionals because of the wide variety of symptoms that the disease presents (Zetola, Engelman, Jensen, & Klausner, 2007). Symptoms of syphilis may become noticeable with sore on the genitals. These symptoms become progressively worse and more noticeable with the amount of time a person has been infected (Healthwise, 2009). The advancement of syphilis is broken down into three stages of the disease; primary, secondary, and latent. The primary stage is marked my the appearance of a sore that can emerge within ninety days of infection and can last up to six weeks after infection. The secondary stage appears in the formation of a rash typically on the palms of hands and bottoms of feet, but can also appear elsewhere on the body. The symptoms of secondary syphilis can occur weeks after the sore from primary syphilis have cleared. The rash and flu-like symptoms of secondary syphilis will clear up without intervention, but without antibiotics the person will remain infected. The latent stage of syphilis occurs when a person has not been treated during the primary and secondary stages. Since the infection can last for years, the latent stage is comprised of hidden symptoms like damage to internal organs, gradual blindness, dementia, etc. If left untreated a syphilis infection can be deadly (Center for Disease Control and Prevention, 2010).
 * Medical Definition **

Syphilis is easily treated in its early stages. Currently, the Centers of Disease Control recommend the use of benzathine penicillin G to treat syphilis. A single injection of penicillin will effectively treat a patient that has had syphilis for less than one year. Additional doses are necessary to treat a patient carrying the disease for longer than a year (Centers for Disease Control and Prevention, 2010). Patients with a history of penicillin allergy require an allergy test, to assess if the allergy still exists. If a patient is allergic to penicillin, they will undergo desensitization to penicillin because it has proven effective in the treatment of syphilis (Osborne, 2008).
 * Treatment **

As a sexually transmitted disease, the spread of syphilis can be reduced by the implementation of safe-sex practices. This includes abstaining from sex or using a condom when engaging in vaginal or anal intercourse and oral sex (Planned Parenthood, 2011). A study conducted to test the effectiveness of condoms in preventing sexually transmitted infections found that the use of latex male condoms or female condoms was associated with a statistically significant reduction in the incidence of syphilis (King K. Holmes et al., 2004). For these reasons it is important for sexual partners to discuss their own sexual histories as well as their shared sex life.
 * Prevention **

The prevalence of syphilis has fluctuated in the United States throughout the decades. During the 1940’s there was a high number of reported cases of syphilis, which was matched by an aggressive public health intervention and a subsequent drop in the number of reported cases. Rates of infection have since shown recurrent high's and low’s (Zelota et al., 2007). In the early 1980’s, the rate of syphilis infection rose again, but decreased with the sexual awareness accompanying HIV/AIDS-related deaths. In the early 1990’s, the use of crack cocaine and an increase in high-risk sexual behavior in urban areas led to another increase in the rate of syphilis infection. This increase was met by the Center of Disease Control and Prevention’s implementation of the National Plan to Eliminate Syphilis. This national intervention was implemented in 1999 and a record low rate of syphilis infection was reached in 2000 (Zelota et al., 2007). AVERT, the international HIV & AIDS charities, in their report on STD statistics in the USA, the number of reported syphilis infections had varied throughout the decades, but is now at a low level. AVERT states that diagnoses of syphilis have dropped, “from a high of 94,957 in 1946 to a low of 5,979 in 2000. This represents a change from 70.9 cases per 100,000 population to 2.1 cases” (AVERT 2011). Recently, the number of syphilis diagnoses has increased. This increase has disproportionately affected males with a noticeable increase in the male to female syphilis incidence rate ratio (Zelota et al., 2007). According to AVERT, “In 2009 the rate among males was almost six times higher than females and the rate increased by 4% among males between 2008 and 2009” (AVERT 2011).
 * Prevalence Through the Decades **

In an attempt to reduce and eliminate the spread of syphilis the Centers of Disease Control and individual states have implemented intervention plans to make the public aware of the dangers of syphilis. In January of 2000, the city of Los Angeles designed and implemented a syphilis intervention plan to address an outbreak of the disease. The plan contained seven component designed to involve medical professionals and the at-risk community. The seven components included provider awareness, community-based organization recruitment, media campaign, community outreach and screening, correctional facility intervention, enhanced active surveillance and rapid evaluation, and interagency collaboration (Chen et al., 2002). Within these seven components were several activities and venues in which information of syphilis’ symptoms, testing, and treatment could be made available to the public. In the component of media campaign there were ten activities and venues to provide resources to the public about syphilis. Some of the activities in the media campaign were print, radio, and Internet advertisements, press releases, billboards, informative chat rooms, condom distribution, and more. The prevention plan that Los Angeles implemented was successful for various reasons. The plan targeted at-risk populations and made resources available to them before they reached epidemic levels of syphilis infection. The seven components of the plan relied on the cooperation of many members in the community. Medical professionals, healthcare providers, clinical staffs, educators, and more groups worked together to provide resources to people within the city of Los Angeles (Chen at al., 2002). The efforts of community members and professions in a multi-step intervention program proved effective in halting an outbreak of syphilis and providing information and resources about syphilis to the community members.
 * Intervention **


 * References **

AVERT. (2010). //Std statistics for the usa//. Retrieved from []

Chen, J. L., Kodagora, D., Lawrence, A., & Kerndt, P. R. (2002). Rapid Public Health Interventions in Response to an Outbreak of Syphilis in Los Angeles. //Sexually Transmitted Diseases//, 29(5), 277.

Healthwise. (2009, September 30). //Sexual conditions health center-syphilis//. Retrieved from http://www.webmd.com/sexual-conditions/tc/syphilis-symptoms

Holmes, K. K., Levine, R., & Weaver, M. (2004). Effectiveness of condoms in preventing sexually transmitted infections. //Bulletin of the World Health Organization//, 82(6), 454-461.

Osborne, N. G. (2008). Syphilis: Should We Change the Treatment of Choice?. //Journal of Gynecologic Surgery//, 24(3), 131-133. doi:10.1089/gyn.2008.999994

Planned Parenthood. (2011). //Syphilis//. Retrieved from http://www.plannedparenthood.org/health-topics/stds-hiv-safer-sex/syphilis-4281.htm

Zetola, N. M., Engelman, J., Jensen, T. P., & Klausner, J. D. (2007). Syphilis in the United States: An Update for Clinicians With an Emphasis on HIV Coinfection. //Mayo Clinic Proceedings//, 82(9), 1091-1100.