• A disease characterized by a primary lesion.
• a later secondary eruption on the skin and mucus membranes, then
• a long period of latency, and late lesions of skin, bones, viscera, CNS and cardiovascular systems.
Infectious agent – Treponema pallidum, a spirochete.
Epidemiology
• Occurrence: Worldwide spread.
• Primarily involving sexually active young people between 20 and 29 years.
• More common in urban than rural areas.
Reservoir - Humans
Mode of transmission:- by direct contact with lesion mainly during sexual intercourse.
§ Accidentally by touching infective tissues. Or via blood transfusion.
§ Or congenitally, which may occur before birth, in the case of an infected mother
Incubation period– 10 days to 3 months, usually 3 weeks.
Period of communicability – variable and indefinite,
• During primary and secondary stages and also in mucocutaneous recurrences that may occur during the first 4 years of latency.
• Extent of communicability through sexual activity during this latent period is not established.
Adequate penicillin treatment usually ends infectivity within 24 – 48 hours
Susceptibility and resistance –
• Susceptibility is universal, although only approximately 30% of exposures result in infection.
• Infection leads to developing immunity against T. pallidum gradually and to some extent,
• But immunity usually fails to develop because of early treatment in the primary and secondary stages.
Clinical manifestations
• The clinical presentation is divided in to three stages
1. Primary syphilis
• Consists of hard chancre, the primary lesion of syphilis, together with regional lymphadenitis.
The hard chancre is a single, painless ulcer on the genitalia or elsewhere (lips, tongue, breasts) and heals spontaneously in a few weeks with out Rx
• Primary stage
• Chancre
• At site of entry
• Painless ulcer
• Regional lymphadenopathy
• Lasts 4 to 8 weeks
2. Secondary syphilis
• After 4-6 weeks of the primary infection,
• A generalized secondary eruption appears, often accompanied by mild constitutional symptoms. These early rashes tend to be symmetrical, quickly passing and don’t itch.
• These early skin lesions are highly infective and many spirochetes are demonstrated in them.
3. Tertiary syphilis
• This stage is characterized by destructive, non-infectious lesions of the skin, bones, viscera, and mucosal surfaces.
• Other disabling manifestations occur in the CVS (aortic incompetence, aneurysms) or CNS (dementia paralytica, tabes dorsalis)
4. Syphilis in pregnancy- According to the severity, congenital syphilis can result in:
• congenital abnormalities,
• still birth, or
• repeated spontaneous abortions.
Diagnosis(Dx)and Treatment(Rx)
• Diagnosis
ü Clinical
ü Microscopy
• RX
Benzathine
Erthromycne- for 7days
Prevention and control
1. Treatment of cases
2. Treatment of contacts and source of infection
3. Health education on safe sex
4. Controlling STDs among commercial sex workers
• Monthly check up and treatment of cases
• Provision of condom
5. Screening of pregnant women and early treatment to prevent congenital syphilis
6. Screening of blood before transfusion
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