Syphilis

Syphilis is a sexually transmitted bacterial infection or STD. It is caused by Treponema pallidum, a spiral-shaped bacterium. It can affect both men and women who are sexually active. Syphilis can be transmitted from an infected person to another during oral, anal and vaginal sex and oral-genital contact. It can also be passed on by direct skin contact with someone who has syphilis sores or a syphilis rash and by sharing sex toys. Syphilis can also be transmitted by blood transfusion. Those who have tested positive for syphilis are vulnerable to other STD like Gonorrhea and HIV.

Syphilis develops in stages. Not everyone will go through all the stages. Between the stages are periods that are symptom-free or latent periods. When the infection is active, symptoms are noticeable. When it's not active, the symptoms are unnoticeable but syphilis persists.

Primary syphilis: Syphilis is highly contagious during the first stage. The incubation period is around 21 days before the first signs and symptoms appear. A painless red sore called a chancre appears on the part of the body like vagina, rectum, penis or mouth, places where the spirochetes moved from the infected person to another. The painless sore isn't noticed or recognized most of the time and the infected individual may not fall ill. The chancre may heal after 4 to 6 weeks but it does not indicate that syphilis has actually gone away. It continues to spread throughout the body.

Secondary syphilis: The bacterial has spread into the bloodstream. Without treatment, blood-borne spread of Treponema pallidum over the next several weeks to months results in secondary syphilis. It usually occurs 2 to 8 weeks after the appearance of chancre sore and several weeks after chancre have healed. Symptoms include fever, multiform skin eruptions, iritis, alopecia, mucous patches and severe pain in the head and joints. The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent stage of disease.

Latent (hidden) syphilis: The signs of the disease may go away, but the disease is present in the body. Syphilis can remain latent for many years.

Tertiary syphilis: Also termed as late-stage syphilis, tertiary syphilis may occur many years after the original infection. The infection has already spread all over the body and can affect the brain, heart, spinal cord and bones. Symptoms vary depending on which organ is infected and affected.

Congenital syphilis: A pregnant syphilis infected woman may pass on the infection through the placenta to the child during fetal development or delivery which is referred to as congenital syphilis. If the infected pregnant woman is not treated before 18th week of pregnancy, the child is most likely to be affected with congenital syphilis. Some babies with congenital syphilis have no symptoms at birth but develop them in a few weeks if not treated immediately. As a precautionary measure, syphilis screening tests (VDRL, RPR, FTA-ABS) has been made a routine part of prenatal care during pregnancy.

Jarisch Herxheimer Reaction: A temporary reaction to penicillin treatment for syphilis that manifests in the form of fever, chills and skin rash or chancre.

Syphilis Test FTA-ABS

Treponema pallidum, the bacterium which causes syphilis has four subspecies:

• Treponema pallidum pallidum, which causes syphilis
  
• T. pallidum endemicum, which causes bejel or endemic syphilis
  
• T. pallidum carateum, which causes pinta
  
• T. pallidum pertenue, which causes yaws
  

To detect antibodies to Treponema pallidum, the FTA-ABS (Fluorescent treponemal antibody absorbed), a blood serum screening test is done. This is sometimes also referred to as syphilis Immunofluorescent Assay (IFA). The FTA-ABS test is a second test to confirm the presence of the infection and is usually done after the RPR test and VDRL test results are positive. FTA-ABS test is used to detect syphilis infection at any stage except during the first 3 to 4 weeks after exposure and in tertiary stages of the disease. The test is more reliable for the secondary stage of syphilis. The test is done on a sample of blood or spinal fluid. A positive FTA-ABS usually indicates infection with syphilis and a negative or nonreactive result means there is no current or past infection with syphilis. The test requires no prior preparation on the part of the individual who is to be tested.

Syphilis Test VDRL

The syphilis test, VDRL is used to diagnose syphilis. The nontreponemal test is usually performed on blood but may be done on a serum sample or cerebro-spinal fluid (CSF). The test checks for an antibody that can be produced while infected with syphilis. Syphilis test VDRL is not very useful for detecting syphilis in very early or advanced stages. The test is also used to monitor patients' response to syphilis treatment. Syphilis VDRL test can result in false positive result even in the absence of infection due to recent immunization, other bacterial and viral infections and certain chronic conditions (e.g. liver disease, malignancy). Hence, a confirmatory test, the FTA-ABS test is done to check for syphilis-specific antibodies. Though no special preparation is required on the part of an individual who is to be tested, health care officials recommend abstaining from alcohol consumption 24 hours before a VDRL test.

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