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Syphilis “The Great Pretender” By: Bruce Martin. Taxonomy Domain: Bacteria Phylum: Spirochaetes Order: Spirochetales Family: Spirochaetaceae Genus: Treponema.

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Presentation on theme: "Syphilis “The Great Pretender” By: Bruce Martin. Taxonomy Domain: Bacteria Phylum: Spirochaetes Order: Spirochetales Family: Spirochaetaceae Genus: Treponema."— Presentation transcript:

1 Syphilis “The Great Pretender” By: Bruce Martin

2 Taxonomy Domain: Bacteria Phylum: Spirochaetes Order: Spirochetales Family: Spirochaetaceae Genus: Treponema Species: pallidum

3 Characteristics Helical, tightly coiled, mobile Helical, tightly coiled, mobile 5-20 um in length, 0.1-0.4 um in diameter 5-20 um in length, 0.1-0.4 um in diameter Pathogenic treponemes associated with 4 diseases Pathogenic treponemes associated with 4 diseases Venereal syphilis (pallidum) Venereal syphilis (pallidum) Yaws (perfenue) Yaws (perfenue) Endemic (endemicum) Endemic (endemicum) Pinta (carateum) Pinta (carateum) Obligate parasites of humans Obligate parasites of humans

4 Method of infection Viable bacteria from a chancre enters through a fissure or mucus membrane Viable bacteria from a chancre enters through a fissure or mucus membrane Bacteria multiply locally and causes a painless chancre Bacteria multiply locally and causes a painless chancre Spreads via blood stream or lymphatic system Spreads via blood stream or lymphatic system Can infect almost any organ or tissue Can infect almost any organ or tissue Continuous in vitro culture has yet to be achieved Continuous in vitro culture has yet to be achieved

5 Symptoms *some have no symptoms for years 3 stages 3 stages Primary Primary Secondary Secondary Late or latent Late or latent Congenital (passed from a mother to her unborn child) Congenital (passed from a mother to her unborn child)

6 Primary stage Appearance of a single sore or chancre (about 21 days after infection) Appearance of a single sore or chancre (about 21 days after infection) Chancre lasts 3-6 weeks and heals w/o treatment Chancre lasts 3-6 weeks and heals w/o treatment If untreated, disease progresses to next stage If untreated, disease progresses to next stage

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11 Secondary Stage Occurs as chancre is healing or a few weeks after Occurs as chancre is healing or a few weeks after Skin rash develops on one or more areas of body Skin rash develops on one or more areas of body Rash can appear like rashes from other diseases (usually doesn’t cause itching) Rash can appear like rashes from other diseases (usually doesn’t cause itching) Other symptoms: fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, fatigue Other symptoms: fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, fatigue Without treatment disease progresses to late stage. Without treatment disease progresses to late stage.

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13 Late stage (hidden stage) Person continues to have syphilis even though there are no symptoms. Person continues to have syphilis even though there are no symptoms. Disease can damage eyes, brain, nervous system, heart, blood vessels, liver, bones, joints Disease can damage eyes, brain, nervous system, heart, blood vessels, liver, bones, joints Signs include: difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia, even death Signs include: difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia, even death

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16 Congenital syphilis and hiv Congenital Congenital Can infect fetus during pregnancy Can infect fetus during pregnancy Can cause still born birth depending on how long mother is infected and when Can cause still born birth depending on how long mother is infected and when Infected babies can be born without immediate signs or symptoms Infected babies can be born without immediate signs or symptoms Infected babies can become developmentally delayed have seizures and even die. Infected babies can become developmentally delayed have seizures and even die. HIV HIV Genital sores make it easier to transmit and acquire HIV Genital sores make it easier to transmit and acquire HIV

17 Diagnosis Material from a chancre can be examined with a dark field microscope Material from a chancre can be examined with a dark field microscope Blood test can be performed to check for presence of syphilis antibodies Blood test can be performed to check for presence of syphilis antibodies A low level of antibodies will stay in the blood for years even after treatment A low level of antibodies will stay in the blood for years even after treatment “Direct Fluorescent Antibody Test” “Direct Fluorescent Antibody Test”

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20 Treatment Easy to cure in early stages Easy to cure in early stages Injection of penicillin < 1year Injection of penicillin < 1year Additional doses >1year Additional doses >1year If allergic other antibiotics can be used If allergic other antibiotics can be used No home remedies or over the counters No home remedies or over the counters Antibiotics will kill the bacteria but cannot repair damage done Antibiotics will kill the bacteria but cannot repair damage done

21 Spread Ways you can get syphilis Ways you can get syphilis Direct contact with a syphilis sore via vaginal, oral or anal sex Direct contact with a syphilis sore via vaginal, oral or anal sex Sores occur on the genitals, anus, vagina, or rectum Sores occur on the genitals, anus, vagina, or rectum Sores can also occur on lips and mouth Sores can also occur on lips and mouth Ways you cannot get syphilis Ways you cannot get syphilis Toilet seats, door knobs, swimming pools, hot tubes, bathtubs, shared clothing, or eating utensils Toilet seats, door knobs, swimming pools, hot tubes, bathtubs, shared clothing, or eating utensils

22 Prevention Ways you can prevent syphilis Ways you can prevent syphilis Like any std: abstinence or mutually monogamous relationship Like any std: abstinence or mutually monogamous relationship Ways you cannot prevent syphilis Ways you cannot prevent syphilis Latex condoms (reduce transmission, but do not prevent) Latex condoms (reduce transmission, but do not prevent) Washing genitals, urinating, or douching after sex Washing genitals, urinating, or douching after sex *Even a cured person can be re-infected *Even a cured person can be re-infected

23 Epidemiology Worldwide Worldwide WHO estimates 12 million new cases per year WHO estimates 12 million new cases per year 90% of those cases in developing countries 90% of those cases in developing countries In Russia and Eastern Europe, its contributing to hiv infections In Russia and Eastern Europe, its contributing to hiv infections North America and Western Europe rates have shifted to MSM, and illicit drug users North America and Western Europe rates have shifted to MSM, and illicit drug users In Africa more females are infected than males In Africa more females are infected than males USA USA During the 90’s rates steadily decreased During the 90’s rates steadily decreased 2001-2002 syphilis rates began to increase 2001-2002 syphilis rates began to increase Increase primarily in males, suggesting MSM Increase primarily in males, suggesting MSM

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26 Latest research and preventative measures Prevention Prevention 1999 National plan to eliminate syphilis 1999 National plan to eliminate syphilis Expanded surveillance and outbreak response activities Expanded surveillance and outbreak response activities Rapid screening Rapid screening Expanded laboratory services Expanded laboratory services Strengthen community involvement Strengthen community involvement Enhance health promotion Enhance health promotion Their target audience Their target audience National, state, and local legislators National, state, and local legislators State and local Health Officers State and local Health Officers Policy “influencers” at national, state, and local levels Policy “influencers” at national, state, and local levels

27 Latest research and preventative measures Faster testing Faster testing One study compared Syphilis Fast latex agglutination test to Treponema pallidum particle agglutination test One study compared Syphilis Fast latex agglutination test to Treponema pallidum particle agglutination test 98.8% agreement between the two 98.8% agreement between the two Syphilis Fast only takes 8 minutes vs 1-2 hrs Syphilis Fast only takes 8 minutes vs 1-2 hrs Ideal for point of care situations, std clinics, and prenatal care clinics Ideal for point of care situations, std clinics, and prenatal care clinics

28 Resources Centers for Disease Control and Prevention STD Prevention 27 Nov. 2004 { "@context": "http://schema.org", "@type": "ImageObject", "contentUrl": "http://images.slideplayer.com/13/3863551/slides/slide_28.jpg", "name": "Resources Centers for Disease Control and Prevention STD Prevention 27 Nov.", "description": "2004


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