In a follow-up on the syphilis outbreak in Oklahoma County, Oklahoma, a NewsOK report states that the number of syphilis cases are “about 80 residents infected over the past few months”.

syphilis
Treponema pallidum spirochete/CDC

The report notes that drug abuse is one of the driving factors for the largest syphilis outbreak in recent state history as the state is seeing a rising number of residents die from heroin and methamphetamine overdoses.

The rate of primary and secondary (P&S) syphilis reported in the United States decreased during the 1990s; in 2000, the rate was the lowest since reporting began in 1941.

However in 2013,  17,375 cases of P&S were reported in the US with a bulk of that attributed to men, particularly gay and bisexual men. And the numbers have kept rising since. In 2015, nearly 24,000 cases of primary and secondary (P&S) syphilis (23,872) – the most infectious stages of the disease, were reported.

Syphilis is a sexually transmitted infection (STI) caused by the bacterium, Treponema pallidum. The most common way to get syphilis is by having sexual contact (oral, genital or anal) with an infected person. The secondary lesions are also infective and contactwith them could transmit the bacteria. It can also be transmitted from an infected mother to her baby (congenital transmission).

Syphilis goes through four stages that can overlap:

Primary Syphilis

The first symptom of primary syphilis is frequently a small, round, firm ulcer called a chancre (pronounced “shanker”) at the place the bacteria enters the body (usually the penis, vulva or vagina, but it may appear on the cervix, tongue or lips). There is usually just one chancre, however there can be many. Swollen lymph nodes in these areas are common.

The chancre usually appears in about 3 weeks after infection, but can occur anytime from 9-90 days after infection.

Because chancres are painless and can occur inside the body, you may not notice it. It disappears after 3-6 weeks whether you are treated or not. If primary syphilis goes untreated, it then moves into the secondary stage.

Secondary Syphilis

The most common symptom of this stage is a non-itchy rash. The rash is usually on the palms of the hands (see below) and soles of the feet, it can cover the whole body or only a select few areas. This occurs 2-10 weeks after the chancre heals. Other common symptoms are sore throat, fatigue, headache, swollen glands and less frequently hair loss and lesions in the mouth.

Much like primary syphilis, secondary syphilis will disappear even without treatment. If untreated it goes into the latent and tertiary stages.

Latent Syphilis

This is the hidden stage of syphilis. At this stage there are no symptoms. This stage can last for weeks or decades.

Early latent syphilis is still an infectious stage and you can transmit the disease to your partner. In late latent syphilis, the risk of infecting a partner is low or absent.

Signs and symptoms may never return or if untreated it goes into the most serious stage, tertiary syphilis.

Tertiary Syphilis

Even without treatment only a minority of infected people develop these horrible complications. In this stage, the bacteria will damage the heart, eyes, brain, bones, joints and central nervous system. This can happen decades after the initial infection. This can result in blindness, deafness, memory loss, heart disease and death. Neurosyphilis is one of the most severe signs of this stage.

Congenital syphilis can results in miscarriages, premature births and stillbirths. Some infants with congenital syphilis have symptoms at birth, but most develop symptoms later. Sore on infected babies are infectious so holding and kissing infected babies could transmit the disease.

It is very easy to detect early stages of syphilis through blood tests that detect antibodies.

It is easy to treat syphilis in the early stages with one injection of Penicillin. Later stages or neurosyphilis may take daily doses given by IV in a hospital. It is important to note in late syphilis, any damage done to organs cannot be reversed.