Pennsylvania’s second most populous county is seeing a resurgence of the sexually transmitted infection, syphilis, according to health officials.


The Allegheny County Health Department (ACHD) today reported a significant increase in syphilis this year in Allegheny County, with 98 cases reported as November 10, compared to 56 at the same time in 2013, representing a 75% increase in early syphilis (primary, secondary and early latent).

Ninety percent of the syphilis infections have occurred among men, the majority of whom are men who have sex with other men (MSM).  Among the men with syphilis, 39% were HIV-positive.

“There has been a resurgence of syphilis in the United States since 2011, with increases noted particularly among MSM.  While infections nationwide and in Allegheny County are primarily occurring among MSM, anyone engaging in risky sexual behavior is at risk,” said Health Director Dr. Karen Hacker.

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 contact with them could transmit the bacteria. It can also be transmitted from an infected motherto 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.

Having a syphilis chancre can increase the transmission of HIV up to 5-fold.

To reduce your risk of syphilis and other sexually transmitted diseases, practice safe sex:

• Avoid sex, or have mutually monogamous sex with one partner who is uninfected.
• Talk with your sex partners about your HIV status and history of other sexually transmitted infections.
• If you don’t know the STI status of your partner, use a latex condom with each sexual contact.
• Avoid excessive use of alcohol or other drugs, which can cloud your judgment and lead to unsafe sexual practices.

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