SYPHILIS – THE PUNISHMENT OF VENUS

Syphilis is a sexually transmitted disease with a fairly long history. Syphilis is contagious and dangerous. It was once considered an incurable, fatal disease. Until about the end of the first half of the twentieth century, syphilis was a serious threat to public health. In the absence of effective ways to protect against this disease and its treatment, as well as a lack of public awareness, syphilis often led to problems such as arthritis, brain damage and blindness. After the invention of penicillin, the situation improved significantly.

The causative agent of syphilis – pale spirochete (formerly called pale treponema) – was discovered in 1905 by German microbiologists Fritz Schaudin and Erich Hoffmann. Typical pale spirochetes are thin spiral-shaped microorganisms 6-14 microns long, 0.25-0.30 microns thick, with a spiral amplitude of 0.5-1.0 microns, the pathogenicity of which is associated with active movement, which leads to a high possibility of spreading through liquids body: intra-articular, ocular and in the skin.
 How are things now with this venereal disease – is the number of patients growing or, conversely, is declining?
Currently in our country there is a decrease in the number of patients with syphilis. The peak of this disease was in the early nineties of the last century. At that time, the state of morbidity was characterized as a pandemic. There are several factors that influenced the growth of the disease. If you remember, this is the period of the collapse of the Soviet Union, when the social and moral systems that had existed for decades were shaken, and even collapsed. There was a moment of sexual emancipation among the population (especially young people), factors of population migration due to the unstable economic situation, a criminal environment. This is where the risk group emerges: people who abuse alcohol, drugs and have a promiscuous sex life, as well as representatives of the oldest profession, i.e. prostitution, both sexes.
 What are the ways of infection with this venereal disease?
Syphilis refers to a sexually transmitted disease that is predominantly transmitted sexually among the adult population. Young children can become infected in utero, while passing through the birth canal and, in rare cases, in the domestic way from mothers with syphilis. In addition, infection is possible through blood transfusion. Fortunately, now there is a very serious system for the prevention of transfusion contamination (through blood transfusion) – the blood of all donors is first checked for the presence of various infections and viruses, including syphilis, and only then is it only used for its intended purpose. If everything is done with strict adherence to the rule, then the risk of infection during transfusion is negligible.
 What is the age of the patients?
These are people of active sexual age – from 18 to 40 years. Although, of course, there are exceptions: among the patients you can meet both teenagers and quite mature people (rarely). Naturally, it depends on the lifestyle. In general, there is such a theory that a person who has changed two or three sexual partners may be infected with some kind of sexually transmitted disease, transmitted mainly through sexual contact. Both men and women get sick, and the course of the disease is almost the same for them.
 How does this venereal disease proceed?
The incubation period is 3-5 weeks from the moment of infection, but this period can be both shortened and lengthened. It depends on the person’s immunity and concomitant diseases. It is more often lengthened in debilitated patients, those who used antibiotics for other reasons, i.e. the concentration of the antibiotic was in a small dose to kill the causative agent of the disease, and it proceeds in a latent form.
Why is the incubation period important? If a patient with syphilis has been identified, the doctor tries to determine the circle of his contacts for the prevention of syphilis during the incubation period.
 How can the disease be detected in the incubation period?
Not during the incubation period. But, when we have already identified the patient, we are interested in his sexual relations in the past. It turns out that he/she had partners six months ago, a month ago and two weeks ago. We invite those partners with whom we had contact a month and two weeks ago, we identify the absence of the disease in them, since they may be in the incubation period, they are given prophylactic antibiotic treatment.
How can a person independently determine the presence of syphilis?
After an incubation disease, primary syphilis occurs. At first it is a seronegative period, i.e. test results (Wasserman reaction) for syphilis are still negative.
At this stage, in most cases, an infected person develops a solitary ulcer (erosion) – a chancre. It looks like a large round insect bite or wart; often it is firm and painless. A chancre appears at the site of entry into the body of the causative agent of syphilis (spirochetes) – the genitals and / or in the mouth (depending on how the person contracted syphilis). Even without treatment, the chancre heals in six weeks, the ulcers leave scars behind. Due to anatomical features in women, primary syphilis is diagnosed less frequently than in men. There may be hidden manifestations of the disease, for example, on the cervix. Since the chancre is painless and does not manifest itself in any way, a woman will not be able to determine this disease on her own.
A week later, the lymph nodes closest to the site of the chancre become inflamed, this is called regional scleradenitis. Then in a week Wasserman’s reaction will be positive, it will already be seropositive primary syphilis. It lasts for 3-4 weeks, the manifestations of the disease can either disappear or remain scarce.
Secondary fresh syphilis is characterized by general malaise, fever, and a small-spotted rash (roseola) appears on the body. She does not bother the patient, does not hurt, does not itch, so the patient may not attach much importance to this phenomenon and is in no hurry to see a doctor.
The rash can appear on the chest and other parts of the body, sometimes it resembles the symptoms of any other diseases, patients can be interpreted as an allergic rash. Along with this, there is an increase in all groups of lymph nodes (polyadenitis), there may be remnants of a hard chancre – scars.
Having existed for some time, these manifestations may disappear and the so-called secondary latent (latent) syphilis occurs – when there are no manifestations other than a positive Wasserman reaction to syphilis. At this stage, the venereal disease is inactive, that is, it does not cause any symptoms. This can go on for months or even years. A person may not even realize that he is sick.
Secondary recurrent syphilis is manifested by a nodular rash (papules). As a rule, they are grouped, more often around natural openings (anus, vagina in women), where wide condylomas are observed. These are comb-like papules of a bluish-purple color that can erode; on their surface there is a huge number of causative agents of syphilis. In addition to these manifestations, hair loss (allopecia) may appear, and these bald spots on the scalp resemble a moth-eaten carpet – this is alopecia areata. Among other things, hyper- and hypopigmentation of the skin may appear. Doctors call it the necklace of Venus, if pigmentation appears on the chest, and if on the border of the scalp, then the crown of Venus. If the localization of papules is on the vocal cords, then hoarseness of voice occurs.
Then comes tertiary syphilis – tuberculous and gummy. If the infection has not yet been cured, it goes into a late stage, which is characterized by serious disorders of the brain, heart and nervous system, which can lead to paralysis, blindness, dementia, deafness, then death.
 Since 1993, all people who seek medical help for the first time have the right to undergo a preventive examination.
 Can syphilis not manifest itself at all?
Along with the manifest (staged) course of syphilis, there is currently a primary latent (latent) course of the disease without clinical manifestations. Such forms of the disease can be detected by serological studies (Wasserman reactions or microreactions) among the population, primarily among the contingent at risk of morbidity.
During pregnancy, the fetus can become infected with syphilis from the mother in utero. What might this mean for the child in the future?
This disease is especially dangerous for future generations. There is a very serious system for the prevention of congenital syphilis in newborns. All pregnant women are required to systematically donate blood for the detection of this disease. Now the treatment of pregnant women is being taken very seriously. If earlier such a pregnancy was interrupted for medical reasons, now a pregnant woman with syphilis is treated quite successfully, and a healthy child is born to her.
 How is syphilis treated?
Treatment is carried out in specialized medical institutions with a whole arsenal of means available to domestic medicine. With fresh forms of the disease, one course of treatment is enough, with late forms – two or three courses.
 Can this sexually transmitted disease reappear after treatment?
 If syphilis is correctly and competently treated, then there can be no relapses, there can only be re-infection.
 What is the prevention of this disease?
Perhaps the only thing is the use of condoms, although they do not give a 100% guarantee, so this should not be a reason for permissiveness of sexual behavior. Much has already been written about the intelligibility and constancy of sexual partners. Therefore, I will not repeat myself.
It has long been known to all that any sexually transmitted disease is easier to prevent than to treat. Therefore, I would like to tell readers that one should not be afraid to go to the doctor if any suspicions suddenly arise. All information about patients is kept strictly confidential, because there is medical ethics.