Syphilis, how to recognize and prevent the sexual disease with cases on the rise

At the International day of sexual well-beingpromoted byWorld Health Organization every 4th September, 35 countries join, including Italy. Established in 2010 byWorld Association for Sexual Health (WAS), the main objective of the Day is to promote awareness of the importance of sexual well-being as a fundamental element for people’s overall health and well-being. According to the WHO «Sexual well-being is fundamental to people’s health and happiness. This has an obvious impact positive about society hey Villages». Sexual well-being is not just about the practice ofsexual activity in itself, but also includes thesex educationthe awareness of your own bodythe ability to to communicate openly and honestly with your partner and prevention from the sexually transmitted diseases.

As reported by the WHO, among bacteria, viruses, protozoa, and parasites, today they are known over 30 different pathogens,responsible for THESexually Transmitted Infections – STI. According to the most updated data of the Istituto Superiore della Sanità, in Italy in 2021 the reports (5,761 cases of STI) are increase of the 17.6% compared to 2020 (4,748 STI cases). Over the entire period, the 71.8% of STI cases were diagnosed in the men and the 28.2% in women. “When it comes to sexually transmitted diseases (mts extension), they say from Santagostino Monitoring – Health Observatory – we all have in mind theAIDSbut the three most widespread in the world and Italy, are chlamydiagonorrhea and syphilis (or light), the latter with 6.3 million cases atyear: a disease of which little is said, but which still constitutes a serious public health problem».

Syphilis numbers

According to the annual report eDC extension (European Center for Disease Prevention and Control), syphilis strikes 9 times moreover the men compared to womenpeaking in the age range between 25 hey 34 yearsand 74% of the cases are men who have sex with other men (msm extension). Furthermore, according to ECDC data, syphilis is far from a problem of the past: in the 28 countries participating in the monitoring (Europe and the United States) cases have steadily grown between 2010 and 2019. A study recently conducted on 5609 screening of STD patients at the Sant’Orsola-Malpighi Hospital in Bologna, found a positive syphilis in the 12.3% of cases, with a clear prevalence of males (16.6% against 4.1%). This study showed that the majority of infected women (63.3%) were foreigners, while the majority of men (86.1%) were Italian citizens.

“The figure shows – explains Dr. Fabio Leva, andrologist of Santagostino – how crucial socio-economic and cultural factors are in the risk of contracting this pathology. In this same study, a significant rate of syphilis-HIV co-infection was found in males; the latter finding is widely documented in the literature and it is also known that syphilis lesions increase the risk of HIV transmission».

What is syphilis

Syphilis is caused by the bacterium Treponema pallidumwhich is mainly present in two different variants called lineages, Nichols And SS14. This MTS can be transmitted through any type of sexual intercourseincluding orogenital intercourse. It can also be transmitted through contact with infected blood and can be passed from mother to fetus during pregnancy, childbirth, or breastfeeding.

In the case of the congenital transmissionthe disease can be asymptomaticca in about two-thirds of cases. However, over the years, symptoms of varying severity may develop.

In the adult, the disease runs through three different phases:

Primary syphilis: between 10 and 90 days from the infection usually appears one skin lesion (syphiloma) at the initial site of contact, most commonly in the genital area, anus, throat or mouth.

Secondary syphilis: 6-8 weeks after the primary infection, red lesions on the skin or mucous membranes may appear, which may be accompanied by systemic manifestations such as fever, bone pain, gastrointestinal disturbances, eyebrow alopecia, headache, weight loss, diffuse lymph node swellings . If left untreated, the infection can further progress into the latent, asymptomatic stage.

Tertiary syphilis: occurs in about 20% of cases not subjected to therapy, from 1 to 20 years after the primary phase. Nodules form and can affect the skin, internal organs (such as bones, liver, cardiovascular system and brain) and the small blood vessels that feed the wall of the aorta. This can consequently cause a weakening of the aortic wall itself, leading to the formation of aneurysms. «It is important to highlight – adds Leva – that about 10% of untreated patients can develop these aneurysms, which represent a serious life risk. Furthermore, syphilis can also cause severe neurological and psychiatric manifestations. These manifestations can lead to extremely disabling consequences and include the condition called neurolue. In the advanced stage of the neurolue2-5% of affected individuals develop progressive paralysis, affecting more men than women. Progressive paralysis is usually associated with tabes dorsalis (loss of spinal cord function and later dementia. For the diagnosis of neurolue, the diagnosis of cerebrospinal fluid is essential). “It is vital to understand that syphilis can have serious health implications if not treated properly. Timely diagnosis – also performed thanks to correct information on the subject – and adequate treatment are essential to prevent these complications and protect the life and well-being of patients”. Syphilis is mainly diagnosed through blood analysis. Commonly used diagnostic tests follow a sequence called non-treponemal tests – treponemal tests. Using non-treponemal testing and treponemal testing together helps doctors confirm the presence of syphilis and distinguish between the different stages of the disease.

Therapies and the future vaccine

The most common therapy for the treatment of syphilis consists of injections penicillin. However, in cases where the patient is allergic to penicillin, penicillin can be used as an alternative clarithromycin. “At the moment – concludes Leva – there is no vaccine available for syphilis. But thanks to advances in diagnostic techniques in recent years, it is now possible sequence the genome of the pathogen starting from samples taken directly from patients. Understanding the genetic differences between different strains of circulating bacteria is critical to the potential development of an effective syphilis vaccine. Future studies and focused research efforts could contribute to progress in creating a preventive vaccine against this disease.”

Currently the recommendation is the early diagnosis. “It is vital to understand that syphilis can have serious health implications if not treated properly. Timely diagnosis – performed also thanks to a correct information on the subject – and the appropriate treatment are essential to prevent these complications and protect the lives and well-being of patients”.

Source: Vanity Fair

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