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Syphilis

“Accept What Life Brings: You Cannot Control Many Things”

– Traditional Alaska Native Value[6]

!! Public Service Announcement !!

Alaska is experiencing an increase in syphilis cases. If you or your partners have had any symptoms of syphilis, it is important to get tested. If you have syphilis, it can be cured with the right antibiotics from your health care provider, but you can get syphilis again, even after completing treatment. Using condoms and getting tested can help reduce your risk and the spread of syphilis.

Last updated April 2021

What is syphilis?

Syphilis is a sexually transmitted infection (STI) caused by a bacteria called Treponema pallidum. If syphilis is left untreated it can result in serious health problems affecting the brain, nerves, eyes, heart, blood vessels, liver, bones and joints[4].

There are four stages of syphilis, each having their own signs and symptoms:

During the primary or first stage of syphilis, sores, also called ‘chancre,’ appear on the body. There may be many sores present, or there may only be one. The sores are often firm, round and painless. They are found at the original site of the infection, which is typically around the genitals, around the anus or in the rectum, or in or around the mouth. Since they are often painless, they can easily go unnoticed and usually resolve or ‘disappear’ within three to six weeks[1]. People still need to receive treatment whether the sores have healed or not in order to prevent syphilis from moving to the next stage of infection, also called secondary syphilis. On average, the first symptoms of syphilis begin 21 days after infection, but can range from 10 to 90 days[3].

Secondary syphilis could begin when the primary sore is still healing or several weeks after the sore has resolved, if the infection was not yet treated[1]. This stage of syphilis usually starts with a rash that can be rough, red or reddish brown. It may be located on the bottoms of the feet or palms of the hands. It can be so faint that people who are infected may not notice the rash on their bodies. In addition to the rash, other symptoms of secondary syphilis include; swollen lymph nodes, fever, patchy hair loss and/or lesions in your mouth, vagina or anus[1]. These symptoms may also be mild and often go unnoticed. The symptoms of secondary syphilis will heal on their own, regardless of receiving treatment or not, but without treatment, will move to the next stage of the infection, which is called latent syphilis.

When the syphilis infection is left untreated after the secondary stage, it progresses to the latent stage. Latent syphilis has no signs or symptoms and may last for years. Although there may never be signs or symptoms, the disease may move to the next stage of the infection, also called tertiary syphilis.

The last stage of infection is called tertiary syphilis. About 15% to 30% of people infected with syphilis who do not get treatment will develop tertiary syphilis[4]. This stage is connected to severe medical problems. Tertiary syphilis affects many different organs and systems in the body including the heart, blood vessels, eyes, liver, brain, bones, joints and the nervous system. This stage would occur 10-30 years after the initial infection and may result in serious medical complications, including death[1].

How is syphilis spread?

Syphilis is spread when a person comes into direct contact with a syphilis sore, also called ‘chancre,’ during vaginal, anal or oral sex. A mother who is infected may also pass syphilis on to their baby during pregnancy or childbirth. On average, the first symptoms of syphilis begin 21 days after infection, but can range from 10 to 90 days[3]. Syphilis is easy to spread to other people when there are sores. Using a latex condom correctly every time can help to prevent the spread of syphilis. Using safer sex tools, such as condoms or dental dams, prevent transmission by preventing person-to-person contact with a sore. If the sore is in an area not covered by a condom, syphilis can still be transmitted.

How is syphilis treated?

Syphilis can be cured with antibiotics from a health care provider. While syphilis is curable, receiving treatment might not undo any damage already caused by the infection. It is important that persons infected with syphilis complete the treatment prescribed by a health care provider.

What happens if syphilis is left untreated?

A syphilis infection that is left untreated may cause severe medical complications, including death. Examples of severe diseases resultant from syphilis infection include:

Without treatment, syphilis can spread to the nervous system, severely affecting important structures like the brain and the eyes. This can happen during any of the four stages of syphilis. Symptoms of neurosyphilis include severe headache, difficulty in coordinating muscle movements, paralysis, numbness, and dementia. Ocular syphilis can result in changes to a person’s vision and even blindness[1].

Congenital syphilis occurs when a mother infected with syphilis passes the infection to the baby during pregnancy. It can have major health impacts on the baby, the severity of which can depend on how long the mother had syphilis and if or when they received treatment. Some of the potential health impacts caused by congenital syphilis are[2]:

  • Miscarriage
  • Stillbirth
  • Prematurity and low birth weight
  • Death shortly after birth
  • Deformed bones
  • Enlarged liver and spleen
  • Brain and nerve problems

Who is at risk for syphilis?

All sexually active individuals are at risk of acquiring syphilis through unprotected vaginal, anal or oral sex. It is important to have an open conversation about risk of syphilis infection with a  health care provider.

Consider getting tested for syphilis, and testing regularly, if you are sexually active and[1]:

  • are a man who has sex with men (MSM)
  • are living with HIV
  • have partner(s) who have tested positive for syphilis

How to reduce the risk of syphilis infection?

The only way to avoid getting STIs, like syphilis, is to not have vaginal, anal or oral sex. If a person is sexually active, they can lower their chances of acquiring syphilis by:

  • Being in a mutually monogamous relationship with a partner who has been tested for and does not have syphilis.
  • Using latex condoms correctly and every time during sexual activities can help prevent the transmission of syphilis. This may help by preventing direct person-to-person contact with a syphilis sore. If there is a sore in an area that is not covered by a condom, the sores can still transmit syphilis from person-to-person.
  • Getting tested regularly if you are at-risk or are concerned about exposure to syphilis.
  • Seek prompt treatment if there are symptoms present, or a recent diagnosis of syphilis has been determined.
  • Having a conversation with your partner(s) about safe practices before engaging in sexual activities, and helping to get all sexual partners tested and treated, can help prevent the spread of syphilis.

What does syphilis look like in Alaska?

Since 2018, Alaska has been experiencing a syphilis outbreak. Between 2018 and 2019 the cases of syphilis more than doubled and included cases in the primary, secondary and early latent stages[5]. The increase in cases were in heterosexual men and women. The increase of syphilis in women highlights the concern for congenital syphilis and the importance of STI screening for those who are at-risk during pregnancy at the initial prenatal visit, during the third trimester, and at the time of delivery.

Where can I go for testing or treatment?

Find a local testing location with the CDC clinic locator :

  • If outside of Anchorage or other urban area, you can find a clinic by region to help locate the nearest STI testing location, or with the CDC clinic locator above.
ORDER A FREE STI SELF-TEST KIT

Sexually transmitted infection (STI) self-test kits are available for free to any mailing address in Alaska. Tests are shipped directly and discreetly to you via iwantthekit.org. It’s the comfort of knowing, regardless of your access to a health care facility.

Where can I go for more information on syphilis?

Take a look at We R Native’s very own Auntie Amanda’s response to the question ‘I think I have an STD…What do you think?

Center for Disease Control (CDC) provides information for patients, educators, and providers about syphilis including how to prevent it, finding testing and treatment sites near you, and support for individuals who have tested positive and their partners.

Healthy Native Youth (HNY) provides resources for tribal health educators, teachers and parents. They offer free curricula and lesson plans about STI/STD’s and related topics that you can adapt to your community. HNY also offers the Talking is Power text line that provides culturally appropriate tips and resources for caring adults discussing sensitive topics with teens.

[1]Centers for Disease Control and Prevention [CDC]. (2017a). Basic Fact Sheet. Syphilis – CDC fact sheet. Reference: https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm

[2]CDC. (2017b). Detailed Fact Sheet. Congenital syphilis – CDC fact sheet. Reference: https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm

[3]CDC. (2017c). Detailed Fact Sheet. Syphilis – CDC fact sheet (detailed). Reference: https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm

[4]Mayo Clinic. (2019). Syphilis. Reference: https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756#:~:text=The%20cause%20of%20syphilis%20is,your%20skin%20or%20mucous%20membranes.

[5]State of Alaska Epidemiology. (2020). Syphilis Update – Alaska, 2019 and Recommendations for Care [PDF]. Reference: http://epibulletins.dhss.alaska.gov/Bulletin/DisplayClassificationBulletins/45

[6]UAF. (2021). Alaska Native Values for Curriculum. Alaska Native cultures. Reference: http://ankn.uaf.edu/ancr/Values/index.html

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