Sexual Health

The infection A2Z web series is currently in development and upon completion will consist of ten websites covering the key principles of infection prevention and control.

Details of the following website launches will be regularly updated on the infection A2Z home page:

- Childhood Diseases
- Decontamination
- Healthcare Practices
- Pregnancy and Childbirth
- Sexual Health
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- Emergency Planning
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A-B-C-D-E-F-G-H-I-J-K-L-M-N-O-P-Q-R-S-T-U-V-W-X-Y-Z

 

Transmission
Incubation
Illness
Treatment
Exclusion
Notification
Complications
Prevention
Vaccine
Contraindications
Further information
Further web links
References


Transmission

Syphilis is a sexually acquired infection caused by the spirochete Treponema pallidum. Transmission of the infection is usually via unprotected vaginal, anal or oral sex, or via genital contact with an infected partner. An individual may be asymptomatic but still be able to pass on the infection.


Incubation

The primary symptoms of syphilis may take up to three months to appear after the initial infection. Secondary symptoms may appear a few weeks after the primary symptoms have disappeared.


Illness

The first symptoms that appear after the initial infection are known as primary symptoms. These include the following:

  • sores or ulcers (known as chancres) on the mouth, anus, penis, vulva, vagina and cervix. These may be weepy and very painful
  • swollen glands in the groin area.

These primary symptoms generally last around six weeks if left untreated. If the primary symptoms are untreated, secondary symptoms will start to appear a few weeks after primary symptoms have resolved. Secondary symptoms can last for a couple of weeks but can continue to reoccur for many years. They include:

  • a non-itchy dark rash that often appears on the palms and soles of the feet
  • a general feeling of unwell, with fever, tiredness and headaches
  • growths on the genitals
  • white patches on the inside of the mouth
  • hair loss
  • on rare occasions major organs like the liver, kidneys and brain can be affected.

Both primary and secondary syphilis are highly contagious.

If untreated, the symptoms of secondary syphilis may heal themselves and the individual may remain asymptomatic for many years. This is known as latent syphilis. Over time however, tertiary syphilis develops which can lead to serious damage to the major organs and body systems.


Treatment

Treatment of syphilis infection is usually with a course of antibiotics. Penicillin is the drug of choice but other drugs can be used if the individual is allergic to it. Antibiotics are used to treat all stages of syphilis. All current and previous sexual partners should be treated to avoid reinfection.

Further guidance on the treatment and management of syphilis includes:


Exclusion

Sexual contact should be avoided when ulcers or sores are present and until they are completely healed.


Notification

Syphilis is not a notifiable disease. However, due to concern about the increase in incidence of syphilis and the potential spread amongst both homosexual and heterosexual men and women, a new surveillance initiative has been set up by the CDSC in partnership with public health, microbiology and genitourinary medicine colleagues. For more information on the surveillance initiative please click here.

Incidence data are also collected in Scotland by the Scottish Centre for Infection and Environmental Health. Consult your local policy document for further information.


Complications

If left untreated, early syphilis can develop into secondary and tertiary forms of the disease. At these stages, the central nervous system (CNS) can be affected, leading to syphilitic meningitis, slight paralysis and dementia. Syphilis can also affect the heart, leading to disabling lesions that can lead to aortic aneurysms, and in some cases a soft tumour (known as a gumma) can appear on the skin, bone or mucosal surfaces around the body. Individuals who also suffer from HIV increase the risk of developing complications in the CNS.


Prevention

The most effective way of preventing syphilis is by the regular and careful use of a condom during sexual contact. It is recommended that performing oral sex or kissing an infected person be avoided when they have active lesions present on the body.


Vaccine

No vaccine available.


Contraindications

As with all antibiotics, certain side-effects can be experienced and they should be given based on the individual.

Syphilis in pregnancy can result in miscarriage or stillbirth, and can cause infant death due to premature birth or systemic disease.


Further information

Click here for further information on syphilis in pregnancy and childbirth.

The Department of Health has published a toolkit for assessing the range of competencies in skills, knowledge and attitudes required to manage sexually transmitted infections when delivering more specialised sexual health services within primary care. Click here for more information.

Click here for more information on sexually transmitted infections, including HIV, in Scotland 2005.

    


Further web links

British Association for Sexual Health and HIV
www.bashh.org

NHS Direct
www.nhsdirect.nhs.uk

NHS Direct Wales
www.nhsdirect.wales.nhs.uk

BBC Health
www.bbc.co.uk/health

National Library for Health
www.library.nhs.uk

Young People’s Sexual Health website run by Central Suffolk NHS Trust
www.ypsh.net

TheSite run by YouthNet UK with advice and support for young adults
www.thesite.org

Playing Safely
www.playingsafely.co.uk

NAM, Aidsmap (Aids information for patients and health professionals)
www.aidsmap.com

Brook Advisory Centre
www.brook.org.uk

Sexual Health InfoCenter
www.sexhealth.org

Society of Sexual Health Advisers
www.ssha.info

Family Planning Association
www.fpa.org.uk

PRODIGY guidance
www.prodigy.nhs.uk

Health Protection Agency
www.hpa.org.uk

Scotland’s Health on the Web provided by NHS Scotland
www.show.scot.nhs.uk

NetDoctor
www.netdoctor.co.uk

Gay Men’s Health
www.gmh.org.uk

Healthy Gay Scotland
www.healthygayscotland.com

Male Health run by the Men’s Health Forum
www.malehealth.co.uk

Avert – an international AIDS charity
www.avert.org

Information for young people on sexual health and life
www.likeitis.org

Health information relating to the National Curriculum and the National Healthy School Standard
www.wiredforhealth.gov.uk

Information for young gay men run by the Terrence Higgins Trust
www.ygm.org.uk

    


References

CHIN J, ed (2000) Control of communicable diseases manual. 17th ed. Washington: American Public Health Association.

FRENCH P (2002) National guideline on the management of late syphilis. Clinical Effectiveness Group [on-line]. London: British Association of Sexual Health and HIV.
Available at: www.bashh.org/guidelines/2002 [Accessed 15 April 2005].

GOH B (2002) National guideline on the management of early syphilis. Clinical Effectiveness Group [on-line]. London: British Association of Sexual Health and HIV.
Available at: www.bashh.org/guidelines/2002 [Accessed 15 April 2005].

HEALTH PROTECTION AGENCY (2004) Syphilis general information [on-line].
Available at: www.hpa.org.uk/infections/topics_az/hiv_and_sti/sti-syphilis [Accessed 14 April 2005].

NHS DIRECT (2004) Syphilis. NHS Direct online health encyclopaedia [on-line].
Available at: www.nhsdirect.nhs.uk/en.asp? [Accessed 15 April 2005].

This content is not intended nor does it replace individual professional advice. Please contact a healthcare professional or seek advice from NHS Direct (0845 46 47) NHS Direct Wales (0845 46 47) or NHS 24 in Scotland (08454 24 24 24).

last reviewed 29 July 2005
last updated 10 April 2007

 

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