If people do certain things, they are more likely to get syphilis. Medical professionals say that these people should get tested regularly. For example, the CDC says that men who have sex with men should be tested at least every year. Getting tested regularly helps prevent syphilis from being spread. If a person is tested and finds out that they have syphilis, they are more likely to get treatment, and will not accidentally spread syphilis to other people.
Syphilis is a notifiable disease in many places, including Canada, the countries in the European Union, and the United States. This means that if a healthcare provider (like a doctor or a nurse) knows that a patient has syphilis, the provider has to tell public health authorities that the patient is infected. Public health workers then talk to all of the patient's sexual partners. They tell them someone might have given them syphilis, without telling them who that person is. Doctors might also try to get patients with syphilis to tell their sexual partners to get treatment.
Syphilis that is not complicated can usually be treated and cured by antibiotic medications.
Usually, people need just one dose of penicillin G or azithromycin. If a person cannot take either of these medicines (for example, because they are allergic to them), some other medications work too. For example, Doxycycline and tetracycline are two other possible choices; however, they cannot be used in pregnant women.
The "Treponema pallidum" bacterium has become resistant to many different antibiotics, including macrolides, clindamycin, and rifampin. This means that these antibiotics no longer kill the bacterium.
Once a person is in the later stages of syphilis, the disease is harder to treat.
For example, if a person has neurosyphilis, they need antibiotics that will kill the infection in their central nervous system (their brain and major nerves). However, it is hard for penicillin G to get into the central nervous system. Because of this, a single shot of penicillin - which will usually cure early syphilis - is not enough to cure neurosyphilis. Instead, people with neurosyphilis usually need to be given large doses of penicillin for at least 10 days. Usually, they also need to get the medicine intravenously (through a needle placed into a vein) so it goes more directly to the central nervous system. If a person is allergic to penicillin, other antibiotics like ceftriaxone, doxycycline, or tetracycline can be used, but they have to be given over longer periods of time.
Once a person has late-stage syphilis, treatment will keep their syphilis from getting any worse. However, if syphilis has already damaged the person's body, the treatment will not make that damage go away. At best, treatment can only have a very small effect on the damage that has already happened.
Sometimes, the treatment for syphilis can cause a side effect called the Jarisch-Herxheimer reaction. This reaction usually starts within one hour after treatment begins, and lasts for 24 hours. Its symptoms include fever, muscle pains, headache, and a fast heart rate.
Antibiotic medication breaks open syphilis bacteria to kill them. As the bacteria break open, proteins come out of them. These proteins cause the Jarisch-Herxheimer reaction.
By 1999, syphilis had infected about 12 million people. More than 90% of these people lived in the developing world.
Syphilis causes problems in 700,000 to 1.6 million pregnancies every year. Syphilis can cause a pregnant woman to have a miscarriage, a stillbirth, a premature baby, a baby with congenital syphilis, or a baby that dies before it is a month old. In sub-Saharan Africa, syphilis causes up to 20% of perinatal deaths (deaths that happen soon after a baby is born).
Syphilis used to be very common, and it caused sickness and death all over the world. It was especially very common in Europe during the 18th and 19th centuries. During the early 20th century, syphilis quickly became less common in the developed world, because antibiotics were being used more and more. Syphilis kept becoming less common until the 1980s and 1990s. Since the year 2000, syphilis is getting more common again in the United States, the United Kingdom, Australia, and Europe, mostly among men who have sex with men.
In China and Russia, syphilis has gotten more common among heterosexual ("straight") people since the 1990s. Studies say this is because of unsafe sexual practices, like having sex with many different people, prostitution (getting paid to have sex), and not having safer sex to protect against sexually transmitted diseases.
Over the 19th and 20th centuries, the symptoms of syphilis have become less severe (not quite as bad). This is partly because there are more treatments that work well, and if they are given early, syphilis does not get as bad. Also, the bacteria that causes syphilis has become weaker.
If people with syphilis get treated early on, they can usually be cured without the disease causing damage that cannot be fixed. However, syphilis is still very dangerous. It still causes serious problems, and sometimes death, if it is not treated.
Syphilis also makes a person two to five times more likely to get HIV. Confection (having both syphilis and HIV) is common. In some big cities, it happens in as many as 30% to 60% of people with syphilis.
Nobody knows exactly where and how syphilis started. There are two major ideas about where the disease came from.
The first idea is called the "Columbian hypothesis." (A hypothesis is an educated guess about how something happened). This hypothesis says that when Christopher Columbus's crew came back to Europe after exploring the "New World", they brought syphilis back to Europe and spread the disease there.
The other idea is called the "pre-Columbian hypothesis." ("Pre-Columbian" means "before Columbus.") This hypothesis says that syphilis was already in Europe before Columbus, and people just did not realize that the disease existed.
While there is evidence that can be used to say that either of these ideas are right, there is more evidence for the Columbian hypothesis.
The first written records that talk about an outbreak of syphilis in Europe are from 1494-1495. The outbreak happened in Naples, Italy, when France was invading (trying to take over Italy). Because syphilis was spread by French soldiers who were coming back from Italy, at first it was called the "French disease."
The name "syphilis" was first used in 1530 by an Italian doctor and poet named Girolamo Fracastoreo. He used the word "syphilis" as the title of a Latin poem that talked about the damage the disease was causing in Italy. At other times in history, syphilis was also called the "Great Pox".
In 1905, two men named Fritz Schaudinn and Erich Hoffmann discovered that syphilis is caused by the "Treponema pallidum" bacteria. Five years later, Paul Ehrlich created the first treatment that helped treat syphilis (called Salvarsan). After that, scientists started to study penicillin. In 1943, it was officially decided that penicillin worked for syphilis.
This was a major success in the treatment of syphilis. Before penicillin, the treatments used for syphilis were often even worse than the disease. For example, people were treated with mercury (which is poisonous and causes serious health problems), or people were just kept away from everyone else.
From 1932-1972, the United States Public Health Service did a study on syphilis in Alabama. They wanted to see how syphilis got worse when it was not treated. The researchers chose a group of poor African-American sharecroppers, but never told them they had syphilis. Even after the 1940s, when the researchers knew penicillin could cure these people, they refused to let them get treatment or even tell them that penicillin could help them. This study, now called the Tuskegee syphilis experiment, was very important in creating medical ethics.