Background

Syphilis is a persistent, highly infectious STD that can have devastating consequences. It is caused by the spiral-shaped bacterium (spirochete) Treponema pallidum, which can live almost anywhere in the body and spreads rapidly. The disease progresses through four distinct stages: primary, secondary, latent, and tertiary; each of which can last for several years. Serious health complications are common and can be fatal in late-stage, or tertiary syphilis. 

Epidemiology

In 2018, a total of 9,808 cases was reported in Taiwan. The ratio of males to females was 5:1. Among male cases in 2018, the majority was cases with age group of 25 to 34 years-old (39%). The following was the age group of 35 to 44 years-old (19%). Among female cases in 2018, the majority was cases with age group of 65+ years-old (60%). The following was the age group of 45 to 54 years-old (10%). (See Figure 1 and Figure 2)

 Figure 1. Statistics on age groups of male syphilis cases in Taiwan, 2007-2018 

Figure 1. Statistics on age groups of male syphilis cases in Taiwan, 2007-2018 

  

 Figure 2. Statistics on age groups of female syphilis cases in Taiwan, 2007-2018

Figure 2. Statistics on age groups of female syphilis cases in Taiwan, 2007-2018 

Prevention and Control

  1. To reduce syphilis transmission.
  2. To promote safe sex education for general population and STI screening for target population.
  3. To provide comprehensive case management, including correct diagnosis; effective treatment to avoid complications; health education and counseling. 

FAQs

1. How is syphilis transmitted?

Syphilis is spread through vaginal, oral, and anal sex during the infection in primary, secondary, and early latent stages. The bacterium is usually transmitted by direct contact between mucous membranes of the genitals, mouth, or anus; or by broken skin coming into contact with open syphilitic sores. An infected mother can pass syphilis through the placenta to her developing fetus. Reinfection after cure is possible. 

2.What is the treatment for syphilis?

A single intramuscular injection of penicillin is the standard treatment for primary, secondary, and early latent syphilis. For those allergic to penicillin, antibiotics such as tetracycline, doxycycline, minocycline, azithromycin, and ceftriaxone may be considered. Follow-up of treatment response by VDRL/RPR is necessary for about 1 year.

Penicillin can also be used to treat tertiary, or late stage syphilis, but cannot reverse damage that has occurred. However, syphilis in the central nervous system may not respond to penicillin during the tertiary stage, even when high doses are administered intravenously. 

More Information

  1. WHO - STIs
  2. STI (Sexually Transmitted Infections) Online 
  3. Guideline on Antimicrobial Therapy of Sexually Transmitted Diseases in Taiwan.       J Microbiol Immunol Infect 2010;43(1):81–83
  4. USCDC - STD treatment guideline 2015 

 

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PublishTime 2014/11/26