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Sexually Transmitted Infections, Part II

In last month’s newsletter we covered chlamydia, gonorrhea, herpes, and hpv. While these can be embarrassing to talk about, knowing more about these infections can help you get important treatments when necessary, as well as protect yourself from infection.

Syphilis

Syphilis

Syphilis is caused by the bacterium Treponema pallidum. Many of the signs and symptoms are indistinguishable from those of other diseases.

Syphilis is passed from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. Transmission of the organism occurs during vaginal, anal, or oral sex. Pregnant women with the disease can pass it to the babies they are carrying.

You cannot contract syphilis through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.

Signs and Symptoms

Many people infected with syphilis do not have symptoms for years, yet they remain at risk for late complications if they are not treated. Although syphilis transmission occurs from people who have sores or are in the primary or secondary stage of the disease, many of these sores go unrecognized, and thus transmission can occur from persons who are unaware of their infection.

Primary Stage

The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage.

Secondary Stage

The secondary stage of syphilis is characterized by skin rash and mucous membrane lesions. This stage typically starts with the development of a rash on one or more areas of the body. The rash usually does not cause itching. Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed.

Other symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs and symptoms of secondary syphilis will disappear with or without treatment. If the infection goes untreated, however, it will progress to the latent and then possibly to the late stages of disease.

Late and Latent Stages

The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. This latent stage can last for years.

The late stages of syphilis can develop in about 15% of people who have not been treated for syphilis, and can appear 10–20 years after infection was first acquired. In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

How does syphilis affect a pregnant woman and her baby?

Syphilis is dangerous for a pregnant woman and for her baby. She may have a high risk of having a stillbirth (a baby born dead) or of giving birth to a baby who dies shortly after birth. An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may become developmentally delayed, have seizures, or die.

Diagnosis

Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.

Treatment

Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year.

Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There are no home remedies or over-the-counter drugs that will cure syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

Hepatitis B

Hepatitis B is a contagious liver disease that results from infection with the Hepatitis B virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness.

Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other drug-injection equipment. Hepatitis B can also be passed from an infected mother to her baby at birth.

Hepatitis B can be either acute or chronic. Acute Hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis B virus. Acute infection can — but does not always — lead to chronic infection. Chronic Hepatitis B virus infection is a long-term illness that occurs when the Hepatitis B virus remains in a person’s body. Chronic Hepatitis B is a serious disease that can result in long-term health problems, and even death.

The best way to prevent Hepatitis B is by getting vaccinated.

Hepatitis C

Hepatitis C is a contagious liver disease that results from infection with the Hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness.

Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, Hepatitis C was also commonly spread through blood transfusions and organ transplants.

Hepatitis C can be either “acute” or “chronic.” Acute Hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For most people, acute infection leads to chronic infection. Chronic Hepatitis C is a serious disease than can result in long-term health problems, or even death.

There is no vaccine for Hepatitis C. The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, especially injection drug use.

HIV/AIDS in Women

HIV, the human immunodeficiency virus, kills or damages cells of the body's immune system. The most advanced stage of infection with HIV is AIDS, which stands for acquired immunodeficiency syndrome.

HIV often spreads through unprotected sex with an infected person. It may also spread by sharing drug needles or through contact with the blood of an infected person.

Women can get HIV more easily during vaginal sex than men can. And if they do get HIV, they have unique problems, including:

  • Complications such as repeated vaginal yeast infections, severe pelvic inflammatory disease (PID), and a higher risk of cervical cancer
  • Different side effects from the drugs that treat HIV
  • The risk of giving HIV to their baby while pregnant or during childbirth

Symptoms

While it's possible that a woman infected with HIV could display no symptoms, it's more typical that women infected with HIV will experience some subtle signs and symptoms of HIV that they may not perceive as warning signs of HIV infection. The three most common symptoms experienced by women after exposure to HIV are:

  1. Frequent or severe vaginal infections
  2. Abnormal Pap smears
  3. Pelvic infections such as PID that are difficult to treat

Of course, other diseases or infections may cause these symptoms. If you are experiencing these symptoms, your AOA physician will do further testing to determine the cause.

Treatment

There is no cure, but there are many medicines to fight both HIV infection and the infections and cancers that come with it. People can live with the disease for many years.

Resources

http://cordbloodbasics.com/
http://www.cordblood.org/cord-blood-banking.html
http://www.mayoclinic.com/health/prenatal-yoga/MY01542/METHOD=print
http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&query=venereal+disease&x=0&y=0
http://www.cdc.gov/std/syphilis/stdfact-syphilis.htm
http://www.cdc.gov/hepatitis/C/
http://womenshealth.about.com/od/aidshiv/f/HIVsymptoms.htm