What Is Syphilis?

What do San Antonio, Texas; Saskatoon, Saskatchewan; and the state of Oregon all have in common? They all saw an increase of syphilis cases in the past few years. According to Oregon Public Broadcasting, cases of syphilis have increased tenfold in the state, from thirty-seven cases in 2007 to 360 in 2013. Dr. Johnmark Opondo, deputy medical health officer with the Saskatoon Health Region, said that reported cases in the first three months of 2014 were triple the expected rate of infection. In San Antonio, the number of cases of syphilis increased 15.2 percent in 2013 according to a Metro Health report from March 31, 2014. So what is syphilis and why is it on the rise? Syphilis is a sexually transmitted disease (STD) that can have a serious effect on a person’s health if left untreated.

The truth is that many people acquire syphilis without even knowing it.
Most young people have heard about sexually transmitted diseases and know that STDs come from having sex with an infected person without using proper protection, such as a latex condom.

Traditionally, condoms have been made from latex. But you may have seen newer polyurethane condoms too. Some people claim that polyurethane condoms are more sensitive than latex ones because they are thinner in texture. But studies show that polyurethane condoms are not as effective in protecting against pregnancy and sexually transmitted diseases. Polyurethane condoms are more likely to slip off the penis during withdrawal and also to break. The bottom line is, unless you are among the small number of people allergic to latex, latex condom are a far safer option.

Despite this knowledge, every year in North America, approximately one in four sexually active teenagers gets an STD. In the United States alone, this means that around three million teens are infected each year.

One of these STDs is syphilis. Over the centuries, the horrible consequences of untreated syphilis in its later stages made it a feared disease. Society often viewed those who suffered from it as sinful or shameful. Today, syphilis is still feared. However, while many young people have heard of this infection, few know much about it.

 Female reproductive system
Female reproductive system
© Superstock, Inc.
A major reason for this lack of information is that in recent years syphilis infections had become quite rare in North America. In fact, in the late 1990s, medical experts and health officials in Canada and the United States foresaw a twenty-first century in which syphilis would be eliminated altogether. In the last few years, however, both countries have seen a new rise in cases of syphilis. Most of those infected have been young people, who lack knowledge about the disease and how it is transmitted. This is unfortunate, because awareness is key when dealing with a disease whose signs are often very hard to detect. The truth is that many people acquire syphilis without even knowing it. On the positive side, tests for syphilis are quick and efficient. If detected early, the disease is easy to treat and leaves no lasting effects.

The Syphilis Infection

Syphilis is a serious but curable infection caused by bacteria called Treponema pallidum. Bacteria are simple microscopic organisms that are the oldest form of life on Earth. They are highly adaptable and can live anywhere—at the bottom of the ocean, in frigid Arctic ice, and in steamy hot springs, as well as in any kind of plant or animal species. The wormlike bacterium that causes syphilis, for example, likes to burrow into the moist mucous membranes of human beings’ mouths or genital areas.

How Syphilis Is Spread

You can get syphilis by coming into contact with a person who already has the disease. Most of the time, this occurs as a result of sexual activity, which is why syphilis is considered an STD. Syphilis can be transmitted either through oral, genital, or anal sex. Even partners who don’t engage in actual sexual penetration—of a penis into a vagina, for example—can still get syphilis.

Syphilis is spread when one person’s infected area, usually an open sore, touches the soft skin of the mucous membrane found inside or around another person’s genital or anal areas, or in or around the mouth. A mucous membrane is a special protective layer of skin that safeguards the body’s internal passages and certain cavities from the outside environment. It lines the skin of nostrils, lips, ears, genitals, and the anus, and helps the body to absorb and secrete fluids. When stimulated, these membranes give off a sticky, thick fluid called mucus (such as what comes out of our noses when we sneeze) that moistens and protects.

Although less common, syphilis can also be spread through needle sharing (which occurs among drug users) and by an infected person coming into contact with any type of open sore or cut on another person. A pregnant woman with syphilis can also infect the unborn baby she is carrying. Syphilis acquired in this manner is known as congenital syphilis.

Treponemes

Male reproductive system
Male reproductive system
LifeArt image © 2006 Lippincott Williams & Wilkins. All rights reserved
There are actually several forms of syphilis. The most serious is the sexually transmitted variety discussed in this article, caused by Treponema pallidum. This spiral-shaped bacterium is one of a related group of bacteria known as the treponemes. Other treponemes cause milder infections that aren’t sexually transmittable. These are usually skin infections that often affect young children. Scientists believe that sexually transmittable syphilis probably evolved from one of these other forms, though precisely when this might have occurred remains a mystery.

Recent Outbreaks

Until recently, outbreaks of syphilis were fairly rare, especially in North America. However, in the last decade, health officials have been concerned by statistics showing an increase in the number of syphilis cases.

According to the Public Health Agency of Canada, there were 1,394 cases of syphilis reported in Canada in 2008 (the last year for which data is available), indicating a 568.2 percent increase in syphilis cases since 1999. Meanwhile, the American Centers for Disease Control and Prevention (CDC) states that the total number of cases of syphilis increased 11.1 percent between 2011 and 2012 (the most recent year for which there is data). In 2012, there were 15,667 reported cases of syphilis in the United States. The highest rate of people infected were from the most sexually active group (between twenty and twenty-nine years old). In both countries, men tend to get syphilis at higher rates than women, but the women who are infected are usually younger (in the United States, syphilis is highest in females between the ages of twenty and twenty-four).

These findings are troubling. They reveal that, despite greater access to and knowledge about safer sex methods such as condoms, an increasing number of people are having unprotected sex.

“The Lost Children”—A Case Study

In 1999, the PBS television program Frontline aired a documentary titled “The Lost Children of Rockdale County.” The film focused on a 1996 syphilis outbreak among teenagers living in a well-off suburb of Atlanta, Georgia. Through interviews with health officials, doctors, teachers, parents, and the teenagers themselves, the filmmakers explored how more than 200 adolescents—some as young as twelve years old—were exposed to the STD and the impact it had on everyone’s lives. What shocked many of the health officials who investigated the outbreak was that what happened with Rockdale’s teens was also occurring elsewhere in North America.

The film offered a disturbing portrait of teenage sexual behavior. At the center of the syphilis outbreak was a group of young girls who were mainly under sixteen. Most came from stable homes and excelled in school. However, many felt bored and were eager to prove themselves, both to their friends and to boys, by engaging in sexual activities. From time to time, the girls would invite groups of older boys (usually between seventeen and twenty-one) to their homes when no parents were around. After drinking alcohol and using drugs, they would spend several hours engaging in sexual activities. This was generally done in front of one another, with both girls and boys having various partners. Most of the teens’ parents never suspected anything. In fact, this behavior was only discovered once infected teens began seeking medical attention and local health officials became alarmed at the astounding rate of young people infected with syphilis.

In interviews, Rockdale County’s teens talked openly about their experiences and feelings. They claimed that they were never forced to have sex, but they did feel pressure—from their friends and themselves—to engage in sex in order to feel as if they belonged and to prove that they were mature. Although some teens were curious and eager to have sex for the first time, they were disappointed by the experience. After having had sex once, many felt they couldn’t say no to second, third, or more times, even though, after a while, most were no longer enjoying themselves. None of the sex was accompanied by love or romantic feelings. Aside from catching and spreading a dangerous disease, a number of the teens, especially the girls, ended up feeling alone and unsatisfied. They wondered if these sexual experiences were going to affect the rest of their lives.