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Syphilis is a highly infectious disease spread primarily by sexual activity, including oral and anal sex.

Syphilis, also known as the Great Mimicker among physicians, is a sexually transmitted disease that has been the source of much debate among doctors and historians who still argue about the timing and whereabouts of its origin. It first made its appearance in Europe in 1495, which coincidentally correlated with the return of soldiers who had participated in the wars of that period. Some even accused Columbus of bringing back the disease from the New World when he returned to Europe.

Regardless of its origin, syphilis has remained a constant presence throughout history, and its contagious properties reside in an organism called Treponema pallidum, a type of bacterium called a spirochete. Syphilis is a highly infectious disease spread primarily by sexual activity, including oral and anal sex. On occasion, the disease can be passed from one infected man to his partner through prolonged kissing or close body contact. Although this disease is spread from sores, the vast majority of cases go unrecognized, and the infected person is often unaware of the disease and unknowingly passes it on.

Syphilis is characterized by three distinct stages.

Primary syphilis: People with primary syphilis develop one or more chancre sores. Chancre (pronounced shang-ker) is a shallow- based, painless ulcer that occurs on the genitals or in the mouth somewhere between seven and ninety days from exposure. The chancre typically resolves on its own without treatment, usually within two to six weeks.

Secondary syphilis begins about six weeks after exposure and can even present while the initial chancre is still present. This stage can last for one to three months if left untreated. People with secondary syphilis experience a rash much like that of chickenpox but more typically on the palms of the hands and soles of the feet. Patients also experience headaches, sore throat, joint pain, and muscle aches. Sometimes moist lesions develop in the groin or as whitish patches in the mouth. These teem with spirochetes and are highly infectious even through kissing. Like primary syphilis, secondary syphilis can resolve without treatment; however, patients do remain infectious.

Tertiary, or late-stage, syphilis progresses if the infection is left untreated. This stage is characterized by problems affecting the cardiovascular system, causing heart- valve damage or aneurysms. It can also affect the central nervous system with neurosyphilis, which is characterized by softening of the brain tissues, causing progressive paralysis, dementia, and death.

Syphilis is diagnosed by a blood test called the rapid plasma regain, or RPR, which is confirmed by a fluorescent treponema antibody test, or FTA. To diagnose tertiary syphilis, a spinal tap (lumbar puncture) may be required.

Treatment for primary and secondary syphilis is with injectable penicillin. For tertiary syphilis, especially in the HIV population, intravenous penicillin is the treatment of choice.

Men account for over 95 percent of the cases of primary and secondary syphilis. Of those men interviewed in New York City by the board of health, MSMs made up most of the population, and half of those men also said they were HIV positive. Syphilis facilitates HIV transmission and men should be screened routinely. Similar outbreaks among MSMs were also noted in other cities like Los Angeles, San Francisco, Seattle, Miami, Atlanta, and Houston.

Syphilis is spread through direct contact with skin, especially during the secondary phase, or through contact with an open sore or lesion. Usually, contact occurs during anal or oral sex, but syphilis can even be spread through kissing if there are sores in the mouth. It is vital that if you are diagnosed with syphilis that you should warn all recent partners. Likewise, if a sex partner informs you of his diagnosis of syphilis, then you should get checked by a doctor even if it was one year ago or longer.

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