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Ms. Chanda Jabeen
PhD (Scholar) Epidemiology & Public Health
12/8/2020 1
Objectives
 Define Syphilis.
 Describe the Disease explanation in the terms
of Epidemiology.
 Describe Clinical features of the disease.
 Define the Laboratory Diagnosis for the
disease.
 Define the Complications of the disease.
 Explain control/management of the disease.
212/8/2020
 Syphilis is a sexually transmitted infection caused by
the bacterium Treponema pallidum subspecies
pallidum.
 It is transmitted from person to person by direct
contact with a syphilitic sore, known as a chancre.
Chancres can occur on or around the external genitals,
in the vagina, around the anus , or in the rectum, or in
or around the mouth.
 It may also be transmitted from mother to baby during
pregnancy or at birth, resulting in congenital syphilis
 Treponema pallidum subspecies pallidum is a spiral-
shaped, Gram-negative, highly mobile bacterium.
312/8/2020
Distribution (time, place& person)
 Time: In 2015, about 45.4 million people were infected
with syphilis, with 6 million new cases. During 2015, it
caused about 107,000 deaths, down from 202,000 in 1990.
 Place: Mostly (60%) of new cases in the United States
occur in men (homosexual). In other countries, syphilis
prevalence among MSM is more than 15 per cent,
including in Afghanistan, Argentina, Fiji,
Guatemala, Jamaica, Morocco, Nicaragua.
 Person: Common in following:
Promiscuity, prostitution, decrease use of condoms, and
unsafe sexual practices among men (homosexual).
412/8/2020
Determinants (primary &
secondary)
Primary Determinants Causal Agents:
 Bacterium Treponema pallidum subspecies pallidum.
Secondary Determinants are :
 Promiscuity, prostitution, decrease use of condoms,
and unsafe sexual practices among men (homosexual).
512/8/2020
Source of Infection
Incubation period :
Primary syphilis usually breaks out about 3
weeks after exposure but can range from 9 to 30 days
after exposure.
Mode of transmission:
Direct contact with the skin.
Treponema pallidum are extremely contagious
infection.
 Reservoir of infection : Human are the only
reservoir.
Portal of entry : Through skin
612/8/2020
Pathophysiology
 Primary syphilis: is characterized by ulceration and
local lymphadenopathy. The primary syphilis ulcer or
chancre containing the T pallidum spirochete is
characterized by mononuclear leukocyte infiltration,
macrophages, and lymphocytes. It heals
spontaneously.
712/8/2020
Pathophysiology
 Secondary syphilis: is caused by hematogenous
spread of bacterium. This leads to a widespread
vasculitis. The mucocutaneous lesions of secondary
syphilis also contain treponemes. The reasons for the
resolution of secondary syphilis are unclear.
812/8/2020
Clinical features of syphilis
 The first sign of syphilis is a small sore, called a chancre
(SHANG-kur), that develops three weeks after exposure.
 The sore appears at the spot where the bacteria entered your
body. One chancre, or several.
 A non-itchy skin rash.
 Rhinitis
 Slight fever
 Fatigue and joint pains
 Sore throat
 Swollen glands
 Headache,
 Muscle aches
912/8/2020
Clinical features of syphilis
 Sores in mouth, vagina, or anus,
 Weight or hair loss.
 Swollen lymph glands.
 Wart-like patches around skin folds or genitals
 Los of appetite
1012/8/2020
Laboratory Diagnosis
The enzyme immunoassay
(EIA) test checks blood using
antibodies specific to syphilis
infection to locate syphilis
antigens.
1112/8/2020
1212/8/2020
Complications
 Syphilis can cause blindness or paralysis.
 It increases your chances of getting and
spreading HIV, the virus that causes AIDS.
 Neurosyphilis can not be reversed and lead to death.
 If it is do spread the STD to your fetus or newborn, it
can be very serious and lead to:
 Stillbirth (the baby is born dead)
 Birth defect
 Infant death
 Cataracts
 Deafness
 Seizures
1312/8/2020
Continue…..
 Heart abnormalities,
 Mental disorders,
 Blindness,
 Neurologic problems
 Death.
12/8/2020 14
Treatment
 It’s easily treated and curable in its early stages.
 Penicillin is one of the most widely used antibiotics
and is usually effective in treating syphilis.
 Penicillin G benzathine (Bicillin L-A)
 Penicillin G procaine.
 People who are allergic to penicillin will likely
be treated with a different antibiotic, such as:
 Doxycycline (Doryx, Vibramycin)
 Tetracycline (Sumycin)
 Erythromycin (E.E.S., E-Mycin)
 Ceftriaxone (Rocephin)
 Azithromycin (Zithromax)
1512/8/2020
Treatment
 Penicillin G benzathine (Bicillin L-A)
 Penicillin G procaine.
 Doxycycline (Doryx, Vibramycin)
 Tetracycline (Sumycin)
 Erythromycin (E.E.S., E-Mycin)
 Ceftriaxone (Rocephin)
 Azithromycin (Zithromax)
1612/8/2020
Treatment
 10-14 day course of antibiotic tablets if you can't have
penicillin.
1712/8/2020
Prevention
 Practicing safe sex is the best way to prevent syphilis
infection.
 Monogamous relationship
 Avoid sex with Patient of syphilis until they have
finished treatment.
 Use condoms during any type of sexual contact.
 Have regular STI check-ups.
1812/8/2020
Reference
Basvanthapa.B.T.(2008).Community Health Nursing.
Delhi: Jaypee Publishers.
1912/8/2020

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Syphilis

  • 1. Ms. Chanda Jabeen PhD (Scholar) Epidemiology & Public Health 12/8/2020 1
  • 2. Objectives  Define Syphilis.  Describe the Disease explanation in the terms of Epidemiology.  Describe Clinical features of the disease.  Define the Laboratory Diagnosis for the disease.  Define the Complications of the disease.  Explain control/management of the disease. 212/8/2020
  • 3.  Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum.  It is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres can occur on or around the external genitals, in the vagina, around the anus , or in the rectum, or in or around the mouth.  It may also be transmitted from mother to baby during pregnancy or at birth, resulting in congenital syphilis  Treponema pallidum subspecies pallidum is a spiral- shaped, Gram-negative, highly mobile bacterium. 312/8/2020
  • 4. Distribution (time, place& person)  Time: In 2015, about 45.4 million people were infected with syphilis, with 6 million new cases. During 2015, it caused about 107,000 deaths, down from 202,000 in 1990.  Place: Mostly (60%) of new cases in the United States occur in men (homosexual). In other countries, syphilis prevalence among MSM is more than 15 per cent, including in Afghanistan, Argentina, Fiji, Guatemala, Jamaica, Morocco, Nicaragua.  Person: Common in following: Promiscuity, prostitution, decrease use of condoms, and unsafe sexual practices among men (homosexual). 412/8/2020
  • 5. Determinants (primary & secondary) Primary Determinants Causal Agents:  Bacterium Treponema pallidum subspecies pallidum. Secondary Determinants are :  Promiscuity, prostitution, decrease use of condoms, and unsafe sexual practices among men (homosexual). 512/8/2020
  • 6. Source of Infection Incubation period : Primary syphilis usually breaks out about 3 weeks after exposure but can range from 9 to 30 days after exposure. Mode of transmission: Direct contact with the skin. Treponema pallidum are extremely contagious infection.  Reservoir of infection : Human are the only reservoir. Portal of entry : Through skin 612/8/2020
  • 7. Pathophysiology  Primary syphilis: is characterized by ulceration and local lymphadenopathy. The primary syphilis ulcer or chancre containing the T pallidum spirochete is characterized by mononuclear leukocyte infiltration, macrophages, and lymphocytes. It heals spontaneously. 712/8/2020
  • 8. Pathophysiology  Secondary syphilis: is caused by hematogenous spread of bacterium. This leads to a widespread vasculitis. The mucocutaneous lesions of secondary syphilis also contain treponemes. The reasons for the resolution of secondary syphilis are unclear. 812/8/2020
  • 9. Clinical features of syphilis  The first sign of syphilis is a small sore, called a chancre (SHANG-kur), that develops three weeks after exposure.  The sore appears at the spot where the bacteria entered your body. One chancre, or several.  A non-itchy skin rash.  Rhinitis  Slight fever  Fatigue and joint pains  Sore throat  Swollen glands  Headache,  Muscle aches 912/8/2020
  • 10. Clinical features of syphilis  Sores in mouth, vagina, or anus,  Weight or hair loss.  Swollen lymph glands.  Wart-like patches around skin folds or genitals  Los of appetite 1012/8/2020
  • 11. Laboratory Diagnosis The enzyme immunoassay (EIA) test checks blood using antibodies specific to syphilis infection to locate syphilis antigens. 1112/8/2020
  • 13. Complications  Syphilis can cause blindness or paralysis.  It increases your chances of getting and spreading HIV, the virus that causes AIDS.  Neurosyphilis can not be reversed and lead to death.  If it is do spread the STD to your fetus or newborn, it can be very serious and lead to:  Stillbirth (the baby is born dead)  Birth defect  Infant death  Cataracts  Deafness  Seizures 1312/8/2020
  • 14. Continue…..  Heart abnormalities,  Mental disorders,  Blindness,  Neurologic problems  Death. 12/8/2020 14
  • 15. Treatment  It’s easily treated and curable in its early stages.  Penicillin is one of the most widely used antibiotics and is usually effective in treating syphilis.  Penicillin G benzathine (Bicillin L-A)  Penicillin G procaine.  People who are allergic to penicillin will likely be treated with a different antibiotic, such as:  Doxycycline (Doryx, Vibramycin)  Tetracycline (Sumycin)  Erythromycin (E.E.S., E-Mycin)  Ceftriaxone (Rocephin)  Azithromycin (Zithromax) 1512/8/2020
  • 16. Treatment  Penicillin G benzathine (Bicillin L-A)  Penicillin G procaine.  Doxycycline (Doryx, Vibramycin)  Tetracycline (Sumycin)  Erythromycin (E.E.S., E-Mycin)  Ceftriaxone (Rocephin)  Azithromycin (Zithromax) 1612/8/2020
  • 17. Treatment  10-14 day course of antibiotic tablets if you can't have penicillin. 1712/8/2020
  • 18. Prevention  Practicing safe sex is the best way to prevent syphilis infection.  Monogamous relationship  Avoid sex with Patient of syphilis until they have finished treatment.  Use condoms during any type of sexual contact.  Have regular STI check-ups. 1812/8/2020