Syphilis – or how love drives people crazy

You've just hovered your cursor too long here, you now have syphilis

Someone (I’ve forgotten who) gave me Syphilis for my birthday (Picture taken by Thomas Tu)

Craaaazy for feeeeling… someone else

Syphilis is a well-known STD (sexually transmitted disease) because it has a funny-looking name and because it infected an estimated 11.8 million people in 1999 alone. Its street names include: “The Syph”; “The Great Pox”, distinguishing it from the other pox that was going around, smallpox; and “Disease that your mum has #17”.

Syphilis is caused by the corkscrew-shaped bacteria Treponema pallidum. It survives a very short time outside the body and only spreads by direct contact with the open sores, so its transmission is almost always associated with sexual contact (Bow-chicka bow wow). Transmission between a mother and child during birth can also occur. In these cases, there is a high chance of still-birth or death of the child after birth, if not treated immediately.

After infection, there is an incubation period of 10 to 90 days. Primary (or early phase) syphilis is characterized by a hard, painless, ulcer-like sore at the site of infection (usually the penis in males and the vaginal canal or labia of females, although the rectum and mouth can also be transmission sites). This heals by itself after 3 to 10 weeks. This comes as a deceptive relief for those too embarrassed to go to the doctor for crotch-rot.

[x] Errortype: I don’t really feel like grossing out people who don’t want to see a penis with a deep ulcer

The disease becomes latent (i.e. presenting no observable symptoms) until 4-10 weeks after the primary sore. The symptoms of second-stage syphilis are incredibly varied. They may include a general unwell feeling, muscle aches, joint pain, fever, rash and/or swollen lymph nodes. People may not even go to a doctor because they may feel like they have the flu and just stay at home for a while. Again, these symptoms go away by themselves without treatment.

Once again the disease goes into a latent period for an indeterminate time. In the early latent phase (defined as the first couple of years of the infection) the primary sore may flare up from time to time. In the late latent phase, the patient is generally non-infectious and asymptomatic.

However, around one third of untreated patients go through to get tertiary syphilis. This can cause infection of the tissue surrounding blood vessels leading to destruction of local organs, muscles, bone or membranes. Organ failure, stroke, blindness, dementia and aneurysm (when blood vessels become weak and rupture) are only a small number of serious outcomes that can come from this. 20% of people with tertiary syphilis end up dying from these complications.

In any stage, syphilis can be cured by penicillin. In early stages, only a single dose is required. However, the damage done to organs can not be reversed. Research is being done into a vaccine to limit transmission.

Concept: Immune system evasion

Pathogenic (disease-causing) microbes need to learn to hide from the immune system, especially those that are latent for long period of time. If they don’t, they are quickly disposed of and aren’t passed on to another host. In the case of T. pallidum, it does this via two mechanisms; covering itself in the body’s proteins and a thick molecular armour.

T. pallidum has receptors on its surface that bind to fibronectin, a protein that is naturally present in the blood. So as it spreads from the infection site to the entire body, these proteins stick to the outside of the bacterium. Thus, the cell gets through without getting noticed by the immune system, who have been “trained” not to attack things that usually occur in the body (if this system breaks down, you get auto-immune diseases, such as lupus or arthritis).

Even if T. pallidum is found by the immune system, it has thick molecular armour (made up of a mesh of long sugar molecules) that makes it resistant to immune attack and that makes it much more likely for T. pallidum to survive.

I can’t find a good pun for syphilis…

A(n) (in)famous research project on the effects of syphilis was carried out in Tuskegee, Alabama in 1932. 600 “Negros”, 399 with tertiary syphilis and 201 without (acting as controls), were part of a study, although originally planned for 6 months, lasting 40 years. Free annual medical care, hot food, burial and trips to and from the city (all subjects were from rural communities, working as sharecroppers) were offered in exchange for X-rays, physical examination, burial assistance and eventual autopsying of the farmers. All of the subjects consented out of free will, however they were later found not to have been informed, saying that they were being treated for “bad blood”: The real purpose of the experiment was never revealed to the men.

When penicillin was found to be a highly effective treatment in 1947, subjects were not given a choice to quit the study (which required them to stay off any treatment) or even informed about the drug. In other words, the scientists let men die to fuel their own research.

The study was stopped immediately when the practices were leaked to the New York Times in 1972. Then, in American tradition, the lawsuits came a’flyin’. The U.S. government settled out of court by paying off the living participants $9 million, free health services and free burial services to them and their family members. Finally, in 1999, the government accepted responsibility publicly when President Clinton presented an apology on behalf of the USA and installed a bioethics committee to oversee the ethical regulations of scientific projects.

These ethical committees have been considered a bane for many researchers, who feel that they need to fill in reams of paper in thirteen-riplicate for a study that involves the word ‘animal’. Of course, with studies like these being carried out before any oversight, we have to admit some necessity for such things. But then again, with so much torture to animals and human going on already and this vast minority of such cruel studies as above, we have to question if it’s worth the millions of man-hours invested in these oversights. But then…

Sorry, I digress. In conclusion, syphilis, bad; intact genitalia, good.

Nom nom nom nom
Euphemisms! (Photo taken by Thomas Tu)

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5 Comments

Filed under Thomas' Corner

5 responses to “Syphilis – or how love drives people crazy

  1. dragonray

    Hi,
    Not to detract form your awesome blog (and it is! I never thought I could be so grossed out so quickly! 😀 ) hehe aren’t STD’s supposed to be called STI’s now?

    :p

    Love Ishta

    • thomastu

      That’s a good point, Ishta.

      Although used interchangably in common usage, “disease” and “infection” are different things.

      If you have a “disease”, it means you are actually sick. There’s some symptoms that you’re showing, e.g. vomiting, bleeding out of your eyes, giant ulcer on your penis, etc.

      If you have an “infection”, it only means you have a microbe living on/in you. The majority of microbes can live with your body without causing disease. For example, you could have an herpes infection and not even know it. That would count as a STI, but not STD.

      So you can have an STI without having an STD, but all people with STDs have STIs.

      There is an emphasis on STIs these days rather than STDs. I think this is because we can detect (using SCIENCE!) STIs a lot better these days.

      -TT

  2. Pingback: De verborum notatio morbi – On the etymology of diseases « Disease of the Week!

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