Syphilis (child care and schools)
What is syphilis?
Syphilis is caused by Treponema pallidum, a bacterium. Syphilis can affect the entire body and has several stages: primary, secondary, latent, tertiary, and neurosyphilis. Symptoms vary and can be indistinguishable from other diseases, and often people with syphilis do not have noticeable symptoms for years.
Signs and symptoms
- Primary stage: One or more small, round, hard, painless sores (called chancres) appear at the site of exposure, usually around the penis, mouth, vagina, and/or anus. Chancres generally resolve after three to six weeks without treatment.
- Secondary stage: If not treated, a non-itchy, reddish, rough rash develops on the palms of the hands and on the bottoms of the feet as well as the abdomen and back. A rash with a different appearance may occur on other parts of the body. Sometimes the rash is faint and not noticed. Second-stage symptoms can also include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and tiredness. Even without treatment, the symptoms of secondary syphilis usually resolve.
- Late stage: A person with untreated syphilis can experience a period of many years without any symptoms following the primary and secondary stages. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. The damage may be serious enough to cause death.
Incubation period
The average time between acquisition of syphilis and the start of the first symptom is 21 days, but it can range from 10 to 90 days.
Contagious period and spread
- Direct exposure to a chancre through sexual contact: oral, anal, and vaginal.
- People with a chancre(s) who are in the primary or secondary stage can spread syphilis.
Public health reporting requirements
- Syphilis infections must be reported by laboratories and health care providers to the state or local public health agency within one working day of a suspected or confirmed diagnosis.
- The possibility of sexual abuse must be considered when infections occur in prepubescent children and must be reported to appropriate authorities.
Control of spread
- People with infection should be examined by a health care provider and treated as soon as the diagnosis is confirmed to prevent complications. Treatment of the partner(s) is a crucial strategy to prevent re-infection. People with infection should seek medical care if symptoms persist or recur. Parental consent is not required for minors to be examined and treated.
- People with infection should avoid sexual activity until they and their partner(s) are treated and cured.
- Patients should correctly and consistently use condoms to help prevent future infections.
- General education on STI prevention is advocated.
Treatment
Treatment is with antibiotics. Syphilis is easy to cure in its early stages. Late-stage syphilis complications require more extensive antibiotic treatment.
Exclusion
No exclusions or environmental interventions are necessary. STIs require close intimate physical contact for transmission, virtually always of a sexual nature.
Role of teachers, caregivers, and family
- General education about sexual health and STI prevention is recommended.
- Infections in prepubescent children and other high-risk individuals must be reported to appropriate authorities to address the possibility of sexual abuse.