Health Indicator Report of Syphilis Cases - Primary and Secondary

Syphilis is a complex sexually transmitted infection (STI) caused by the bacterium ''Treponema pallidum'' (spp. ''pallidum''). The initial stage (primary syphilis) is characterized by a highly infectious painless open sore, called a chancre, at the site of infection. Chancres occur mainly on the external genitals, vagina, anus, rectum, or in the mouth in the case of oral exposure. Syphilis is passed from person to person through direct contact with the chancre. Sexual transmission can also occur during the secondary stage of syphilis. In the second stage of syphilis, a skin rash can appear as well as other more generalized symptoms such as swollen lymph nodes, fatigue, and hair loss. Some patients can have additional skin manifestations including mucous patches (raised patches in the mouth or anus) and condylomata lata (wart-like lesions in the genital or rectal areas). Without treatment, syphilis will persist in the body even though symptoms resolve. This latent stage of syphilis is divided into early latent and late latent. Early latent syphilis refers to an infection that has been acquired in the past 12 months and late latent refers to an infection that has been acquired more than 12 months ago. Neurological, ocular, and otic manifestations can occur at any stage of syphilis and are caused by syphilis bacteria invading the brain, eyes, and auditory system, respectively. These manifestations can present as altered mental status, meningitis, decreased vision, hearing loss, and vertigo. In later stages of the disease (tertiary syphilis), the bacteria can move throughout the body, damaging internal organs over time. Affected organs can include the brain, spinal cord, heart, liver, and bones. An infant can acquire syphilis in utero through the placenta if the mother is infected. This is referred to congenital syphilis (CS). CS can have major health impacts on an infant including miscarriage, stillbirth, prematurity, low birth weight, vision, hearing loss, and bone abnormalities. Children aged 2 years of older may have signs such as abnormal tooth development, eye disorders, changes to the facial bones, and deafness. The open nature of syphilis sores makes it easier to acquire HIV, if exposed, or to transmit the virus, if infected. Public health intervention and education measures are crucial in eliminating syphilis.