1. Click to edit Master title style SyphilisSyphilis

2.  Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum.  The infection is usually sexually transmitted, in which case it is called venereal syphilis. Source CDC, 2011 What is Syphilis?

3. Click to edit Master title style  It may also be passed from an infected mother to her unborn child, in which case it is known as congenital syphilis.  The signs and symptoms are indistinguishable from those of other diseases. Source CDC, 2011 What is Syphilis?

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5. Source : CDC Symptoms and Pathogenesis

6. Click to edit Master title style  Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.  There are at least 3 stages of Syphilis.  Primary stage: marked by the appearance of a single sore (called a chancre), but there may be multiple sores. Source CDC

7. Click to edit Master title style  The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days).  The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body. Source CDC

8. Click to edit Master title style  The chancre lasts 3 to 6 weeks, and it heals without treatment.  However, if adequate treatment is not administered, the infection progresses to the secondary stage Source CDC

9. Click to edit Master title style Primary syphilis infection with oral ulcer and facial chancre on nose or the entire face DermNet.com.

10. Click to edit Master title style  Secondary stage: characterized by skin rash and mucous membrane lesions characterize the secondary stage.  This stage starts with the development of a rash on one or more areas of the body. Source CDC

11. Click to edit Master title style  Sometimes rashes associated with secondary syphilis resembled rashes caused by other diseases or can be so faint that they are not noticed.  In addition to rashes, symptoms of secondary syphilis may include : fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. Source CDC

12. Click to edit Master title style  The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent and possibly late stages of disease. Source CDC

13. Click to edit Master title style secondary syphilis infection

14. Click to edit Master title style

15.  Late and Latent (hidden) Stages: begins when primary and secondary symptoms disappear without treatment and can last for years.  The infected person continues to have syphilis even though there are no signs or symptoms; infection remains in the body. This latent stage can last for years.  The infected person continues to have syphilis even though there are no signs or symptoms; infection remains in the body. This latent stage can last for years. Source CDC

16. Click to edit Master title style  The late stages of syphilis can develop in about 15% of untreated people, and can appear 10–20 years after infection was first acquired.  Untreated early syphilis in pregnant women results in perinatal death in up to 40% of cases and, if acquired during the 4 years before pregnancy, can lead to infection of the fetus in 80% of cases. Source CDC

17. Click to edit Master title style EpidemiologyEpidemiology

18.  During 2009–2010, the number of cases of early latent syphilis reported to CDC increased from 13,066 to 13,604 cases (4.1% increase), and the number of cases of late and late latent syphilis increased from 17,338 to 18,079 cases (4.3% increase ).  The total number of cases of syphilis reported to CDC increased 2.2% (from 44,830 to 45,834 cases) during 2009– 2010 (Table 1). Source CDC

19. Click to edit Master title style  In 2010, 67% of P&S syphilis cases in 44 states and the District of Columbia that provided information about sex of sex partners were among M having sex with men (MSM).  During 2004–2008, rates of Primary and Secondary syphilis increased the most among 15–24 year-old m Source CDC

20. Syphilis—Reported Cases by Stage of Infection, United States, 1941–2010

21. Primary and Secondary Syphilis—Rates by State, United States and Outlying Areas, 2010

22. Click to edit Master title style Source MDH 2011 HIV/AIDS in M Minnesota : Annual Review Overview of Syphilis in Minnesota

23. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Syphilis Rates by Stage of Diagnosis Minnesota, 2001-2011 * P&S = Primary and Secondary

24. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review 2011 Minnesota Primary & Secondary Syphilis Rates by County Rate per 100,000 persons > 1.0 0.21 – 1.0 0 – 0.2 # 7-county metro area, excluding the cities of Minneapolis and St. Paul St. Louis Itasca Cass Lake Polk Beltrami Aitkin Pine Cook Koochiching Otter Tail Clay Roseau Marshall Becker Todd Stearns Kittson Swift Lyon Pope Morrison Wilkin Renville Carlton Martin Rice Wright Norman Fillmore Mower Nobles Murray Grant Sibley Brown Rock Redwood Douglas Jackson Meeker Goodhue Winona Isanti Faribault Dakota Freeborn Olmsted Scott Stevens Anoka Nicollet McLeod Chippewa Wabasha Carver Pennington Hubbard Crow Wing Lake of the Woods Clearwater Kandiyohi Lincoln Blue Earth Mille Lacs Houston Steele Traverse Dodge Wadena Hennepin Kanabec Lac qui Parle Benton Big Stone Cottonwood Waseca Chisago Le Sueur Mahnomen Yellow Medicine Pipestone Red Lake Sherburne Watonwan Washington Ramsey City of Minneapolis 15.2 (58 cases) City of St. Paul 4.9 (14 cases) Suburban # 2.4 (52 cases) Greater Minnesota 0.5 (13 cases)

25. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Primary & Secondary Syphilis Rates by Gender Minnesota, 2001-2011

26. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Primary & Secondary Syphilis Rates by Age Minnesota, 2001-2011

27. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Age-Specific Primary & Secondary Syphilis Rates by Gender, Minnesota, 2011

28. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review *Includes persons reported with more than one race Primary & Secondary Syphilis Cases by Race Minnesota, 2011 Total Number of Cases = 139

29. Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review Primary & Secondary Syphilis Rates by Race/Ethnicity Minnesota, 2001-2011 * Persons of Hispanic ethnicity can be of any race.

30. Click to edit Master title style  Detection by microscope: examining material from a chancre (infectious sore) using a special microscope called a dark-field microscope  Blood test Diagnosis of Syphilis Infection Source CDC

31. Click to edit Master title style Risk factors

32. Click to edit Master title style  Although transmission occurs from persons with sores who are in the primary or secondary stage, many of these sores are unrecognized.  Thus, transmission may occur from persons who are unaware of their infection.  Syphilis is passed from person to person through direct contact with a syphilis sore. TransmissionTransmission Source CDC

33. Click to edit Master title style  Transmission of the organism occurs during vaginal, anal, or oral sex.  Transmission of the organism occurs during vaginal, anal, or oral sex.  Pregnant women with the disease can pass it to the babies they are carrying.  Syphilis cannot be spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils. TransmissionTransmission Source CDC

34. Click to edit Master title style  Syphilis, as a genital ulcerative disease, causes significant complications if untreated and facilitates the transmission of HIV infection.  Genital chancres caused by syphilis make it easier to transmit and acquire HIV infection sexually.  There is an estimated 2 to 5 fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. Syphilis and HIV Source CDC

35. Click to edit Master title style PreventionPrevention

36.  Abstain from sexual activity or be faithful (be in a long- term mutually monogamous relationship with an uninfected partner).  Limit your number of sex partners : the fewer partners you have, the less likely you are to get infected.  Notify sex partners immediately if infected.  Make sure partners are tested and treated. Source CDC

37. Click to edit Master title style  Correct and consistent condom use. Latex condoms are highly effective at preventing transmission of HIV and some other sexually transmitted diseases.  Get tested and treated and insist that your partners do too.  Get a test from a medical provider if infection is suspected and obtain medical treatment immediately if you think you were exposed. Source CDC

38. Click to edit Master title style  Do not inject drugs. If you inject drugs, you should get counseling and treatment to stop or reduce your drug use. Source CDC

39. Click to edit Master title style TreatmentTreatment

40.  Syphilis is easy to cure in its early stages.  A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. Source CDC

41. Click to edit Master title style  For people who are allergic to penicillin, other antibiotics are available to treat syphilis.  Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.  Because effective treatment is available, it is important that persons be screened for syphilis on an on-going basis if their sexual behaviors put them at risk for STDs. Source CDC

42. Click to edit Master title style  Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed.  Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary. Source CDC