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Spring is here – swingers, meet syphilis

Unwanted pregnanacy? Genital warts? Chlamydia? Herpes? HIV? The biggest worry right now for sexual adventurers who like a bit of the old “natural” is a very old, very contagious STD.

Secondary syphilis. Phot0: Centers for Disease Control and Prevention’s Public Health Image Library (PHIL), #680

by Mark Cubey

Syphilis is back. Not that it went away. The sexually transmitted disease that first thrust its way into pubic, sorry, public consciousness in the 15th century, and hung around for around 400 years, destroying dangly bits, making people mad, bad, and crippled, and generally putting the V into VD is back. Big time.

According to Family Planning, the syphilis outbreak in Wellington and Auckland right now is worse than the 1800s, with reported rates of the disease in clinics at their highest ever.

Not that they had sexual health clinics in the 1800s.

People just went out and did their social connections and collapsed next to a vat of stunned mullet, and a while later went, OMG, what is that ugly sore on my [insert body part here]?

And yes, it could be any body part. Inserted anywhere.

Go ahead. Google “syphilis chancres” if you don’t believe me. Guaranteed to put you off your (naked) lunch.

And that’s just the start.

Skipping over the secondary symptoms, which may include fever, headache, sore throat, weight and hair loss, then lie dormant, a third of people who fail to get treatment get tertiary symptoms which again may lie dormant for up to 46 years and can result in Gummatous syphilis (soft, tumor-like inflamed balls that typically affect the skin, bone, and liver), Neurosyphilis, an infection involving the central nervous system occurring 4 to 25 years after the initial infection and involving meningitis or aortic aneurysms, or Congenital syphilis, passed on, hideously, to children.

And, now, in the late teens of the 21st century, when all the local escort sites make it determinedly clear that unprotected “natural” is a no-no, New Zealand is in the midst of a syphilis outbreak.

Ministry of Health stats say the number of people presenting with syphilis has more than doubled since 2015.

That’s 470 cases in 2017, mainly in Wellington and Auckland, with the highest number of cases among women aged 20 to 39. This is a growing trend that has been increasing since 2012, following a wider global trend seen in Australia, the United Kingdom and the United States.

Again, WTAF, for a disease that modern health thought was largely sorted.

The first recorded outbreak of this cunning bacterium, a helically coiled microorganism, was during an invasion of mid-1400s Naples, which led to its being called the “French disease” after dissemination by returning French troops (I won’t get into heavy French kissing theory here, though prolonged activity of this sort, in contact with a lesion, can be transmissive.)

The term “syphilis” was first nailed in 1530 by Italian poet and physician (top combo) Girolamo Fracastoro.

The horrible, untreatable disease made desperate people turn to desperate measures including blood-letting, laxatives, and baths in wine and herbs or olive oil (maybe not so desperate, but sadly, ineffective).

As late as the 1800s, people were using mercury as a treatment, even though they knew it was highly toxic. A continuous treatment of eating or inhaling mercury, or rubbing it into the skin… worked. Unless the patient died.

The first effective treatment, the drug Salvarsan, was developed in 1910 in the laboratory of Nobel Prize-winning scientist Paul Ehrlich. But it took another 33 years, and the introduction of penicillin, before a treatment could properly mitigate the spread of the disease.

It went largely untreated for centuries, affecting well-known modern figures such as composers Franz Schubert and Scott “The Entertainer” Joplin, gangster Al Capone, and painter Édouard Manet, who had his gangrenous foot cut off (love those side effects) shortly before he died.

And now, in the 21st century, we’re facing a serious public health problem, as bacteria such as syphilis are becoming resistant to most commonly available antibiotics.

I’m going to turn over now to Family Planning National Medical Advisor Beth Messenger,. who can explain what sexually active people in 2018 need to know about syphilis.

“Syphilis usually begins as an ulcer somewhere on the skin or on the lining of the genital area. Although syphilis is spread through these lesions, most go unrecognised. Usually people aren’t aware that they have syphilis so they unknowingly pass it on through unprotected oral, vaginal, or anal sexual activity.

“In its late stages, syphilis can cause damage to the heart, brain and spinal cord. Paralysis, blindness, dementia, arthritis, deafness, impotence, and death are the outcomes of long-term undiagnosed and untreated syphilis. If you’re pregnant and you have syphilis and it’s not detected during antenatal care, you can pass it on to your unborn children, causing stillbirth or serious complications.

“If you have syphilis you may have no symptoms but if you do have signs the first one will likely be a painless ulcer called a chancre, usually on your genitals or anus. Because it’s painless, you might not notice it – or you might think it’s nothing to worry about.

“Syphilis has four stages. At the primary stage, you’ll start with a single painless chancre but there may be multiple lesions. In the secondary stage, you’ll get a rash, usually on the palms of your hands and soles of your feet. Other symptoms may include fever, sore throat, weight loss, hair loss, and headache.

“In latent syphilis, which can last for years, there are few or no symptoms.

“In tertiary syphilis, there are gummas (soft non-cancerous growths), neurological, or heart symptoms.

“Syphilis can be treated at every stage with antibiotics. But to stop the spread, you need to tell your sexual partners so they can be treated.

“You can prevent contracted syphilis by always using condoms for all sexual activity including oral sex. Syphilis can also spread by close contact and it can be spread from mother to baby through the placenta during pregnancy, so diagnosis and knowing the risks is really important. You will be tested or syphilis if you are pregnant and you will need a repeat test if you have a change of partner during your pregnancy.”

Recommendations:

Sexually active people can have an STI test any time if you want to look after yourself and your partner or partners. But you should definitely have one at the following times:

  • You and a new partner are beginning a sexual relationship.
  • You have had unprotected sex.
  • You think you may have an STI.
  • A condom broke.
  • You are pregnant.
  • You have symptoms or just feel something is not right.
  • You have had sex—anal or vaginal—with an HIV-positive partner
  • You have injected drugs and shared needles or works (for example, water or cotton) with others.
  • You have exchanged sex for drugs or money.
  • You have had sex with someone who could answer “yes” to any of the above questions or someone whose sexual history you don’t know.

Stay safe. Stay clean. Spring into summer.