Learn more about syphilis.

Syphilis - P&S?

Per the Centers for Disease Control (CDC) “During 2015, there were 74,702 reported new diagnoses of syphilis (all stages), compared to 44,784 estimated new diagnoses of HIV infection in 2014 and 395,216 cases of gonorrhea in 2015. Of syphilis cases, 23,872 were primary and secondary (P&S) syphilis, the earliest and most transmissible stages of syphilis. In 2015, the majority of P&S syphilis cases occurred among gay, bisexual, and other men who have sex with men (MSM). In 2015, MSM accounted for 81.7% of all P&S syphilis cases among males in which sex of sex partner was known and 60% of all P&S syphilis cases overall. However, in recent years, the rate of P&S syphilis has been increasing among MSM as well as heterosexual men and women.”

What is meant by "P&S syphilis"?

Syphilis is one of the more venerable sexually transmitted diseases (STDs). It is caused by Treponema pallidum, a microscopic organism called a spirochete. This worm-like, spiral-shaped organism infects people by burrowing into the moist mucous membranes of the mouth or genitals.

The Three Stages of Syphilis

  • The first (primary) stage: This involves the formation of the chancre. At this stage, syphilis is highly contagious. The primary stage can last one to five weeks. The disease can be transmitted from any contact with one of the ulcers, which are teeming with spirochetes. If the ulcer is outside of the vagina or on the scrotum, the use of condoms may not help in preventing transmission. Likewise, if the ulcer is in the mouth, merely kissing the infected individual can spread syphilis. Even without treatment, the early infection resolves on its own in most women.
  • The second (secondary) stage: However, 25 percent of cases will proceed to the secondary stage of syphilis, which lasts four to six weeks. This phase can include hair loss; a sore throat; white patches in the nose, mouth, and vagina; fever; headaches; and a skin rash. There can be lesions on the genitals that look like genital warts, but are caused by spirochetes rather than the wart virus. These wart-like lesions, as well as the skin rash, are highly contagious. The rash can occur on the palms of the hands, and the infection can be transmitted by casual contact.
  • The third (tertiary) stage: This final stage of the disease involves the brain and heart, and is usually no longer contagious. At this point, however, the infection can cause extensive damage to the internal organs and the brain, and can lead to death.

Diagnosis and Treatment The diagnosis of syphilis is usually made today by a blood test, either the rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) test. The treatment is with antibiotics.

The Name "Syphilis" The name "syphilis" was coined by Hieronymus Fracastorius (Girolamo Fracastoro). Fracastorius was a true Renaissance man; he wrote on the temperature of wines, the rise of the Nile, poetry, the mind, and the soul; he was an astronomer, geographer, botanist, mathematician, philosopher and, last but not least in the present context, a physician. In 1530 he published the poem "Syphilis sive morbus gallicus" (Syphilis or the French Disease) in which the name of the disease first appeared. Perhaps more importantly, Fracastorius went on in 1546 to write "On Contagion" ("De contagione et contagiosis morbis et curatione"), the first known discussion of the phenomenon of contagious infection: a landmark in the history of infectious disease. P&S Syphilis Returning to "P&S syphilis", what does it mean? It stands for primary and secondary syphilis.

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Medically reviewed by Robert Bargar, MD; Board Certification in Public Health & General Preventive Medicine August 18, 2017

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