STD Awareness: Syphilis Treatment Through the Ages

Posted on February 25, 2019 by Anna C.

The spiral-shaped bacteria that causes syphilis.

When syphilis first descended upon Europe, questions surrounded this mysterious scourge. Was it a punishment from God? Was it introduced by a hated Other? Was it caused by the stars’ alignment or the presence of “bad air”? We now know that syphilis is not caused by supernatural forces, foreigners, or a harmful atmosphere, but rather by a species of corkscrew-shaped bacteria called Treponema pallidum, which is spread by sexual contact — vaginal, anal, or oral sex — in which one person comes into contact with a syphilis sore.

Thanks to penicillin, we don’t have to go back to the “good old days” of puke chalices, antivenereal underpants, and rat poison.

Before good treatments were developed in the 20th century, syphilis was the most feared STD out there. Its initial symptoms can include a painless sore filled with a highly infectious liquid. As the infection spreads, lesions and rashes might appear on the soles of the feet or the palms of the hand. After these first waves of symptoms, the infection enters a latent phase, which can lull people into a false sense of security, thinking the disease has disappeared. Unfortunately, 15 percent of people with untreated syphilis reach the late stage, which can occur up to 20 years after initial infection, and includes severe damage to the nervous system, brain, heart, or other organs, and can be fatal.

These days, a shot of penicillin is all it takes to cure syphilis. Back in the day, though, there were myriad “treatments” for syphilis — but they were highly toxic and ineffective. Unfortunately, thanks to the latent phase of syphilis, it often seemed like these treatments did work, which probably explains why folks tortured themselves with them for centuries. If only penicillin had been around: Countless people would have been spared the unpleasant — and often fatal — quackery that syphilis attracted. Continue reading →

STD Awareness: The History of Syphilis

Posted on February 9, 2015 by Anna C.

Have you ever heard that syphilis originated in the New World, and was imported to Europe by unwitting explorers? Some say it’s a fitting revenge for Europeans, who brought deadly diseases like smallpox and measles to the Americas. Others say that, while it’s an interesting hypothesis, it’s mostly speculation backed by some intriguing circumstantial evidence.

The predominating theory of syphilis’ origin is that it was transmitted from the Americas to Europe via sailors on Christopher Columbus’ ships — sailors who, in addition to other horrific acts, probably raped the natives of Hispaniola, from whom they could have contracted the infection. Historical records show that syphilis popped up in Europe in the last decade of the 1400s, coinciding with the return of Columbus and his crew — when Europe was deeply mired in war. With war came the far and wide travel of troops, who could have introduced the pathogen to prostitutes and other members of local populations.

In the era before antibiotics, syphilis was the world’s most feared sexually transmitted disease.

But we don’t know for certain that Columbus’ crew brought syphilis back from the West Indies in 1493. Some scholars point to ancient writings, from Biblical texts to Chinese records, that contain descriptions of diseases that are consistent with syphilis — though they might merely have described tuberculosis or leprosy. There are also pre-Columbian skeletons from Europe, Africa, and Asia that seem to exhibit evidence of syphilis infection — though diagnosing syphilis based on bone samples is problematic at best. Is it possible that syphilis had existed in the Old World all along, but didn’t become an epidemic until the wars of the Renaissance era allowed syphilis to conquer the continent?

Or perhaps the New World was home to a mild strain of the disease that mutated once it hit European soil. One team of researchers, studying Guyana’s remote Akwio tribe, discovered a disease that was a lot like syphilis, but was not an STD — it spread by skin-to-skin contact and infected about 1 in 20 children. Genetic analysis showed that it was caused by a bacteria that was closely related to the same bug that causes syphilis. Could Columbus’ men have picked up this transitional strain of bacteria and brought it back to Europe, where it mutated to evolve into the virulent pathogen we know today? Continue reading →

STD Awareness: Antibiotic-Resistant Syphilis

Posted on November 20, 2012 by Anna C.

Treponema pallidum under a microscope. Image: Dr. Edwin P. Ewing, Jr., CDC

The image to your right, with lively yellow splotches against a pale green background, is not a long-lost Jackson Pollack piece, and the dark squiggly lines aren’t strands of paint haphazardly splattered onto a canvas. In fact, those squiggly lines are magnified images of the spiral-shaped bacteria species Treponema pallidum. You might not have heard of T. pallidum, but you’ve probably heard of syphilis, the sexually transmitted disease (STD) that these bacteria cause. While syphilis isn’t as common as other STDs, like chlamydia and HPV, it’s still out there, and occasionally communities experience outbreaks. It’s always best for sexually active people to be screened for STDs and practice safer sex.

The evolution of syphilis strains that are resistant to certain antibiotics underscores the need to use antibiotics properly.

Syphilis can inflict serious long-term damage — in fact, before the introduction of antibiotics, syphilis was the worst STD out there! Known as the Great Pox when it descended upon Europe 500 years ago, it could cause large and painful boils. Eventually, natural selection led to T. pallidum’s evolution into a form with milder symptoms, which benefited the bacteria by enabling its less boil-ridden (and presumably more attractive) human hosts to spread it farther and wider. Nevertheless, the symptoms of syphilis, if present, still include infectious sores, and when the disease goes untreated, it can cause severe, possibly fatal, damage to the nervous system.

Back in the day, there were myriad inadequate “treatments” for syphilis, ranging from straight-up quackery to the use of partially effective but toxic chemicals such as mercury. But a century ago, in 1912, a new arsenic-based chemical called Neosalvarsan was hailed as a “magic bullet.” Unfortunately, this treatment took weeks or even more than a year to administer — and had dangerous side effects. Quack treatments continued to flourish, and it wasn’t until the widespread adoption of penicillin in the 1940s that an effective cure with few side effects was available.

But natural selection endures; in fact, by flooding T. pallidum’s habitat with certain antibiotics, we’ve created an environment that favors the organism’s evolution against us. While not as immediately threatening as antibiotic-resistant gonorrhea, syphilis has been quietly evolving resistance to some of the antibiotics we use to treat it. This underscores the importance of using antibiotics correctly and emphasizing safer-sex practices, such as using latex condoms during vaginal or anal intercourse and during oral contact with a penis. Continue reading →

STD Awareness: Syphilis

Posted on September 6, 2011 by Anna C.

Treponema pallidum, the causative agent of syphilis, is seen in this electron micrograph adhering to a surface with the tapered end of its structure. Image: Public Health Image Library, CDC

When syphilis first descended upon Europe, it was seen as a new plague, and anxiety and blame coalesced around this mysterious scourge. Was it a punishment from God? Was it introduced by a hated Other? Was it caused by the stars’ alignment or the presence of “bad air”? The panic it provoked foreshadowed the hysteria that surrounded the emergence of HIV in the 1980s, as syphilitics were discriminated against, feared, or thought to have received punishment for their “unbridled lust.”

We now know that syphilis is not caused by supernatural forces, foreigners, or “bad air,” but rather by a species of spiral-shaped bacteria called Treponema pallidum, which can cause infections in the vagina, anus, urethra, or penis, as well as the lips and mouth. It is mostly spread by sexual contact — vaginal or anal intercourse, as well as oral sex — in which one person comes into contact with a syphilis sore. These sores can be hidden on the cervix or in the vagina, urethra, rectum, or mouth, making it not immediately apparent that one is infected with syphilis. Syphilis can also spread to a fetus during pregnancy. Sexually active people can reduce their risk of contracting syphilis by using latex barrier methods such as condoms or dental dams. Continue reading →