STD Awareness: Is There a Vaccine for Syphilis?

Before antibiotics, syphilis was the most feared sexually transmitted disease (STD) out there. It was easy to get, quack cures were ineffective and often unpleasant, and it could lead to blindness, disfigurement, dementia, and even death. Syphilis rates were highest during World War II, and plummeted when penicillin became widely available later in the 1940s. By 2000, syphilis rates hit an all-time low, and many scientists thought the United States was at the dawn of the complete elimination of syphilis.

What a difference an antibiotic makes. Image: CDC

Unfortunately, it soon became apparent that syphilis wasn’t ready to go out without a fight. Since 2000, syphilis rates have nearly quadrupled, climbing from 2.1 to 7.5 per 100,000 people by 2015 — the highest they have been since 1994. If you look at the above graph, you might think syphilis rates have been pretty stable over the past 20 years — but if you zoom in, the fact that we’re in the midst of an epidemic becomes more clear.

After hitting an all-time low in 2000, syphilis rates have been increasing nearly every year since.

The epidemic is disproportionately affecting men who have sex with men (MSM), with Arizona seeing a higher-than-average syphilis rate in this group. Additionally, syphilis rates are climbing among women, who have seen a 27 percent bump between 2014 and 2015. And, since women can carry both syphilis and pregnancies, a rise in syphilis in this population also means a rise congenital syphilis (the transmission of syphilis from mother to fetus), which causes miscarriages, stillbirths, preterm births, neonatal death, and birth defects. Ocular syphilis — that is, syphilis infections that spread to the eyes and can lead to blindness — is also on the rise.

Men, women, babies — no one is immune to the grasp of syphilis. Continue reading

STD Awareness: What Does “Congenital Syphilis” Mean?

Treponema pallidum, the bacteria that causes syphilis

Treponema pallidum, the bacteria that causes syphilis

Congenital syphilis, for centuries a leading cause of infant mortality, is often thought of as an antique affliction, relegated to history books — but it is on the rise again. Between 2012 and 2014, there was a spike in congenital syphilis rates, which increased by 38 percent and are now the highest they’ve been in the United States since 2001. As of 2014, the last year for which we have data, more babies were born with syphilis than with HIV.

The word “congenital” simply means that the baby was born with syphilis after being infected in the womb. When an expecting mother has syphilis, the bacteria that cause the disease can cross the placenta to infect the fetus — and will do so 70 percent of the time. As many as 40 percent of babies infected with syphilis during pregnancy will be stillborn or will die soon after birth. It can also cause rashes, bone deformities, severe anemia, jaundice, blindness, and deafness. Congenital syphilis is especially tragic because it’s almost completely preventable, especially when expecting mothers have access to adequate prenatal care and antibiotics. Penicillin is 98 percent effective in preventing congenital syphilis when it is administered at the appropriate time and at the correct dosage.


More babies are being born with syphilis — but this trend can be reversed with wider access to prenatal care.


Incidence of congenital syphilis is growing across all regions of the country, but rates are highest in the South, followed by the West. Rates have also been increasing across ethnic groups, but, compared to white mothers, congenital syphilis rates are more than 10 times higher among African-American mothers and more than 3 times higher among Latina mothers, illustrating the need to increase access to prenatal care for all expecting mothers — and to ensure that this prenatal care is adequate.

Anyone receiving prenatal care should be screened for syphilis at their first visit, and some pregnant people — including those at increased risk or in areas where congenital syphilis rates are high — should be screened a second time at the beginning of the third trimester and again at delivery. Continue reading

STD Awareness: Will STDs Go Away on Their Own?

teensCan gonorrhea go away without treatment? Does chlamydia eventually clear up? Can trichomoniasis go away on its own? These are the kinds of questions people pose to Google before Google sends them here — at least that’s what I learned by looking at the blog’s stats. They’re tricky questions to tackle, and for so many reasons.

Some viral STDs stay with you for life, such as herpes and HIV. Others, such as hepatitis B and human papillomavirus (HPV), can be prevented with vaccines but cannot be cured. It’s also possible for the immune system to defeat hepatitis B virus and HPV — but in some cases, these viruses are able to settle in for the long haul, causing chronic infections that can endure for life and even lead to cancer.


Left untreated, syphilis can kill, and gonorrhea can cause infertility.


Non-viral STDs, like chlamydia and gonorrhea, can be cured. However, they usually don’t have symptoms, or symptoms can come and go, making it seem like an infection went away when it actually didn’t. You can’t know your STD status without getting tested, and you can’t self-diagnose an STD based on symptoms and then assume the infection went away when symptoms subside. Getting tested can uncover a problem and clear the way for treatment.

Nonetheless, people want to know if an STD can go away by itself — but there aren’t many studies on the “natural history” of curable STDs like gonorrhea, chlamydia, and trichomoniasis. Studying the natural course of a curable infection would require that scientists put their subjects at risk of the dangers of long-term infection, and no ethics board would approve such an experiment. Continue reading

STD Awareness: The History of Syphilis

syphilisHave 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: Three Sexually Transmitted Bacteria That Will Shock and Amaze You

It’s hard to appreciate a pubic louse as an intriguing creature in its own right. Not when an infestation with pubic lice is such a vexing experience. The same can be said for the germs that cause any number of human diseases. But, just as you might have marveled at the microorganisms you spied under the microscope in your high school biology class, the bacteria and other microbes that cause sexually transmitted diseases (STDs) can be fascinating, strictly as scientific subjects.

Let’s look at a few of these fascinating bacteria!

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 obtained from the CDC’s Public Health Image Library.

Image: Public Health Image Library, CDC

Treponema pallidum: the bacteria that cause syphilis

Before the age of antibiotics, syphilis was the most feared STD out there. Untreated, it can cause serious, sometimes fatal, damage to the body, and can also spread to a fetus during pregnancy. But did you know that earlier versions of syphilis might have been even worse?

Written records of syphilis date back to 1495 when it seemed to appear in Europe for the first time. According to a 1519 description, it caused

Boils that stood out like Acorns, from whence issued such filthy stinking Matter, that whosoever came within the Scent, believed himself infected. The Colour of these was of a dark Green and the very Aspect as shocking as the pain itself, which yet was as if the Sick had laid upon a fire.

Interestingly, such descriptions don’t match modern forms of syphilis, which suggests that it might have evolved into a less virulent form, possibly in response to selective pressure against symptoms that render the host sexually unappealing. Basically, that means that someone with boils emitting “filthy stinking Matter” might have trouble find sexual partners; the pustules of yore don’t seem to decorate the epidermis of contemporary sufferers, making them more likely to perpetuate milder forms of syphilis through sexual transmission.

We can’t hop into a time machine and take samples from European syphilitics in 1495, but some biologists believe that it took about 50 years for evolution to work its mojo on the disease, giving rise to the milder Syphilis 2.0 in the mid-1500s. Continue reading

STD Awareness: Can You Get an STD in Your Eye?

eyeSexually transmitted diseases (STDs) usually haunt the nether regions, whether germs have set up shop in the urethra, clustered around the cervix, or burrowed inside a cell. There, they might cause symptoms, like a burning sensation when urinating, unusual discharge, or warts or sores in the genital area.

Sometimes, however, STDs can infect other parts of your body, usually places that boast environments that are warm and moist, just like your genitals. For example, the virus that causes genital warts can also infect the throat to cause growths inside the airway. Oral sex can transfer the bacteria that cause gonorrhea from a urethra to a throat. And herpes can spring up around the mouth or in the genital region, and can be transferred between the two locations.


Instead of wearing goggles during sex, get tested for STDs at Planned Parenthood!


But did you know that certain sexually transmitted organisms can find their way into human eyes? If you didn’t, you do now, so read on to learn about some of the types of STDs that can affect your eyes.

Chlamydia and Gonorrhea

The most common bacterial STD in the country is chlamydia, which strikes nearly 3 million American groins annually. In second place is gonorrhea, which infects around 800,000 Americans every year. Bacteria that infect the genital region have an affinity for its warm, moist atmosphere. And while eyes might not be their first choice, the ocular environment can be pretty inviting as well. When chlamydia or gonorrhea infect the eye, the resulting conditions are called chlamydial conjunctivitis and gonococcal conjunctivitis, respectively. Continue reading

STD Awareness: Do Sexually Transmitted Diseases Increase HIV Risk?

virion HIVYou might have heard that having an STD like syphilis, herpes, or gonorrhea can make it easier to catch HIV, the virus that causes AIDS. But have you ever wondered if this was true? Maybe it’s just a simple correlation — for example, someone who doesn’t practice safer sex would be more likely to catch HIV along with any other STD. That doesn’t mean that one causes the other, does it?


Common STDs like herpes and trichomoniasis can increase HIV risk.


But it’s not a mere correlation. If you take one person with an STD and one person without an STD and expose them both to HIV through sexual contact, the person with the STD will be at least two to five times more likely to become infected with HIV. Why is that? First, many STDs can make you more susceptible to an HIV infection. Second, the immune response triggered by many sexually transmitted infections can summon the types of immune cells that HIV targets.

Furthermore, if a person with HIV is co-infected with another STD, he or she is more likely to transmit HIV to a partner. In other words, STDs can make a person with HIV more infectious. HIV is more likely to appear in their genital secretions, making it easier to transmit HIV through sexual activity. Continue reading