Syphilis - SpeedyLook encyclopedia

Names

Various names of the name in Europe show well the advance of the progression of the first epidemic.

Badly of Naples or badly Neapolitan (for the French)
(for the Italians)
(for the Spaniards)
Badly Spanish (for the Portuguese)
(for the English)
(for the Scot)
(for the Germans)
Badly German (for the Poles)
(for the Russians)
Tired bubas

Specificity (medical term):

Grande (or “gross”) pox (small pox being the Variola)
Tabès is the attack of the spinal-cord

History

The origins of syphilis are not known. For a long time, the theory which prevailed was that the disease had been brought Nouveau World in the Old one at the time of the first voyage of Christophe Colomb. This theory seems called in question today. In 1963, Hackett proposes a theory according to which, the pale tréponème comes from another tréponème, the Treponema caracteum having also generated the Treponema pallidum sub species endemicum also named béjel.

For the anecdote, some think that the conquistadors brought back it new world by catching it with the indigenous women. The legend would like that they caught it by their husbands shepherds, who were going to live only several weeks in mountain… Knowing that the colonist of LAMA is known to be a place where the germ of syphilis naturally seems to like itself.

However, Hippocrates seems to have made the description of the tertiary form of the disease. Archaeological research seems to indicate that the disease was present in the Greek city of Métaponte in Italy at sixth century BC Moreover, the discovery with Pompéi of teeth presenting of the grooves, deformations characteristic children infected during the pregnancy by their mother reached of the disease, appears to confirm this anteriority.

However, the most outstanding proof of the presence of syphilis in medieval Europe was found at the time of the excavations of the monastery augustinien dating from the 13th century and 14th century in the port from Kingston-upon-Hull in the North-East from the England.

At that time, Kingston-upon-Hull was the second most important port of England after London and a port city with international vocation. Its monastery, like much of others, was destroyed on order of Henri VIII in 1539, following the reform Anglican. Two thirds of the skeletons updated during the excavations present typical osseous deformations of the third stage of the disease. One discovers these characteristic marks in particular on the skeletons buried with more close to the furnace bridge, which means that the rich person givers of the monastery, the members of the privileged class of Kingston-upon-Hull, were among the people touched by the disease. The dating with carbon confirms that these skeletons were buried for the active period of the monastery, which agrees with difficulty with the American theory.

Before these recent discoveries, one considered that syphilis had made its appearance in 1494 with Naples and that it had been brought there by Spanish sailors of the crew of Christophe Colomb who took part in a military campaign of Charles VIII. According to the countries, it is called “badly of Naples”, “badly of the English”, “badly of the French”. Nobody wants to assert paternity of it. It does not save their royal highnesses François I {{er}} and Charles Quint.

The name of syphilis is used for the first time by Girolamo Fracastoro in 1530 in its sive work “Syphilis of morbo gallico” where it describes the history of a shepherd named Syphilus which would have been the first to contract the disease.

It is only at the 19th century that the affection will be recognized clinically and well defined in its symptomatology. Before 1870, nothing the contents of the medical writings gives a distressing image of syphilis. It presents serious public health problems associated with the usual venereal propagation. The treatments containing mercury are widely diffused but the doctors often have difficulties in convince their patients to treat this not very spectacular disease. The mercury, remedy pluricentenaire and iodizes it potassium seemed able with them two to regulate all the situations. In fact, mercury killed as much as syphilis itself. Syphilis was a grave disease (mortal), which is transmitted easily but which is cured easily (some antibiotic injections). It is currently in recrudescence in France and in the majority of the countries. It can be associated with the infection by the HIV. As for the HIV, the condom or the serologic knowledge of the statute of its stable partner are the best means of protecting itself some.

Epidemiology

In the world

In 1995, one would have counted a few 12 million new cases of syphilis in the world adult population, and the greatest number in South Asia and of South-east, followed by sub-Saharan Africa (Figure WHO).

In France

Syphilis is in recrudescence in France since the years 2000. An investigation, coordinated by the National Sanitary Surveillance Institute (InVS), made state of an alarming increase in the number of cases of syphilis. In this context, the Delegated minister with health decided to set up a strategy of prevention in the form of actions of communication and actions targeted towards the populations at risk.

Sources: these two reports/ratios of the InVS:

In the United States

The séroprévalence of syphilis has increased for a few years in the big cities of the United States.

Transmission, stages and treatment of the disease

Syphilis is transmitted by not protected sexual relations (vaginal, anal and bucco genital), by blood way (transfusion or seldom use of soiled material) and during the pregnancy, of the mother to the child.

Primary education syphilis

She always does not have apparent signs, and when they exist, they in general appear only 3 weeks after the contamination. It is about a lesion characteristic of the mucous membranes called the canker of inoculation (small wound dew, digs, Atone, at hardened bottom, the aspect hard-bound with the touch, and painless): it corresponds to the entrance point of the bacterium. This generally single ulceration, is found on the level of the sleeve of the Verge, on the nipple, in the urethra (invisible), on the level of the cervical collar, the Vagin, the Vulve. Other localizations are possible, anus, amygdalae (what makes think of an angina), lips, language… etc This lesion is accompanied by a important Adénopathie, surrounded by several others smaller in the area of lymphatic drainage of the canker. ( Préfet of the groin is the qualifier for the largest ganglion of the groin). These adénophathies are slightly inflammatory and painless.

Attention, at the woman, the lesion can be intra-vaginal and thus not be seen.

The syphilitic lesions all are extremely contagious. The taking away with the research of the bacterium in is thus facilitated.

Secondary syphilis

It is accompanied by multiple eruptions on the skin and/or the mucous membranes without itching: it is the roseola (small spots pale pink on the skin and red on the mucous membranes of the nipple, the anus, the throat, the language, the lips). These lesions can be seen on the palms and the plant of the feet, but still on the chest or the back, which is rare enough for a dermatological eruption. The visible signs can disappear even without treatment, but syphilis remains present in the organization and transmissible. It is the most contagious form by far because a simple contact of a syphilitic skin against a skin having an unspecified form of lesion (scraping, cut, burn or another shape of wounds) is enough to be contaminant.

Syphilis latent

It is about the persistence of the tréponème in certain sites (eye, brain, aorta…). It is one asymptomatic period which is often detected at the time of an examination serologic of routine (premarital, antenatal, of recruiting…).

Tertiary syphilis

It worsens seriously without treatment by cardiovascular, nervous attacks (in particular intense cephalgias and dysarthrie), articular. It touches all the bodies in a general way, and even neat in time and thus noncontaminant after treatment, it can involve secondary signs like the gastric burns of the tabès. Transitory paretic episodes are characteristic (aphasia, hémiplégie, hemiparesy etc) It also seriously increases the transmission risk of HIV and it becomes complicated at the HIV positive people by a faster evolution and more frequent neurological complications. The neurological syphilis thus starts as of the tertiary phase.

Quaternary syphilis

Without treatment, from 8% to 10% of the people reached important central nervous system disorders ten to twenty years test after the beginning of the disease (see Neurosyphilis). A quarter of the untreated patients are victim of a meningoencephalitis (Syphilis cerebrospinalis) which leads to the insanity (with sometimes a transitory increase in the mental and cognitive capacities of the contaminated individuals). Extraordinary changes in the sensitivity or psychism were described during this phase, but they are not systematic. The excessive increase in the libido and various kinds of hallucinations were reported. The patients can also present a Ataxie locomotor, known as tabes syphilitic by progressive destruction of the posterior roots or a degeneration of the posterior cords of the Spinal-cord which is accompanied by pains invalidating with dysfunctions and losses of control of the bladder and the intestines. The evolution is made towards the general Paralysie. In addition disorders of circulation or damage with the skeleton are frequent. In the Western countries it is only seldom that we observe such an evolution because the antibiotics allow a sufficient therapy.

Less often, syphilis can reach the heart and the large vessels (Aorta for example) involving a cardiac failure which can be mortal. The articular attacks ostéo with damage with the skeleton are frequent with spontaneous fractures and perforating evils plantar.

Syphilis congenital

Concerning the children during 2nd and 3rd quarter of the pregnancy, if the mother presents a primary education or secondary syphilis, it can be fulminant and result in the death of the newborn or change into syphilis latent and involve congenitally acquired malformations and after the birth.

Diagnostic methods

direct Examination under the microscope on black bottom: Easily identifiable Tréponème
Tracking by a blood test (syphilitic serologies)

Treatment

It is the parenteral Pénicilline which represents the treatment of choice of syphilis at all its stages. However for early syphilis (firstly-secondary), WHO advises this protocol: injection will intra some muscular of benzathine penicillin (extencilline), in the event of allergy the cyclines can be justified except for the children and the expectant mothers. For syphilis late, the extencilline is recommended, it should be noted that the cyclines or the érythromycine can replace them in the event of allergy. For a neurosyphilis, syphilis at one immunodéprimé (AIDS) penicillin G into intravenous is recommended. In the event of diagnosis of syphilis, it is important that partners of the patient (contemporary (S) or old (S)) are dealt with by doctor so that a tracking are made and that they are treated if they are positive.

Famous cases of infection

1491 Henri VIII of England and five of its wives
1523 Ulrich von Hutten
1537 Edouard VI of England wire of Henri VIII
1606 William Davenant
1797 Franz Schubert
1818 Mary Todd Lincoln
1810 Robert Schumann
1821 Charles Baudelaire
1849 Randolph Churchill
1850 Guy of Maupassant
1853 Vincent Van Gogh
1862 Georges Feydeau
1862 Frederick Delius
1864 Henri of Toulouse-Lautrec
1866 Friedrich Wilhelm Nietzsche
1868 Scott Joplin
1870 Lénine
1872 Harry Nelson Pillsbury
1883 Benito Mussolini
1899 Al Capone
1909 Howard Hughes and a certain number of actresses whom he attended
1915 Karen Blixen
1932-1972 the patients of the study Tuskegee on syphilis

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