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Q: Syphilis ( Answered 4 out of 5 stars,   0 Comments )
Question  
Subject: Syphilis
Category: Health > Conditions and Diseases
Asked by: devoted-ga
List Price: $100.00
Posted: 23 Jun 2005 08:41 PDT
Expires: 23 Jul 2005 08:41 PDT
Question ID: 536307
If a non-syphilis-infected man receives oral sex from a
syphilis-infected person with syphilis sores present in their mouth,
it is likely that syphilis will be transmitted to the non-infected
person. However, can that non-infected person then transmit the
infection immediately to another person (ie within 24 hours) or is the
infection only transmitted through direct contact with the sores which
tend to develop within 1-12 weeks of initial infection. For the answer
to be yes, I presume the infection must be contained in semen as no
sores are present 24 hours after initial infection. However, the later
stages of syphilis (when the sores etc have cleared) is non-contagious
and I therefore assume that the infection is not contained in semen
and is therefore not capable of being transmitted immediately (or
within 24 hours of initial infection).
Answer  
Subject: Re: Syphilis
Answered By: crabcakes-ga on 23 Jun 2005 15:14 PDT
Rated:4 out of 5 stars
 
Hi devoted,

   According to eMedicine, studies in rabbits show the appearance of
the T. pallidum spirochetes (Causative bacteria of syphilis) can be
seen in the lymph tissue of rabbits as soon as 30 minutes after
exposure to the syphilis bacteria.

?Treponemes are highly invasive pathogens which often disseminate
relatively soon after inoculation. Evasion of host immune responses
appears to be, at least in part, due to the unique structure of the
treponemal outer membrane (i.e., its extremely low content of
surface-exposed proteins). Although treponemes lack classical
lipopolysaccharide (endotoxin), they possess abundant lipoproteins
which induce inflammatory processes.? (Treponemes are the bacterial
family to which T. pallidum belong)
http://gsbs.utmb.edu/microbook/ch036.htm

?Treponemes multiply by binary transverse fission. The in vivo
generation time is relatively long (30 hours).?
http://gsbs.utmb.edu/microbook/ch036.htm

  While the risk of acquiring syphilis may be reduced in your
scenario: ?However, can that non-infected person then transmit the
infection immediately to another person (ie within 24 hours) or is the
infection only transmitted through direct contact with the sores which
tend to develop within 1-12 weeks of initial infection.?, it *is*
possible. The organism can live in a moist environment. Without being
overly graphic, Person A, the one with oral sores, can transmit the
organism to Person B?s genitals, in the crevices, folds, foreskin, and
skin cells of the penis, or crevices and folds of the labia/vagina. If
Person B then has oral sex performed on him/her by Person C within a
short time (within 24 hours), Person C can acquire the infection from
organisms found on Person B.

   Don?t confuse incubation time with transmission time. Incubation
time is the estimated time before an infected person displays
symptoms. This does not mean this person is not contagious. Depending
on the pathogen involved? some diseases can be spread before symptoms
present. A blood test for syphilis in an infected person is unlikely
to be positive before the incubation period, as antibodies are
produced during this period. (A microscopic test can determine the
actual organism much sooner however)

?The incubation period is the time it takes for an infection to
develop after a person has been exposed to a disease-causing organism
(such as bacteria, viruses, or fungi). The incubation period ends when
the first signs or symptoms of the disease appear.?
http://my.webmd.com/hw/health_guide_atoz/sti150819.asp

?The incubation period of a disease is the period of time from when
the patient is exposed - the germ first invades the body - and when
the first manifestations (symptoms or signs) of the disease manifest
themselves.?
http://www.drhull.com/EncyMaster/I/incubation_period.html

?Contagion summary - syphillis: Sexually transmitted; only contagious
in the early stages. Also mother to fetus. Rare contagion from oozing
fluid exposure into broken skin. No longer contagious 24 hours after
beginning antibiotic therapy.?

Contagiousness properties of Syphilis: 
  Contagious overall?: Yes 
  Contagious by sex?: Yes 
  Contagious by anal sex?: Yes 
  Contagious by vaginal sex?: Yes 
  Contagious by physical contact (non-sexual)?: Yes, rarely. 
  Contagious from mother to fetus (transplacental)?: Yes
http://www.wrongdiagnosis.com/s/syphilis/contagious.htm


?Secondary syphilis is the second stage of the sexually transmitted
disease syphilis. This stage is the most contagious of all stages and
is characterized by the spread of the bacteria which causes syphilis
throughout the body.? ?Approximately one-third of untreated
individuals with primary syphilis will progress to the second stage:
secondary syphilis. This usually occurs at about 2 to 8 weeks after
the appearance of the original painless sore (chancre) and in some
cases the chancre may still be present.

In secondary syphilis, the bacteria have spread in the bloodstream and
have reached their highest numbers. The most common symptoms include
skin rash, which can be varied in appearance, yet frequently involves
the palms and soles, in addition to lesions in the mouth, vagina or
penis, called mucous patches. Other lesions that can appear are moist,
warty patches on the genitalia or skin folds called condylomata lata.

During secondary syphilis, additional symptoms such as fever, malaise,
loss of appetite, and swollen lymph nodes may also be noted. This
stage is the most contagious stage of syphilis. While it usually
resolves within weeks, in some cases it may last up to a year.?
http://www.drugs.com/enc/syphilis___secondary.html

   
?Transmission occurs by penetration of the spirochetes through mucosal
membranes and abrasions on epithelial surfaces. Incubation time from
exposure to development of primary lesions averages 3 weeks but can
range from 10-90 days. Lesions develop at the primary site of
inoculation. Pathologically, the primary lesion of syphilis is a focal
endarteritis and periarteritis. Rabbit studies show that spirochetes
can be found in the lymphatic system as early as 30 minutes after
primary inoculation, suggesting that syphilis is a systemic disease
from the outset.?
http://www.emedicine.com/med/topic2224.htm



Page 2 of a Communicable Disease report from Northern Ireland document
states that syphilis can be transmitted immediately to 90 days after
exposure.
http://www.cdscni.org.uk/publications/MonthlyReports/Volume_10_2001/No_9.pdf

?An infected person who has not been treated may infect others during
the first two stages, which usually last 1 to 2 years. In its late
stages, untreated syphilis, although not contagious, can cause serious
heart abnormalities, mental disorders, blindness, other neurologic
problems, and death.?
http://pediatrics.about.com/od/stds/a/04_syphilis.htm

?Although viral STI pathogens and Treponema pallidum ? the causative
agent of syphilis ? may be detected in semen, their presence may be
more sensitively detected through antibody testing of the donor.?
http://www.pulsus.com/INFDIS/16_02/peel_ed.htm

"The existing evidence shows that oral sex is a lower risk activity
than penetrative vaginal or anal intercourse. However, low risk is not
the same as no risk, and a variety of infections, including HIV, can
be transmitted in this way." " There is a risk of transmission of
syphilis by oro-genital sex, although it is difficult to quantify.
Certainly, men and women may develop syphilitic mouth ulcers, or
chancres, which shed the bacterium that causes syphilis, Treponema
pallidum."

"Diseases that can be transmitted by direct contact are called
contagious (contagious is not the same as infectious; although all
contagious diseases are infectious, not all infectious diseases are
contagious). These diseases can also be transmitted by sharing a towel
(where the towel is rubbed vigorously on both bodies) or items of
clothing in close contact with the body (socks, for example) if they
are not washed thoroughly between uses. For this reason, contagious
diseases often break out in schools, where towels are shared and
personal items of clothing accidentally swapped in the changing rooms.
?Syphilis is a sexually transmitted disease that appeared suddenly in
the 1400s. Syphilis is caused by a bacteria called Treponema pallidum.
The bacteria like the warm moist linings of the genital passages, the
rectum and mouth, but dies quickly outside the body. Syphilis has an
incubation period of between 9 days and 3 months. Syphilis is almost
always a result of unprotected sex with an infected person.?
http://menshealth.about.com/od/sexualdiseasesstds/a/syphilis.htm


"Syphilis is a curable STI is caused by the bacterium "Treponema
pallidum." Syphilis, which is transmitted through direct contact with
a lesion on an infected partner, can and will progress through at
least four stages if left untreated. The symptoms determine the stage
of the syphilis infection. The stages are primary, secondary, latent,
and late syphilis. The symptoms of primary syphilis occur between 10
days to three months after infection. The first symptom is usually a
painless ulcer, called a chancre, which occurs at the infection site.
It is very easy not to notice the first lesion, especially if it is in
the vagina or on the cervix. If left untreated, the lesion usually
disappears after a few weeks. This does not mean that the syphilis has
disappeared."

"During both primary and secondary phases, the infected person is
highly infectious to partners. The symptoms of secondary syphilis are
so common that they can be mistaken for other medical conditions, for
example, flu or an allergic reaction."

" Anyone with latent syphilis can live many years without experiencing
any more symptoms and the only way to detect that he/she is infected
with syphilis is through a blood test."

" Not having sex at all is the only 100 percent effective, foolproof
method of preventing pregnancy and sexually transmitted infections.
Latex condoms, when used consistently and correctly, can reduce the
risk of syphilis only when the infected area is covered or protected
by a condom."
http://www.mysistahs.org/health/STI/description.htm#syphilis

?Communicability exists when moist mucocutaneous lesions of primary
and secondary syphilis are present. However, the distinction between
the infectious primary and secondary stages and the noninfectious
early latent stage of syphilis is somewhat arbitrary with regard to
communicability, since primary and secondary stage lesions may not be
apparent to the infected individual. The lesions of secondary syphilis
may recur with decreasing frequency up to four years after infection.
However, transmission of infection is rare after the first year.
Consequently, in the United States infectious early syphilis is
usually defined as ending after the first year of infection.?
http://www.doh.wa.gov/notify/guidelines/syphilis.htm

?The primary stage is manifested by a sore that may ulcerate.  It is
called a chancre (but is not the same as the chancre of
"chancroid".)The sore may be present on the genitalia, anus, lips etc.
Unfortunately in about 50% of females and 30% of males this primary
lesion of early syphilis is not apparent.? Note that many people do
not get lesions!
http://www.fazeteen.com/health/articles/std.htm#syphilis

?Unlike both gonorrhea and chlamydia, syphilis can be transmitted
through both contact with syphilitic lesions (including hand to
genital) as well as with vaginal and anal sex.  It is estimated that
80,000 people are infected with syphilis each year. However, the
actual number of cases may be higher.?
http://www.vpul.upenn.edu/shs/whsti.html#Syphilis


"A number of pathogens have been detected in semen (6-16) and are
capable of being transmitted through semen used in assisted conception
(17-22), whether by insemination or in vitro fertilization (IVF). The
attached table lists some of these pathogens and summarize some
relevant information for each of them."
(Scroll down to see chart)
Re; Treponema pallidum (Syphllis)
"Acquisition from an infected partner during infectious phase
estimated at 30 to 60%."
http://www.hc-sc.gc.ca/english/media/releases/1999/9990ebk2.htm



?Infection may occur without a clinically evident chancre; i.e., it
may be in the rectum or on the cervix? and ?By direct contact with
infectious exudates from obvious or concealed, moist, early lesions of
skin and mucous membranes of infected people during sexual contact;
exposure nearly always occurs during sexual intercourse. Transmission
by kissing or fondling children with early congenital disease occurs
rarely. Transplacental infection of the fetus occurs during the
pregnancy of an infected woman.?
http://www.doh.wa.gov/notify/guidelines/syphilis.htm


During the past 50 years, transfusion-transmitted syphilis has become
extremely rare because of improved donor selection processes,
universal serologic screening, and the shift from fresh blood
components to transfusion of refrigerated products.  Only 3 cases of
transfusion-related syphilis have been reported in the English
literature in the last 35 years. Infection by contact with
contaminated articles may be theoretically possible but is
extraordinarily rare. Health professionals who neglected to wear
protective gloves have developed primary lesions on the hands
following clinical examination of infectious lesions.
http://www.doh.wa.gov/notify/guidelines/syphilis.htm


From the makers of Trojan condoms:
" You can give Syphilis to your sexual partner. The organism that
causes syphilis can be killed with antibiotics. A mother with Syphilis
can give it to her baby at childbirth. When untreated, Syphilis can
cause heart disease, brain damage, blindness and/or death. If caught
early, you may not experience any health problems associated with this
diseases."
http://www.trojancondoms.com/info_center/std101/#6

"Syphilis testing detects current or past infection with the organism
Treponema pallidum that causes syphilis. Individuals with this
infection may have many different symptoms often starting with skin
lesions. This infection can be transmitted to a fetus and result in
stillbirth or a child with a congenital infection."
http://www.fairfaxcryobank.com/cryo/infectious_disease.cfm

?Syphilis results in the formation of lesions throughout the body. The
bacteria usually enter the body during sexual intercourse, through the
mucosal membranes of the vagina or urethra, but may rarely be
transmitted through scar wound or scratches?

?Hence, the disease is passed on through infectious blood, mucosal or
sexual contact. T. pallidum tends to invade the interstitial spaces of
tissue at the site of infection and to move rapidly to other
locations. Both of these activities are aided by the active,
"cork-screw" motility of T. pallidium, which allows it to bore its way
through tissues. Following inoculation, T. pallidium penetrates intact
mucous membranes or broken skin, begins to divide slowly and
disseminates.?

?Syphilis has the properties of an invasive disease. In the early
stages, large numbers of organisms accumulate at sites of infection,
and millions of treponemes move throughout the body. Most of the
tissue damage appears to be primarily due to the continuing immune
response.?

?The spirochetes are able to swim in viscous environments (e.g. oral
cavity, intestinal tract), but are only able to spin in water due to
the lack of friction. Any contact with air, antiseptics, or sunlight
will kill the microbe. T. pallidum requires the presence of tissue
culture cells, a microaerobic environment and serum components for
growth. Its fastidious nature may account for its obligate parasitism
and rapid death outside the host. If kept outside of the body in a
moist dark place it will live no more than two hours. This
microorganism is responsible for natural disease in humans only,
although rabbits can be infected experimentally. T. pallidum cannot be
grown in cell free cultures. Limited growth has been achieved in
cultured rabbit epithelial cells, but replication is slow (doubling
time, 30 hours) and can be maintained for only a few generations.?
http://www.bact.wisc.edu/Bact330/lecturesyphilis

Page 18 of this .pdf document states:
?Direct contact with infectious exudates, body fluids and secretions
of infected persons during sexual contact. Congenital infection occurs
through placental transfer or at delivery.?

Infectious period:
Mostly during primary and secondary stages. Congenital transmission
does not occur before the 4th month, and is most probable during early
maternal syphilis. Penicillin therapy usually ends infectivity within
24 to 48 hrs.?
http://203.147.140.236/phs/Documents/cdu/13954.pdf





"MODE OF TRANSMISSION: By direct contact with skin lesions, mucous
membranes, body fluids and secretions (semen, vaginal discharge,
saliva, blood) of infected persons during sexual contact; rarely by
kissing, blood transfusion; congenital transmission is possible"
http://www.phac-aspc.gc.ca/msds-ftss/msds154e.html

Direct Contact spread of transmissable diseases: 
Some diseases that are transmissible by direct contact include:
  Quick Facts about: Syphilis
A common venereal disease caused by the Treponema pallidum spirochete;
symptoms change through progressive stages; can be congenital
(transmitted through the placenta)Syphilis (on rare occasions, if an
uninfected person touches a Quick Facts about: chancre
A small hard painless nodule at the site of entry of a pathogen (as
syphilis) chancre)
http://www.absoluteastronomy.com/encyclopedia/T/Tr/Transmission_(medicine).htm

?Syphilis is a venereal disease that can also be acquired by exposure
to infected blood. The organism can cross the placenta and infect the
unborn child.?
http://www.emedicine.com/med/topic2224.htm


Because of copyright laws, I can only post small snippets of this study:
?--Oral syphilitic lesions disrupt the protective epithelial barrier
and recruit HIV target cells, increasing the risk for HIV transmission
(5). Although oral sex might carry a lower risk for transmitting HIV
than other forms of sex, repeated unprotected exposures, especially in
the presence of syphilitic lesions, represent a substantial risk for
HIV transmission. Syphilis might also increase progression of HIV
disease

--Some men who engaged in only oral sex believed that they were
practicing safe sex and were surprised when they received a syphilis
diagnosis. These data underscore the need for educating sexually
active persons regarding the risk for syphilis transmission through
oral sex.?

??some MSM (Men who have sex with men) reported they had engaged in
only oral sex and were surprised to have acquired syphilis. In
response, CDPH began collecting information on oral sex from persons
with syphilis. To assess the role of oral sex in the transmission of
P&S syphilis in Chicago, CDPH analyzed surveillance data and interview
responses. This report summarizes the results of these analyses, which
suggested that a substantial proportion (13.7%) of syphilis cases were
attributed to oral sex, particularly among MSM.?

??During the period of syphilis acquisition among the 325 MSM, oral
sex was the only sexual exposure reported by 18 (22.7%) of 79 with
primary syphilis, 48 (19.5%) of 246 with secondary syphilis, 36
(21.6%) of 167 with HIV infection, nine (19.6%) of 46 without HIV
infection, and 21 (18.7%) of 112 with unknown HIV status. Thirty-three
(17.2%) of 192 non-Hispanic white MSM, 16 (30.2%) of 53 Hispanic MSM,
and 14 (19.4%) of 72 non-Hispanic black MSM reported having only oral
sex during the period in which they likely acquired syphilis. When
compared with heterosexual men and women, respectively, MSM were 3.8
and 3.4 times more likely to report only oral sex during the period of
syphilis acquisition.?
?The findings in this report are subject to at least one limitation.
The data might underestimate the role of oral sex in syphilis
transmission because most persons who reported engaging in anal and
vaginal sex also reported engaging in oral sex. Transmission was
attributed to oral sex in only the 14% of cases in which oral sex was
the only sexual exposure reported during the interval when syphilis
likely was acquired.

Some men who engaged in only oral sex believed that they were
practicing safe sex and were surprised when they received a syphilis
diagnosis. These data underscore the need for educating sexually
active persons regarding the risk for syphilis transmission through
oral sex. That syphilis might hasten the progression of HIV disease
should provide a further motivation for MSM, especially HIV-infected
MSM, to avoid syphilis acquisition. Persons who are not in a long-term
monogamous relationship and who engage in oral sex should use barrier
protection (e.g., male condoms or other barrier methods) to reduce the
risk for STD and HIV transmission.?
http://www.hivdent.org/oralm/oralmTPSS102004.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5341a2.htm

http://www.thebody.com/cdc/syphilis_oral.html


?The apparent increase in orogenital sexual activity has resulted in
an increase in primary oral lesions. Although the lesion formed at the
site of Treponema pallidum entry may develop on the tongue, tonsils,
hard and soft palate and buccal mucosa, the lips are the predominant
sites. This lesion, called chancre, is characterized by the presence
of a chronic painless encrusted ulcer, that heals spontaneously after
some weeks and is highly infective. Maculopapular lesions and ulcers
covered by mucous membranes are the most observed oral manifestation
of secondary syphilis (Mani, 1982). The histopathological findings of
primary and secondary syphilis lesions consist of a lymphohistiocytic
infiltrate containing a variable proportion of plasma cells and
proliferative endarteritis. In these stages of disease, the
spirochetes in tissue can be easily detected by traditional silver
stains, immunofluorescence, immunoperoxidase method using monoclonal
antibodies against Treponema pallidum or electron microscopy
(Jeerapaet and Ackerman, 1973).?
http://www.bacteriamuseum.org/species/Tpallidum.shtml

?All identified sexual contacts of patients with infectious syphilis
should be thoroughly evaluated.5,6,17 Even if no sign or serologic
evidence of active disease is found, contacts of patients with
primary, secondary or early-latent disease should receive prompt
treatment for primary syphilis, without waiting for clinical
manifestations or positive serologic test results. Patients who have
had syphilis of unknown duration and who have high (greater than 1:32)
nontreponemal serologic test titers are considered to be infected with
early syphilis.?
http://www.aafp.org/afp/990415ap/2233.html

?Mechanisms of T. pallidum pathogenesis are poorly understood. No
known virulence factors have been identified, and the outer membrane
is mostly lipid with a paucity of proteins.?
http://www.tigr.org/tdb/CMR/gtp/htmls/Background.html


?Yes - other STIs are also transmitted by oral sex. Indeed, the risk
of acquiring gonorrhoea or syphilis by oral sex is considered to be
much higher than for HIV. This is because gonorrhoea and syphilis are
much more easily transmitted than HIV, however unlike HIV they can
both be treated relatively easily with antibiotics.
Gonorrhoea is becoming more common, and though syphilis is rarer than
either gonorrhoea or HIV, it can also be transmitted orally. Indeed,
oral sex has been a
major "driver" in a syphilis outbreak in Manchester of late.?
?Good oral hygiene will to some extent help in the prevention of
transmission. However brushing or the use of dental floss shortly
before oral sex may increase the risk of HIV transmission especially
if gums bleed. The presence of sores or other infections in the mouth,
or recent dental surgery, will also increase the risk of HIV
transmission. The use of mouth wash in the period prior to or shortly
after oral sex is not recommended as it removes protective substances
that are found in saliva and may increase risk of transmission.?
http://www.tht.org.uk/gaymen/oral_sex/faq02.htm

?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.?
http://www.medicinenet.com/script/main/art.asp?articlekey=10688


?Syphilis in the oral cavity may be asymptomatic, or the lesions may
be mistaken for aphthous ulcers or herpes, the authors point out.
Lesions may carry high concentrations of Treponema pallidum and are
thus highly infectious. By disrupting the protective epithelial
barrier, oral lesions may increase the risk of HIV infection.?
http://www.hivandhepatitis.com/health/102204.html




"Syphilis remains infectious for a period of up to two years, possibly
longer. Transmission of infection depends on the existence of
infectious lesions (sores), which may or may not be visible. No
natural immunity to syphilis develops and past infection offers no
protection to future exposure. "
http://www-micro.msb.le.ac.uk/video/Tpallidum.html

"Syphilis is usually transmitted by sexual contact. In heterosexual
man, the organisms are present in lesions of the penis or discharged
from deeper genitourinary sites along with seminal fluid. In women,
the infectious lesions are most commonly located in the perineal
region or the labia, vaginal wall, or cervix. Homosexual men account
for a large proportion of early syphilis cases in many cities; the
infectious lesions in these individuals occur in or around the rectum.
Primary infection may also occur in the mouth or other areas."

"Congenital syphilis ? T. pallidum readily crosses the placenta."
http://virology-online.com/Bacteria/Spirochaetes.htm

"Syphilis is spread directly from person to person by direct contact
with an infectious lesion. That contact can be genital intercourse,
oral intercourse, or anal intercourse. The bacteria pass through
intact mucous membranes and abraded skin; they are then carried by the
blood stream to every organ in the body. Babies can also get syphilis
from their mothers if the mothers are infected during pregnancy."

Something to note: "If I have syphilis, can I have other STDs as well?
It is possible to have more than one STD at a time. Different STDs are
spread in the same manner through sexual contact (oral, anal, vaginal
and penile). In addition, an infection with syphilis can increase your
chances of acquiring HIV infection. It is important to visit your
doctor's office or clinic to be examined and tested for STDs as soon
as you notice any unusual signs or symptoms or are aware of sexual
exposure to someone with an STD."
http://dhfs.wisconsin.gov/communicable/Communicable/factsheets/PDFfactsheets/Syphilis6.pdf

?Lesion (Chancre): The organism cannot enter through intact skin, but
does enter through the mucous membranes or breaks in the epithelium.
The chancre is seen at the site of entry, usually occurs singly, and
represents the entry of Treponema. Multiple chancres occur if more
than one organism enters. The chancre lesions contain the Treponeme.
In its typical presentation the chancre presents as a clean, painless,
indurated ulcer. However, there may be several variations in
presentation. Common sites for the lesions include genitalia, rectum,
urethra and mouth.?
http://edcenter.med.cornell.edu/Pathophysiology_Cases/STDs/STD_06.html

?The syphilis bacterium is very fragile, and the infection is almost
always transmitted by sexual contact with an infected person. The
bacterium spreads from the initial ulcer (sore) of an infected person
to the skin or mucous membranes (linings) of the genital area, mouth,
or anus of an uninfected sexual partner. It also can pass through
broken skin on other parts of the body.? (Graphic pictures)

?The initial infection causes an ulcer at the site of infection. The
bacteria, however, move throughout the body, damaging many organs over
time. Medical experts describe the course of the disease by dividing
it into four stages-primary, secondary, latent, and tertiary (late).
An infected person who has not been treated may infect others during
the first two stages, which usually last 1 to 2 years. In its late
stages, untreated syphilis, although not contagious, can cause serious
heart abnormalities, mental disorders, blindness, other neurologic
problems, and death.?
http://www.doereport.com/displaymonograph.php?MID=87

?Transmitted by giving or receiving anal sex, oral sex and arse play
with an infected person. A person can easily pass the disease to sex
partners when first or second stage signs or symptoms are present.?
http://www.aidsaction.org.au/content/hiv_sti_health/sti_guide.php


?The increased incidence of syphilis in recent years is associated
with drug abuse as well as changes in sexual behavior. The connections
between drug abuse and syphilis include needle sharing and exchanging
sex for drugs. In addition, people using drugs are more likely to
engage in risky sexual practices. With respect to changing patterns of
conduct, a sharp increase in the number of people having sex with
multiple partners makes it more difficult for public health doctors to
trace the contacts of infected persons.?
http://www.chclibrary.org/micromed/00067190.html


Additional Information:

http://www.hmc.psu.edu/healthinfo/articles/sexuality/blooddisease.pdf

Not particularly relevant to your question, this article on the
history of syphyllis is quite interesting:
http://homepages.primex.co.uk/~lesleyah/grtscrge.htm

Rather graphic terms are used on this site to explain transmission modes:
http://www.actoronto.org/website/home.nsf/pages/lookwhatsback

?High-risk sexual activity puts you at risk of syphilis and other
sexually transmitted diseases (STDs). Men who have unprotected sex
with other men are at special risk. Syphilis incidence since 2000 has
increased only among men, and about half the men recently diagnosed
with syphilis are also infected with the human immunodeficiency virus
(HIV).
Anyone who has unprotected sex is at risk of contracting syphilis.
Even if you've had syphilis and been treated for it previously, you
can contract it again.?
http://www.cnn.com/HEALTH/library/DS/00374.html



To summarize, the risk is low in your scenario, but not non-existent.
As you read in the answer, the secondary phase of syphilis is the most
contagious phase. This is not to say other stages are not contagious. 
I found no actual studies giving the transmission speeds of T.
pallidum, but as seen on some of the sites I have posted, the organism
appears within 30 minutes in lymph nodes of rabbits. The bacteria CAN
be found in semen, and one does not have to have open sores in order
to transmit syphilis. Open sores certainly make it easier to transmit
the bug, but it is not the only criteria for spreading the organism.
Since reproduction time for the T. pallidum bacteria is very slow, up
to 30 hours, one would receive a very small innoculum from sex with a
freshly infected person.

However:

As you have read, abstinence is the ONLY sure way to avoid an infection.  



If you are asking this question, because of your own possible
exposure, I urge you to see a doctor. Since these days syphilis and
HIV seem to like traveling together, I would want you to be checked
and tested for both diseases as soon as possible.

Please do not rate this answer if any part of this answer is unclear,
or if I have repeated information you already had.  Simply ask for an
Answer Clarification, before rating, and I will be happy to clarify
any part of this question.

Sincerely, Crabcakes


Search Terms
============
mode transmission + treponema pallidum
treponema pallidum transmission semen
treponema pallidum infectivity
treponema pallidum + semen
group sex + transmission syphilis
multiple partners transmission T.pallidum
rapid  transmission syphilis
syphilis transmission immediate

Request for Answer Clarification by devoted-ga on 24 Jun 2005 08:29 PDT
Thank you for the answer which I am very pleased with. If you have
time, please confirm where you obtained the following paragraph from
as it appears to be written in your own words with no reference...many
thanks...

While the risk of acquiring syphilis may be reduced in your
scenario: ?However, can that non-infected person then transmit the
infection immediately to another person (ie within 24 hours) or is the
infection only transmitted through direct contact with the sores which
tend to develop within 1-12 weeks of initial infection.?, it *is*
possible. The organism can live in a moist environment. Without being
overly graphic, Person A, the one with oral sores, can transmit the
organism to Person B?s genitals, in the crevices, folds, foreskin, and
skin cells of the penis, or crevices and folds of the labia/vagina. If
Person B then has oral sex performed on him/her by Person C within a
short time (within 24 hours), Person C can acquire the infection from
organisms found on Person B.

Clarification of Answer by crabcakes-ga on 24 Jun 2005 09:21 PDT
Hi again devoted,

   You're right, the paragraph you quote in the clarification, begins
with me quoting *your* scenario. Then I elaborated, using Person A,
and so on, to better explain the transmission pathway. Those are my
own words, and therfore, no citation  of references.

   I'll look around and see if I can find an illustration of this scenario for you.

   By the way, researchers often answer questions using their own
knowledge and professional experience, but always cite references when
quoting other's material.

  I'll post some examples as soon as possible.  :-)

  regards, Crabcakes

Clarification of Answer by crabcakes-ga on 24 Jun 2005 10:42 PDT
Here is some more information for you!

?The disease is caused by bacteria which nestle in the mucous membrane
of the mouth, vagina, penis or anus. Later the bacteria can enter the
bloodstream and spread throughout the body.? ***Graphic images on this
page.
http://www.nvsh.nl/Website_Engels/Texts/Sexual_Information/Safesex/GI_5.htm

?t can also pass through broken skin on other parts of the body. The
syphilis bacterium is very fragile and is rarely, if ever, spread by
contact with objects such as toilet seats or towels?
http://permanent.access.gpo.gov/websites/www.4woman.gov/faq/syphilis.htm



I explained in the original answer that I found little information on
the timing of transmission from person to person. My scenario is
allegorical in nature, to portray the possible transmission of
syphillis. Note that many reliable web sites state that one can?t
contract syphilis trough a damp towel or a toilet seat. Yet other
sites indicate that while it is rare, it can happen.

This is why I attempted to explain that while the risk is low in the
situation you described, it is possible to become infected. The
T.pallidum bacteria survives in a warm moist location (mouth,
genitals) and makes itself at home by boring into the mucous
membranes.

No one knows with certitude the incidence and speed of syphilis
transmission in the scenario you described, only it is possible. Err
on the side of caution.

?The primary mode of transmission is by sexual contact, and the next
most common is transfer across the placenta (324). Kissing, blood
transfusion, and accidental inoculation have also been reported as
routes of transmission but are of minor importance today?
http://cmr.asm.org/cgi/content/full/12/2/187#SEC2_1

?Anyone who comes into close physical contact with a person who has
syphilis can develop syphilis. You don't have to have sexual
intercourse to get syphilis?exposure can result from close contact
with an infected person's genitals, mouth, or rectum.?
http://babies.sutterhealth.org/health/healthinfo/index.cfm?section=healthinfo&page=article&sgml_id=hw195071

?In acquired syphilis, T. pallidum enters through the mucous membranes
or skin, reaches the regional lymph nodes within hours, and rapidly
disseminates throughout the body. In all stages of disease,
perivascular infiltration of lymphocytes, plasma cells, and, later,
fibroblasts causes swelling and proliferation of the endothelium of
the smaller blood vessels, leading to endarteritis obliterans.?
http://www.merck.com/mrkshared/mmanual/section13/chapter164/164d.jsp

The following (unusual and non-medical) site describes an unlikely,
but possible way bacteria spread
http://ethnikoi.org/aidsscare.html

This illustration depicts the spread of organisms, from person to person
http://www.motivate.maths.org/conferences/conf45/Images/R=2(4).jpg

Again, if you have concerns for your own heath, or that of a partner,
please consult with your doctor about getting tested.

I hope this has helped. Feel free to request additional clarification, if needed. 

Regards, Crabcakes
devoted-ga rated this answer:4 out of 5 stars
Great answer - I will definitely use again!

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