The word evokes evils of other times: la syphilis it is a sexually transmitted disease that in the past has claimed many excellent victims, from Charles VIII to Paul Gauguin, but in recent decades it has disappeared from the radar because thanks to the advent of the antibiotic penicillin, very effective in treating it, it was thought to be a problem to be relegated to oblivion or at most limited to low-income countries. Wrong: data from the European Center for Disease Prevention and Control show that in recent years there has been an upward trend in the number of patients both in Europe and in Italy.
«In our country, over 1,500 new cases are reported per year and it is hypothesized that there will be at least as many hidden cases», confirms Niccolò Gori, dermatologist at the Irccs Foundation Policlinico Universitario Gemelli in Rome and member of the Italian Society of Dermatology and Sexually Transmitted Diseases (SIDeMaST). .
Less protection during sexual intercourse
«Syphilis is the third most common venereal disease after chlamydia and gonorrhea, which have also been growing in the last two decades due to a progressive trend towards less protection during sexual intercourse. Today there is no longer the great fear of the 80s for HIV because that infection can also be cured and made chronic, so people underestimate the risks of unprotected relationships; in addition, the use of alcohol and drugs during sexual intercourse has increased, the so-called “chemsex”, which reduces the ability to control and can lead to less protection. People with many sexual partners and homosexuals are especially at risk, because the type of intercourse can lead to greater blood loss and encourage contagion. However, the correct use of a condom would avoid this and other sexually transmitted diseases.” The result of the limited use of condoms is a slight but constant increase in syphilis, nine times more frequent among men than women and more common in the age group between 25 and 34 years.
How the disease presents
If primary prevention has failed and the disease has been contracted, however, by recognizing it early it can be treated very effectively, as Gori explains: «The classic presentation of primary syphilis, which manifests itself 10 to 90 days after infection, is an ulcer with hard edges, not painful, at the point where you came into contact with the pathogen (the Treponema pallidum bacterium, ed.); sometimes the lymph nodes in the area are swollen and in many cases there is spontaneous regression within a few weeks.
«Secondary syphilis typically presents with a skin rash with itchy red spots, malaise, weakness and fever that appear six to eight weeks after infection and can last up to two years, with a chronic-relapsing pattern in which the symptoms evident alternating with periods of well-being. In these first two phases of syphilis, an intravenous dose of penicillin is enough to definitively resolve the problem: today syphilis can be cured, but it must be recognised”, underlines the dermatologist.
«Sometimes it doesn’t happen because the symptoms do not appear and the disease remains latent to manifest itself only as tertiary syphilis, more serious: it affects 20-30 percent of patients and causes damage to the nervous system, liver, spleen, cardiovascular disease with even serious consequences. Sometimes, however, patients do not pay attention to the signs and symptoms of the first two phases, they do not think it could be syphilis: even today, serious cases are not so uncommon because the disease has been neglected and undiagnosed. Doing so is also very important because syphilis is a risk factor for HIV and goes hand in hand with many other sexually transmitted diseases: protecting yourself during sexual intercourse is the best weapon to keep them all away”, concludes Gori.
The diatribe on origins
Where did the “French disease” come from, as syphilis was called in Italy (but in France they called it the “Neapolitan disease”)? Even today, experts have not agreed on the origin of this disease which was described for the first time by the Venetian military doctor Marcello Cumano in 1495. According to some, the Christopher Columbus hypothesis is true, according to which the bacterium it arrived in the Old Continent “following” the navigator’s sailors, others believe it arrived with the African slaves brought by Spanish and Portuguese colonizers. Regardless of the “vectors”, at the end of the 15th century the disease was already in Europe and after naming it syphilis (this is what Girolamo Fracastoro, doctor and philosopher friend of Nicolaus Copernicus called it), its sexual origin was recognized almost immediately: this it made the methods of contrast a mix between very varied medical interventions and laws that tried to prevent its spread by focusing on the “sinful” nature of evil such as the closure or confinement of brothels in the 16th century.
To find out if it has been contracted, a blood test is enough
To diagnose syphilis, a blood test is sufficient in which two specific types of tests are performed, which are also useful for distinguishing between the different phases of the disease, which do not always have a standard trend. The andrologist Fabio Leva of the Santagostino Institute in Milan specifies that «when you have occasional relationships with different partners it is important to regularly undergo complete screening for sexually transmitted diseases, including syphilis which is also transmitted through oral intercourse which often they are not protected.”
Syphilis can be easily treated in the first two phases, but there is not yet a preventive vaccine: «Its development has so far been hindered by the difficulty of growing the bacterium that causes the disease in vitro, but today some problems have been overcome and furthermore thanks to new technologies it is possible to obtain the complete genome sequence starting from samples taken from patients”, concludes Leva.
2023-12-08 07:20:32
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