Houston, we have an STI problem: Syphilis cases among women have spiked 130% since 2019 - these are the five bizarre signs to look out for
By Jessica Hamilton
Daily Mail
July 18, 2023
Syphilis is often known as 'the great pretender' as the disease has overlapping symptoms with several other STDs, which can lead to health professionals overlooking symptoms entirely. Here are five warning signs of the disease to look out for
An outbreak of syphilis has been declared in Houston after cases in women more than doubled since 2019.
Official data showed a 128 percent rise in cases detected in the group in America's fourth-largest city, up from 295 cases in 2019 to 674 last year.
For congenital syphilis or infections in unborn infants, cases have risen nine-fold in the city since 2016 to about 150 per year.
Health officials are concerned because the disease can cause damage to the internal organs of developing babies, leading to their death or leaving them with serious disabilities.
Dr Foye Ikyaator, the medical director for Life Savers Emergency Room in Houston, warned many Texans not to believe that the sexually transmitted disease (STI) had largely been eradicated.
She told FOX26: 'We've gotten to the point where we think it's eradicated. I talk to people all the time who say, "Is that still going on?". Well, yeah, it is.'
In its alert, the Houston Department of Health said cases of the disease in unborn children — congenital syphilis — had risen nine-fold since 2016.
There were 16 cases reported in 2016, they said, but by the year 2021, the latest available, the figure had hit 151 cases.
Overall, infections are up 57 percent in three years from 1,845 cases in 2019 to 2,905 in 2022.
Marlene Ward, the deputy assistant director for the department, said: 'It is crucial for pregnant women to seek prenatal care and syphilis testing to protect themselves from an infection that could result in the deaths of their babies.
'A pregnant woman needs to get tested for syphilis three times during pregnancy.'
In response to the declaration, the Department will waive all clinical fees for STI testing at its health centers across the city of 2.3million people. They are also rolling out more mobile STI/HIV testing clinics to help people get checked for the disease.
Nationwide, syphilis cases are also on the rise having ticked up 32 percent from 2020 to 2021 alone according to the latest data available.
Some 174,000 Americans are now diagnosed with the disease every year, including nearly 3,000 unborn children. South Dakota had the highest rate of syphilis cases nationwide in 2021, while at the time Texas ranked 25th.
It is not clear what is driving the trend, but experts say it may be linked to dropping condom use and the rise of online dating that can encourage more sexual encounters and riskier riskier sexual behavior.
The disease can be easily treated with antibiotics, with pregnant women tested for it three times during their pregnancy.
But if left untreated the disease can damage the internal organs in babies, leading to their death or leaving them with disabilities.
Below are the five warning signs of the infection to watch out for:
Multiple sores
Syphilis — most commonly spread through sex — is caused by a bacteria called Treponema pallidum.
The earliest warning sign is a concave sore, known as a chancre, in the mouth or genitals.
Many infected people only develop one sore, which is usually firm and painless.
Chancres typically occur three weeks after being exposed to the bacteria, at the spot where the bacteria entered the body.
Jeffrey Klausner, former director of STD Prevention and Control Services at the San Francisco Department of Health, told The Washington Post that 'people may not be very aware' of the tell-tale syphilis symptom.
Chancres can last six weeks and may disappear without treatment, but that doesn't mean you're in the clear.
Rash on the palms of your hands
If syphilis is left untreated, the disease can enter a second stage of infection.
Symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore. This usually consists of a rash.
Syphilis can lead to a rash, which often appears on the palm of your hands but could persist anywhere on the body, including the soles of your feet. It is usually non-itchy and could disappear without treatment
NHS describes the rash as 'a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet'.
The rash may be faint and hard to notice, and may even resemble rashes caused by other diseases, such as psoriasis and eczema, which means even doctors could overlook the signs.
Klausner said doctors can sometimes misdiagnose syphilis as a viral infection, which he said is because: 'There are fewer and fewer syphilis experts.'
Swollen glands
In the primary stage of infection, syphilis can also lead to 'enlarged lymph nodes in the area of the sore,' according to Penn Medicine.
The swollen glands can persist in the second stage, as the bacteria continues to grow.
Swollen glands are a sign the body is fighting an infection. They usually get better by themselves within two weeks, the NHS says.
Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.
Swollen glands can persist in the primary and secondary phases of infection as the bacteria continues to grow
Hair loss
While a less common symptom of syphilis, the disease can lead to hair loss.
The NHS says it can look like 'patchy hair loss on the head, beard and eyebrows'.
According to a 2013 study published in the National Institutes of Health, the frequency of hair loss in secondary syphilis only ranges from 2.9 to 7 percent.
This most common type of hair loss is a 'moth-eaten' pattern and is a non-scarring alopecia that can affect other areas of the scalp.
However, the hair loss is not lasting and, according to the study: 'The alopecia usually resolves within three months of appropriate treatment for syphilis.'
Hair loss is a less common symptom of syphilis and is usually not a lasting side effect =, when treated the hair may return
Flu-like symptoms
Another warning sign to look out for is flu-like symptoms, which can persist in the second stage of infection.
While these symptoms usually go away without treatment, if an infected person is never treated for syphilis, they could enter a third stage of the disease.
The 'latent stage' — when there are no visible signs or symptoms — can last years, according to the Centers for Disease Control and Prevention (CDC).
Tertiary syphilis can then occur up to 30 years after a person gets infected.
It can be fatal and may affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.
In the second stage of infection, flu-like symptoms may persist while this may go away without treatment if a person is never treated they could enter a third stage of infection and experience life-altering side effects
What are the other signs of syphilis?
At any stage of the infection, the disease can invade the nervous system (neurosyphilis), the visual system (ocular syphilis) and auditory and/ or vestibular system (ostosyphilis).
According to the CDCP, signs of neurosyphilis include:
- severe headache;
- trouble with muscle movements;
- muscle weakness or paralysis (not able to move certain parts of the body);
- numbness; and
- changes in mental status (trouble focusing, confusion, personality change) and/or dementia (problems with memory, thinking, and/or making decisions).
Signs of ocular syphilis can include:
- eye pain or redness;
- floating spots in the field of vision (“floaters”);
- sensitivity to light; and
- changes in vision (blurry vision or even blindness).
Signs and symptoms of ostosyphilis may include:
- hearing loss;
- ringing, buzzing, roaring, or hissing in the ears (“tinnitus”);
- balance difficulties; and
- dizziness or vertigo.
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