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The Rise of Syphilis

STDs are a substantial health challenge facing the United States that affect the blood supply. The CDC estimates that nearly 20 million new sexually transmitted infections occur every year, accounting for almost $16 billion in health care costs annually.1

Syphilis, a genital ulcerative sexually transmitted disease caused by the bacterium Treponema pallidum (a spirochete bacteria), can be fatal if left untreated and can facilitate the transmission and acquisition of HIV. Additionally, historical data demonstrates that untreated early syphilis in pregnant women, if acquired during the four years before delivery, can lead to infection of the fetus in up to 80% of cases and may result in stillbirth or death of the infant in up to 40% of cases.2 Left untreated, the effects of syphilis can span decades.

“During 2015–2016, the overall rate of reported P&S syphilis cases increased in all age groups among those aged 15 years or older. Rates increased 13.0% among those aged 15–19 years, 8.1% among those aged 20–24 years, 19.6% among those aged 25–29 years, 20.1% among those aged 30–34 years, 22.1% among those aged 35–39 years, 12.8% among those aged 40–44 years, 13.6% among those aged 45–54 years, 25.0% among those aged 55–64 years, and 50.0% among those aged 65 or older.”2

Everyday over 21,000 people receive blood products in some form.3 The U.S. blood system is dependent on donations to meet the demand for those blood products. Less than 38 percent of the U.S. population is eligible to donate blood and out of those, less than 10% donate each year.4 Every drop of donated blood is valuable to those who receive a transfusion or other blood product.

Because STDs are a threat to the nation’s blood supply, blood and cadaveric donations are tested. Treponema pallidum, the causative agent of syphilis, induces the production of at least two types of antibodies in the human body. The Anti-treponemal antibody can be detected by the FTA-ABS (Fluorescent Treponemal Antibody Absorption) test, and the anti-nontreponemal antibody (reagin) is detected by using the Rapid Plasma Reagin (RPR) test.

Arlington Scientific advocates the use of the RPR test (a nontreponemal test) that detects antibodies formed in response to damaged host cells for screening donors. The RPR test indicates if a person has an active infection. This test follows the CDC’s recommended traditional algorithm.5

Primary Stage:

Syphilis is transmitted by individuals in either the primary or secondary stage of the disease but often these people do not even realize that they are infected. In primary syphilis the initial sign of the disease is a sore known as a chancre, a firm round, small and painless sore which appears at the site where the organism entered the body. Untreated, the disease will progress to the secondary stage.

Secondary Stage:

This stage of the disease is characterized by a rash on one or several areas of the body. These rashes typically do not itch and can present while the initial chancre is healing or a few weeks after it has healed. The rashes typically appear on the palms of the hands and the bottom of the feet. These rashes range from difficult to see to rough, red or reddish-brown spots. The rash can have a different appearance on different parts of the body and often even resemble rashes characteristic of other disease states. Other symptoms that can begin during the secondary stage are swollen lymph nodes, sore throat, fever, head ache, weight loss, fatigue, and muscle aches. Untreated, the infection will progress to the latent stage.

Late and Latent Stages:

The patient moves into the latent stage when the primary and secondary stages have passed. This final stage of the disease can last for years with little or no observable signs and symptoms as late as 10 – 20 years following the initial infection. In this stage, signs and symptoms may include dementia, paralysis, numbness, blindness and difficulty coordinating movement. Internal organs including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints may be damaged. These complications can result in death.

How is Syphilis treated?

There are no home remedies or over-the-counter drugs that will cure syphilis. Syphilis however is easy to treat and cure in its early stages. A single injection of a long acting penicillin is sufficient to cure a person who has primary, secondary or early latent syphilis. Individuals diagnosed with late latent syphilis or latent syphilis of unknow duration may receive additional doses of penicillin at weekly intervals. The treatment of syphilis will kill the bacterium and prevent further damage; however, it will not repair or reverse damage already done. Patients allergic to penicillin can be treated with another antibiotic.6

Methodology:

The ASI® RPR (rapid plasma reagin) Card Test for syphilis is a qualitative and semiquantitative nontreponemal flocculation test for the detection of reagin (anti-nontreponemal antibody) antibodies in human serum and plasma as a screening test in syphilis serology. These materials are intended to be acquired, possessed and used only by health professionals.

1. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/STD-Trends-508.pdf

2. https://www.cdc.gov/std/stats16/Syphilis.htm

3. https://www.redcrossblood.org/promotions/midwest/its-national-blood-donor-month

4. www.redcrossblood.org/learn-about-blood/blood-facts-and-statistics

5. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6005a1.htm

6. https://www.cdc.gov/std/syphilis/treatment.htm

Rev. 04_2018 CR1593

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