Syphilis, Trichomoniasis, Hepatitis B and Gonorrhea
WebMD Medical Reference in collaboration with
Sexual Health:
Syphilis
Syphilis is a highly contagious disease spread primarily by sexual activity,
including oral and anal sex. Occasionally, the disease can be passed to
another person through prolonged kissing or close bodily contact with an
infected person. Although this disease is spread from sores, the vast
majority of these sores go unrecognized. The infected person is often
unaware of the disease and unknowingly passes it on to their sexual partner.
Pregnant women with the disease can spread it to their baby. This disease,
called congenital syphilis, can cause abnormalities or even death to the
child.
Syphilis cannot be spread by toilet seats, door knobs, swimming pools, hot
tubs, bath tubs, shared clothing or eating utensils.
What Causes Syphilis?
Syphilis is caused by the bacteria Treponema pallidum.
How Common Is Syphilis?
This sexually transmitted disease was once a major public health threat,
commonly causing serious long-term health problems such as arthritis, brain
damage, and blindness. It defied effective treatment until the late 1940s,
when the antibiotic penicillin was first developed.
According to the CDC, the rate of new cases of syphilis had plummeted in the
1990's and in the year 2000 it reached an all time low since reporting began
in 1941. However, since 2001 new cases are again on the rise.
How Does Someone Know If They Have Syphilis?
Syphilis infection occurs in 3 distinct stages:
EARLY or PRIMARY SYPHILIS. People with primary syphilis will develop one or
more chancre sores. The sores resemble large round bug bites and are often
hard and painless. They occur on the genitals or in or around the mouth
somewhere between 10-90 days (average 3 weeks) after exposure. Even without
treatment they heal without a scar within 6 weeks.
The SECONDARY STAGE may last 1-3 months and begins within 6 weeks to 6
months after exposure. People with secondary syphilis experience a
rosy "copper penny" rash typically on the palms of the hands and soles of
the feet. They may also experience moist warts in the groin, white patches
on the inside of the mouth, swollen lymph glands, fever, and weight loss.
Like primary syphilis, secondary syphilis will resolve without treatment.
Latent syphilis. This is where the infection lies dormant (inactive) without
causing symptoms.
TERTIARY SYPHILIS. If the infection isn't treated, it may then progress to a
stage characterized by severe problems with the heart, brain, and nerves
that can result in paralysis, blindness, dementia, deafness, impotence and
even death if it's not treated.
How Is Syphilis Diagnosed?
Syphilis can be easily diagnosed with a quick and inexpensive blood test
given at your doctor's office or at a public health clinic.
If you have a chancre, your doctor will take a swab or scraping of the sore.
It will then be sent to a lab to analyze under a microscope for the
characteristic bacteria.
How Is Syphilis Treated?
If you've been infected for less than a year, a single dose of penicillin is
usually enough to destroy the infection. For those allergic to penicillin,
tetracycline or doxycycline can be given instead. If you are in a later
stage of disease, more doses will be needed.
People who are being treated for syphilis must abstain from sexual contact
until the infection is completely gone. Sexual partners of people with
syphilis should be tested and, if necessary, treated.
What Happens If I Don't Get Treated?
If syphilis is left untreated, it can cause serious and permanent problems
such as dementia, blindness or death.
How Does Syphilis Affect a Pregnant Woman and Her Baby?
Depending on how long a pregnant woman has been infected, she has a good
chance of having a stillbirth (birth of an infant who has died prior to
delivery) or of giving birth to a baby who dies shortly after birth.
If not treated immediately, an infected baby may be born without symptoms
but could develop them within a few weeks. These signs and symptoms can be
very serious. Untreated babies may become developmentally delayed, have
seizures or die.
How Can I Prevent Infection?
To reduce your risk of infection:
Practice SEXUAL ABSTINENCE
Avoid intimate contact with a person you know is infected
If you do not know if a sexual partner is infected, use a condom in
every sexual encounter
What Is the Outlook for People With Syphilis?
Syphilis is a curable disease with prompt diagnosis and treatment. However,
if treated too late, there may be permanent damage to the heart and brain
even after the infection is destroyed.
Trichomoniasis
Trichomoniasis is a sexually transmitted disease caused by a small organism
called Trichomonas vaginalis. Women are most often affected by this disease,
although men can become infected and pass the infection on to their partners
through sexual contact.
How Common Is Trichomoniasis?
Trichomoniasis is the most common curable STD in young, sexually active
women. An estimated 7.4 million new cases occur each year in women and men
How Do I Know If I Have Trichomoniasis?
Many women do have signs or symptoms of infection. Symptoms in women can
include:
Greenish-yellow, frothy vaginal discharge with a strong odor
Painful urination
Vaginal itching and irritation
Discomfort during intercourse
Lower abdominal pain (rare)
Symptoms usually appear within five to 28 days of exposure in women.
How Is Trichomoniasis Diagnosed?
To diagnose trichomoniasis, a doctor must perform a physical examination and
laboratory test. Laboratory tests are performed on a sample of vaginal fluid
or urethral fluid to look for the disease-causing parasite. The parasite is
harder to detect in men than in women.
How Is Trichomoniasis Treated?
Usually an oral antibiotic called metronidazole (Flagyl) is given to treat
trichomoniasis. Before taking this medication, it is very important to let
your doctor know if there is any chance that you could be pregnant, since
the drug could harm the baby.
A partner should also be treated at the same time to prevent reinfection
and further spread of the disease. In addition, persons being treated for
trichomoniasis should avoid sex until they and their sex partners complete
treatment and have no symptoms. It is important to take all of your
antibiotics, even if you feel better.
What Happens If I Don't Get Treated?
Trichomoniasis in pregnant women may cause premature rupture of the
membranes that protect the baby and preterm delivery. The genital
inflammation caused by trichomoniasis might also increase a woman's risk of
acquiring HIV infection if she is exposed to HIV. Trichomoniasis in a woman
who is also infected with HIV can increase the chances of transmitting HIV
infection to a sex partner.
How Can I Prevent Trichomoniasis Infection?
To reduce your risk of infection:
Sexual Abstinence
Use condoms correctly every time you have sex.
Limit the number of sex partners, and do not go back and forth
between partners.
Practice SEXUAL ABSTINENCE, or limit sexual contact to one
uninfected partner.
If you think you are infected, avoid sexual contact and see a doctor.
Any genital symptoms such as discharge or burning during urination or an
unusual sore or rash should be a signal to stop having sex and to consult a
doctor immediately. If you are told you have trichomoniasis or any other STD
and receive treatment, you should notify all of your recent sex partners so
that they can see a doctor and be treated.
Hepatitis B
What Is Hepatitis B?
Hepatitis B is a serious disease caused by the hepatitis B virus (HBV).
Infection with this virus can cause scarring of the liver, liver failure,
liver cancer, and even death.
Hepatitis B is spread in infected blood and other bodily fluids such as
semen and vaginal secretions.It is spread in the same way that the virus
that causes AIDS (HIV) is spread but hepatitis B is 100 times more
infectious. About 30% of people who are infected with hepatitis B in the
United States do not know how they got it.
What Happens to People With Hepatitis B?
In most adult cases (up to 95%), hepatitis B causes limited infection.
Usually people manage to fight off the infection successfully within a few
months, developing an immunity that lasts a lifetime. (This means you won't
get the infection again.) Blood tests show evidence of this immunity, but no
signs of active infection. Unfortunately this is not true in infants and
young children in which 90% of infants and 30% of children will develop a
chronic infection.
While the majority of adults with hepatitis B recover completely, a small
percentage of them can't shake the disease and become carriers. Carriers can
transmit the disease to others even when their own symptoms have vanished.
Some carriers go on to develop chronic hepatitis B. Chronic hepatitis is an
ongoing infection of the liver that can lead to cirrhosis. Cirrhosis, or
hardening of the liver, causes liver tissue to scar and stop working.
If you are carrying the virus you should not donate blood, plasma, body
organs, tissue, or sperm. Tell your doctor, dentist, and sex partner that
you are a hepatitis B carrier.
How Common Is Hepatitis B?
Approximately 73,000 Americans contract Hepatitis B each year, making
infection with this virus about twice as common as infection with HIV, the
virus that causes AIDS. However, rates have greatly declined since the
1980's when around 260,000 Americans were infected each year. This decrease
in infection rates is, in large part, due to the increased use of the HBV
vaccine.
There are an estimated 1.25 million people living with chronic Hepatitis B
in the U.S.
How Do I Know I Have Hepatitis B?
Symptoms of acute infection (when a person is first infected with hepatitis)
include:
Jaundice (yellowing of the skin or whites of the eyes and/or a
brownish or orange tint to the urine)
Unusually light colored stool
Unexplained fatigue that persists for weeks or months
Flu-like symptoms such as fever, loss of appetite, nausea, and
vomiting
Abdominal pain
Often, symptoms occur 1-6 months after exposure. An estimated 30% of those
infected do not have any symptoms at all.
People with chronic active hepatitis experience similar symptoms, but their
fatigue is much more severe, and they can have confusion or disorientation.
How Is Hepatitis B Diagnosed?
If your doctor suspects that you may have hepatitis B, he or she will
perform a complete physical examination and order blood tests to look at the
function of your liver. Hepatitis B is confirmed with blood tests that
detect the virus.
If your disease becomes chronic, liver biopsies (tissue samples) may be
obtained to detect the severity of the disease.
How Is Hepatitis B Treated?
If you get to a doctor shortly after the exposure, you'll often receive
immediate immunization with the first in a series of three shots with the
Hepatitis B vaccination and a shot to boost the immune system to fight off
the infection.
But if you get sick, bed rest is usually necessary to speed recovery. Some
doctors recommend a special diet, and suggest that sufferers try to eat as
much as possible despite the nausea.
Also, take extra care of your liver! Now is not the time to drink alcohol,
or take Tylenol (acetaminophen) because they can harm the liver. Check with
your doctor before taking any other medications, herbal remedies or
supplements as some of them can worsen liver damage.
If your hepatitis persists beyond 6 months and is active (chronic active
hepatitis), your doctor may prescribe much more aggressive treatment. If
it's chronic but not active, your doctor may just watch you closely.
People with chronic active hepatitis are treated with a combination of
drugs.
Interferon. The immune system boosting medicine interferon is
injected either daily, several times a week, or weekly for up to a year.
Interferon does have some undesirable side effects, including: fatigue,
depression, and loss of appetite and it can lower the number of white blood
cells. There are two types of interferon: interferon-alfa (Intron) and
peginterferon alfa (Pegasys).
Epivir.Another drug often given in combination with interferon is
lamivudine (Epivir). This drug is taken orally once a day. Usually, this
drug is well tolerated, but it can cause a worsening of liver functioning in
rare instances.
Hepsera.This drug is taken by pill once a day and works well in
people whose disease doesn't respond to Epivir. It can cause kidney problems
especially in people that already have kidney disease, but it can occur in
anyone.
Baraclude.This drug is taken by pill daily and studies are showing
it may be one of the most effective antiviral medications available for
hepatitis B.
Can a Pregnant Woman Give Hepatitis to her Baby?
Yes. A pregnant woman can spread the hepatitis virus to her baby at the time
of birth. (It is unlikely that an infected woman will spread the virus to
her baby during pregnancy.)
Many babies infected with hepatitis B develop long-term liver problems. All
newborn babies should be given the vaccine for hepatitis at birth and two
additional booster injections during their first year of life.
How Can I Avoid Becoming Infected, or Infecting Others?
The best ways to try and avoid becoming infected with Hepatitis B include:
Get vaccinated (if you have not already been infected)
Practice SEXUAL ABSTINENCE
Use condoms every time you have sex
Wear gloves when touching or cleaning up body secretions on personal
items, such as bandages/band aids, tampons, and linens
Cover all open cuts or wounds
Do not share razors, toothbrushes, manicuring tools, or pierced
earrings with anyone
Do not share chewing gum or pre-chew food for a baby
Make certain that any needles for drugs, ear piercing, or tattooing
are properly sterilized
Clean areas with blood on them with 1 part household bleach and 10
parts water
Can I Catch Hepatitis B From Blood Transfusions?
The chance of catching hepatitis B from receiving blood transfusions is
unlikely because donated blood is tested for the virus. Any infected blood
is discarded.
Who Should Be Vaccinated for Hepatitis B?
Everyone 18 years of age and younger, including all newborn babies
People who are exposed to infected blood or body fluids of friends
or family members
People who use needles to take recreational drugs
All people who have sex with more than one person
Health care providers who may come in contact with the virus
People working in day care centers and institutions caring for
children and prisoners.
Gonorrhea
Also called the "clap" or "drip," gonorrhea is a contagious disease
transmitted most often through sexual contact with an infected person.
Gonorrhea may also be spread by contact with infected bodily fluids, so that
a mother could pass on the infection to her newborn during childbirth. Both
men and women can get gonorrhea. The infection is easily spread and occurs
most often in people who have many sex partners.
What Causes Gonorrhea?
Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and
multiply easily in mucus membranes of the body. Gonorrhea bacteria can grow
in the warm, moist areas of the reproductive tract, including the cervix
(opening to the womb), uterus (womb) and fallopian tubes (egg canals) in
women, and in the urethra (the tube that carries urine from the bladder to
outside the body) in women and men. The bacteria can also grow in the mouth,
throat, and anus.
How Common Is Gonorrhea?
Gonorrhea is a very common infectious disease. In the U.S. each year, about
700,000 people are infected with gonorrhea, and about 75% of all reported
gonorrhea is found in younger persons aged 15 to 29. The highest rates of
infection are usually found in 15- to 19-year-old women and 20- to 24-year-
old men.
How Do I Know If I Have Gonorrhea?
Not all people infected with gonorrhea have symptoms, so knowing when to
seek treatment can be tricky. When symptoms do occur, they are often within
2-10 days after exposure, but can take up to 30 days and include the
following:
Symptoms in women:
Greenish yellow or whitish discharge from the vagina
Lower abdominal or pelvic pain
Burning when urinating
Conjunctivitis (red, itchy eyes)
Bleeding between periods
Spotting after intercourse
Swelling of the vulva (vulvitis)
Burning in the throat (due to oral sex)
Swollen glands in the throat (due to oral sex)
In some women symptoms are so mild that they escape unnoticed.
Many women with gonorrhea discharge think they have a yeast infection and
self-treat with yeast infection medications purchased over-the-counter.
Because vaginal discharge can be a sign of a number of different problems,
it is best to always seek the advice of a doctor to ensure proper diagnosis
and treatment.
How Is Gonorrhea Diagnosed?
Your doctor will use a swab to take a sample of fluid from the urethra in
men or from the cervix in women. The specimen will then be sent to a
laboratory to be analyzed. You also may be given a throat or anal culture to
see if the infection is in your throat or anus. There are other tests which
check a urine sample for the presence of the bacteria. You may need to wait
for several days for your tests to come back from the lab.
Gonorrhea and chlamydia, another common STD, often occur together, so you
may be tested and treated for both.
Can Gonorrhea Be Cured?
Yes. Gonorrhea can be treated and cured.
How Is Gonorrhea Treated?
To cure the infection, your doctor will give you either an oral or
injectable antibiotic. Your partner should also be treated at the same time
to prevent reinfection and further spread of the disease.
It is important to take all of your antibiotics even if you feel better.
Also, never take someone else's medication to treat your illness. By doing
so, you may make the infection more difficult to treat. In addition,
Tell anyone you have had sex with recently that you are infected. This is
important because gonorrhea may have no symptoms. Women, especially, may not
have symptoms and may not seek testing or treatment unless alerted by their
sex partners.
Don't have sex until you have completed taking all of your medicine.
Always use condoms when having sex.
What Happens If I Don't Get Treated?
Untreated gonorrhea can cause serious and permanent problems in both women
and men.
In women, if left untreated, the infection can cause pelvic inflammatory
disease, which may damage the fallopian tubes (the tubes connecting the
ovaries to the uterus) or even lead to infertility, and untreated gonorrhea
infection could increase the risk of ectopic pregnancy (when the fertilized
egg implants and develops outside the uterus), a dangerous condition for
both the mother and baby.
Gonorrhea can spread to the blood or joints. This condition can be life-
threatening. Also, people with gonorrhea can more easily contract HIV, the
virus that causes AIDS. People with HIV infection and gonorrhea are more
likely than people with HIV infection alone to transmit HIV to someone else.
How Does Gonorrhea Affect a Pregnant Woman and Her Baby?
Gonorrhea in a pregnant woman can cause premature delivery or spontaneous
abortion. The infected mother may give the infection to her infant as the
baby passes through the birth canal during delivery. This can cause
blindness, joint infection, or a life-threatening blood infection in the
baby. Treatment of gonorrhea as soon as it is detected in pregnant women
will lessen the risk of these complications. Pregnant women should consult a
doctor for appropriate medications.
How Can I Prevent Infection?
To reduce your risk of infection:
SEXUAL ABSTINENCE
Use condoms correctly every time you have sex.
Limit the number of sex partners, and do not go back and forth between
partners.
Practice SEXUAL ABSTINENCE, or limit sexual contact to one uninfected
partner.
If you think you are infected, avoid sexual contact and see a doctor.
Any genital symptoms such as discharge or burning during urination or an
unusual sore or rash should be a signal to stop having sex and to consult a
doctor immediately. If you are told you have gonorrhea or any other STD and
receive treatment, you should notify all of your recent sex partners so that
they can see a doctor and be treated.