Scary Spring Roll: "Xiaomei"

I saw a report like this in Nikkei Asia: "Statistics from the National Institute of Infectious Diseases of Japan show that the incidence of syphilis has been rising since 2021. The number of new cases in 2023 surged to 14,906. As of September 15, 2024, the number of new cases this year has reached 10,162, compared with only 1,000 cases in the same period of 2013, a 10-fold increase in the past 11 years. Detailed data show that in the first half of this year, men accounted for 65% of new syphilis cases, and most of the infected people were between 20 and 50 years old. Among female infected people, about 60% are young women in their 20s."

1. First, let’s understand what syphilis is?

Syphilis is a sexually transmitted disease caused by Treponema pallidum. This is the spring-like microorganism in the picture below. It infects the human body and causes chronic, systemic sexually transmitted diseases, which can cause damage to multiple systems and organs in the human body. Before the emergence of AIDS, syphilis was an extremely terrible disease with a mortality rate ranging from 8% to 58%, with a higher mortality rate among men.

2. What are the dangers of syphilis infection?

First, pregnant women with syphilis can infect the fetus, causing stillbirth, miscarriage, premature birth, and congenital syphilis in the baby, seriously endangering the health of women and children.

Secondly, Treponema pallidum invades the central nervous system, which can cause meningeal vascular diseases, tabes dorsalis, and paralytic dementia. It may also invade the cardiovascular system, causing aortitis, aortic valve insufficiency, aortic aneurysm, etc., and in severe cases it can be fatal.

Secondly, Treponema pallidum damages the bones, eyes, respiratory tract, digestive tract and other systems, causing tissue and organ destruction, loss of function, and in severe cases, leading to disability or other adverse consequences.

3. How is syphilis transmitted?

Syphilis is mainly transmitted through sexual contact, vertical transmission from mother to child, and blood, among which sexual transmission accounts for as high as 95%.

Because the skin and mucous membranes of syphilis patients contain Treponema pallidum, uninfected people may become infected if there is even slight damage to the skin or mucous membranes during sexual contact with syphilis patients.

In rare cases, syphilis can also be transmitted through kissing, breastfeeding, blood transfusion, contact with clothing, towels and tableware contaminated by the patient, etc.

IV. Frequently Asked Questions

1. Can you get syphilis by taking a bath in a bath center?

It is unlikely that STDs will be transmitted through bathing. In fact, most pathogens of STDs, such as Treponema pallidum, HIV, gonococci, etc., are relatively demanding on the environment and easily lose their ability to infect after leaving the body. For example, HIV will not be infected by bathing together unless the infected person bleeds heavily in the bath and the people bathing together have open wounds. The reason why some informal bathing places are prone to become hotbeds of STDs is that these places skirt the line between attracting customers and providing pornographic services, and people become infected because of unsafe sex in these places. Therefore, bathing in a hygienic and clean formal bathing place will not cause STDs.

2. If you suspect you have syphilis, when should you go to the hospital for examination to get more accurate results?

Syphilis infection has a certain incubation period. After being infected with Treponema pallidum, it takes about 2-4 weeks for the human body to produce syphilis-specific antibodies, and about 4-6 weeks for lipid antibodies. If the serological test is conducted too early, the result may be negative, but it cannot rule out syphilis infection. Therefore, it is recommended to go to the hospital for syphilis serological test 6 weeks after high-risk sexual behavior.

3. Can syphilis antibodies and titers turn negative?

After being infected with syphilis, if active anti-infection treatment is given, the syphilis titer may gradually turn negative. However, the titer turning negative does not mean that the syphilis antibody will turn negative. The antibodies are basically positive for life, and occasionally turn negative.

4. After being cured of syphilis, will patients have lifelong antibodies and will not be infected again?

After being cured, syphilis patients will have antibodies for life. Some people think that they will not be infected with syphilis again in the future, but in fact they can still be infected again. This is because the antigenicity of the Treponema pallidum is weak and cannot release enough antigens. The antibodies produced are defective in both quality and quantity, and cannot exert sufficient immune effects and prevent infection, causing patients to be infected again after being cured.