A woman in her 30s was shocked to be diagnosed with secondary syphilis, after a medical team suggested she get screened for sexually transmitted infections (STIs) for a persistent headache and hair loss, and later discovered she likely contracted it from her boyfriend who admitted having an affair.
The case was shared at the Centers for Disease Control (CDC) on Tuesday last week by Yang Chia-jui (楊家瑞), director of Far Eastern Memorial Hospital’s Department of Infectious Diseases, while the centers announced the publication of the “Guidelines for the Clinical Diagnosis, Treatment and Prevention of Syphilis in Adults in Taiwan.”
CDC Deputy Director-General Tseng Shu-hui (曾淑慧) said local cases of gonorrhea and syphilis, both STIs, have slightly increased in the past few years, especially among adolescents and young adults.
Photo courtesy of the Centers for Disease Control
Therefore, the CDC collaborated with the Infectious Diseases Society (IDS) and other medical associations to publish the guidelines to improve accuracy and consistency in diagnosis and treatment, she said.
IDS member Lin Hsi-hsun (林錫勳), a doctor, said there were 5,826 cases of syphilis reported in the first seven months of this year, an increase of 7 percent from the same period last year.
There were 1,772 cases among people aged 13 to 24 reported last year — a 19 percent increase from the previous year, he said, adding that there were 1,126 cases reported among the same age group from January to last month, an increase of 14 percent compared with the same period last year.
“Clinical studies have proved that syphilis can be prevented,” Lin said, adding that gonorrhea and syphilis can be cured with the right treatment, so it is important to have standardized treatment guidelines.
Some people buy over-the-counter antibiotics to treat syphilis on their own, but the syphilis bacteria have been showing resistance to certain antibiotics, which is a growing concern, he added.
Yang said a woman was hospitalized and suspected of having meningitis due to a persistent headache, but she also developed hair loss, so the medical team suggested she get tested for syphilis, despite only having sex with her boyfriend.
The woman was diagnosed with secondary neurosyphilis — the Treponema pallidum bacteria had invaded her brain — and she recovered after receiving standard treatment during hospitalization, he said.
People who have engaged in high-risk sexual behaviors are advised to seek medical attention if they develop symptoms, said Chen Po-liang (陳伯亮), a doctor at Taipei Veterans General Hospital.
Syphilis has different signs and symptoms as it progresses through primary, secondary, latent, and tertiary stages, he said.
During the primary stage, people might develop painless ulcers or round and firm sores, usually on the genitals, and they might heal and go away in a few weeks; while in the secondary stage, people might develop rashes on their palms, the bottoms of their feet, or anywhere on their body, and might also experience hair loss, headaches, fatigue, weight loss and muscle aches, he said.
Latent syphilis is a period when there are no visible signs or symptoms, but the bacteria are still present in the body, Chen said, adding that untreated syphilis after three to seven years might develop into tertiary syphilis, which can affect many different organ systems.
Meanwhile, the CDC on July 1 launched a free anonymous STI consultation program, which includes free rapid syphilis tests for people aged 24 or younger at 13 hospitals across the nation, Tseng said.
In the month since the program started, 382 people have used the service, including 256 people who received a syphilis screening, 10 of whom were tested positive, she added.
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