These are a group of communicable diseases which are transmitted by sexual intercourse and are caused by a wide range of bacterial, viral, protozoal and fungal agents and ectoparasites. Formerly the sexually transmitted diseases were known as venereal diseases and are one of the acute public health problems.
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Many instances of broken homes, family unhappiness and high infant mortality rate can be attributed to sexually transmitted diseases which may be due to marital disharmony, poverty, alcoholism and family quarrels.
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The basic social factors responsible for the spread of sexually transmitted diseases is prostitution which is quite high in large cities, ports and pilgrim centers, where there are more men and less women and where men are forced by circumstances to remain separated from their families. Modern publicity in books, nude films, television and advertising lead the young boys and girls to indulge in undesired sexual practices.
Moreover lack of discipline in the family and parental supervision contributes to the worsening of the situation. Urbanisation is another major factor responsible for this problem. STD is more prevalent in the 20-40 years age group. The examples of STD include syphilis, gonorrhoea, chancroid, lymphogranuloma venereum (LGV), AIDS etc.
Syphilis is a chronic infectious disease which occurs throughout the world but in western countries its incidence has been decreased to a great extent due to strict laws and better medical facilities.
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The disease is self-inflicted because wounds remain hidden and unnoticed due to stigma and shame. Untold sufferings of a large number of people go unnoticed and the disease continues to spread in spite of the availability of specific treatment.
Causative Organism:
Syphilis is caused by Treponema pallidum. It is a spiral shaped germ which has 8-15 spirals which passes through cracks in the skin or mucous membrane.
Types of Syphilis:
Syphilis is of two types:
(a) Acquired syphilis
(b) Congenital syphilis
(a) Acquired Syphilis:
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Generally adults and elderly persons get this disease through sexual intercourse whereas children get this disease through kissing or fondling of sex organs. The patient of syphilis passes through three stages:
(i) Early Syphilis or Primary Stage:
During this stage a hard sore called cancer appears on genitals in 2-6 weeks time. This sore is hard, almost painless, without itching and there is no discharge. It heals up itself leaving behind a scar.
(ii) Secondary Stage:
This stage appears 6 weeks to 6 months after the infection. During this stage there is enlargement of glands, headache, sore throat, and low irregular fever. Loss of voice and loss of hair are also seen.
(iii) Tertiary Stage:
This stage may appear after 5 years of infection. It affects almost all organs of the body. During this stage lesions appear almost anywhere but the skin, bones, tongue, testes, liver; heart and CNS are affected more. Gumma, a chronic granulomatous lesion of the internal organs appears which is not painful and tender.
(b) Congenital Syphilis:
Congenital syphilis occurs from birth because the infection is passed from the mother to the faetus through placenta. In congenital syphilis mother does not conceive, if pregnancy occurs after repeated abortions there may be still birth of 2 or 3 children in 3rd, 6th and 7th months of pregnancy respectively. If third or fourth child is born alive he may be a defective child both physically and mentally.
Mode of Spread:
The acquired syphilis is spread through sexual intercourse whereas the congenital syphilis is transmitted from the infected mother to the child through placenta. Syphilis may also spread through infected towels, kissing and fondling of sex organs.
Incubation Period:
Incubation period varies from 10 days to 10 weeks. Average is 3 weeks.
Treatment:
Procaine penicillin is the drug of choice which can be given in early stages in a daily dose of 6, 00,000 units intramuscularly for 10 days. For secondary syphilis it is given in double dose for 20 days. In tertiary syphilis the course of procaine penicillin is repeated several times.