INFORMATION FOR WOMEN WHO HAVE SYPHILIS DURING PREGNANCY OR BREASTFEEDING

What is syphilis?

Syphilis is a sexually transmitted infection (STI), and also a congenitally transmitted disease, resulting from infection by Treponema pallidum, a bacterial species that belongs to a group of bacteria called Spirochaetes, which are distinct in that they are corkscrew or spiral-shaped and have a double-membrane surrounding them. Syphilis develops in a series of distinct stages. The first stage, called primary syphilis, shows up around 3 weeks after contact with an infected person as a sore called a chancre on the skin at the location where the T. pallidum penetrated into the body. About 2-8 weeks after the chancre heals, secondary syphilis begins as the spread of the bacteria through the blood causes symptoms throughout the body, especially the nervous system. This also is called neurosyphilis and it can be followed by a latent period, during which the person does not experience symptoms, but can have occasional relapses. There is a late phase of the latent period (sometimes called late latent syphilis) that is important in connection with pregnancy because it’s a time when the disease can be transmitted to the developing baby (prior to this, the immune system keeps the bacteria in check). Finally, there is a late stage of the disease, called tertiary syphilis that can develop 1 – 20 years after the initial infection. This phase can involve more effects in the nervous system, called late neurosyphilis, which can include meningitis (inflammation of the layers covering the brain, called meninges), and problems in the blood vessels of the meninges. Another aspect of tertiary syphilis is cardiovascular syphilis, which includes problems with the valve between the heart and the large artery called the aorta, aneurysm (ballooning out) of the aorta, and narrowing of the openings into the coronary arteries.