Treponema pallidum (Syphilis)

Treponema Pallidum (Syphilis)

What is Treponema pallidum?

Treponema pallidum is a spirally wound, gram-negative bacterium. It can cause the infectious disease syphilis. The pathogen exists exclusively within human reservoirs.

How is Treponema pallidum transmitted?

The pathogen is usually transmitted via direct sexual contact. So-called venereal syphilis is one of the most widespread infectious diseases. In unprotected sexual contact, the pathogen enters the body through micro lesions, such as tiny injuries to the mucous membrane or skin. However, infection can also occur from contaminated needles or other objects; however, this is rarely the case. Transmission from an infected mother to her unborn child is also possible.

What are symptoms of the disease?

Syphilis occurs in several phases. A distinction is made between early syphilis (up to one year after infection) and late syphilis. The first stage of early syphilis is called primary syphilis. Here, the disease first manifests itself in a hardening of the tissue, or a small lesion called a chancre, at the site where the pathogen entered the body. Such hardening, also known as induration, often develops into a painless ulcer. When properly treated with antibiotics, the disease can be cured in four to six weeks. A spontaneous healing can also occur. If neither is the case, the transition to secondary syphilis is possible.

This second stage begins after four to ten weeks and manifests itself with very different symptoms. At the beginning of this stage, fever, fatigue, headache, joint pain and muscle pain may occur. These symptoms are usually accompanied by swollen lymph nodes. Following these early symptoms, a skin rash may appear on various areas of the body and increase over the course of one to three weeks. Sometimes, during secondary syphilis, “moth-eaten” pattern of hair loss, depigmentation of the neck and spots in the oral cavity may occur. Skin symptoms subside about a year after infection.

If early syphilis has not been sufficiently treated, tertiary syphilis may occur. This occurs after one to several years and is manifested by severe skin changes, ulcers, elastic protrusions on the skin. Cardiovascular diseases may develop, such as permanent dilation of the blood vessels.

If those affected also do not receive sufficient treatment for tertiary syphilis, syphilis may manifest itself on the central nervous system (CNS). This stage of late syphilis is then called neurosyphilis. Depending on which parts of the CNS are affected, neurosyphilis can take on different forms or can be completely asymptomatic. Firstly, in 30 percent of untreated syphilis cases, degeneration of the posterior spinal cord occurs after an average of 20 years, causing pain and loss of sensitivity in the lower abdomen and legs.

On the other hand, syphilitic meningitis can also develop, resulting in mild paralysis of the cranial nerves and slight increases in pressure. Patients suffering from chronic meningitis may also experience seizures and a loss of speech. If syphilis is not adequately treated at this stage, parenchymal syphilis can occur after 15 to 20 years, causing numerous neurological and psychiatric abnormalities. Untreated, this stage of syphilis leads to death in four to five years.

The antibiotic penicillin is regarded as the most effective drug against the disease. The development of penicillin was the reason for the sharp decline in syphilis cases since the end of the 1970s. Since the turn of the millennium, however, the number of cases has risen again slightly, particularly in metropolitan areas.

SIGNIFICANCE FOR INFECTIONS IN HOSPITALS AND IN THE OUTPATIENT SECTOR

The Robert Koch Institute recommends standard accommodation and basic hygiene measures, which include hand disinfection and the disinfection of surfaces in the patient environment, as well as other surfaces that are frequently touched.

The Infection Protection Act in Germany requires that the RKI must be notified of the direct or indirect detection of Treponema pallidum within two weeks. In Austria and Switzerland, the syphilis disease must be reported.

SURVIVAL TIME OF PATHOGENS ON INANIMATE SURFACES

Because the pathogen depends on specific nutrients from its host organisms, it can only survive for a short time outside the body and on inanimate surfaces.

DISINFECTANT EFFECTIVENESS FOR PREVENTION

The required spectrum of activity against Treponema pallidum is: bactericidal.

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