
Can Syphilis Be Contracted Through Intercourse?

Are these test sufficient for my wife?
Could I have passed syphilis to her even being treated about 48 hours before our sex
Pregnancy is a cause of BFP
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic
I have taken note of your query.
VDRL can be Biologic falsely positive (BFP), specially if it is in low titres such as in your wife's case. Pregnancy is one of the many causes of BFP.
Moreover, RPR is not a confirmatory test for syphilis.
Many infectious diseases have been reported as causes of transient biologic false positive VDRL/RPR e.g malaria, leprosy, tuberculosis, infectious mononucleosis; pregnancy and immunizations etc are also causes of transient BFP reactivity.
Connective tissue disease may also cause BFP reactivity.
A low titre positive VDRL/RPR should always be followed up with a specific test for syphilis, which has already been concluded as negative for syphilis in your wife's case.
Therefore, I think RPR reactivity in your wife's case is nothing more than a Biologic false positive reactivity, most likely due to pregnancy and requires no further testing.
Regards


Also please review this link a post by Dr. Handsfield a famous STD doc in the United States, it says people are non contagious 24 hours after being treated by penicillin. Do you agree with the statement? http://www.medhelp.org/posts/STDs/How-long-are-you-contagious-after-treatment-for-syphilis/show/0000
You are safe
Detailed Answer:
Hi.
Yes, you mentioned it rightly; If indeed she was infected with syphilis the RPR titre should either go up Or it should remain the same during the intervening 2 weeks.
Moreover, a negative RPR test by another lab justifies the well known fact that transient low titre RPR reactivity can occur in pregnancy. Also the specific test by chemiluminescence came out to be negative.
These are enough evidence to confer that she had a BFP reactivity.
Regarding the statement made by Dr. Handsfield, I don't agree with it. The reason being that syphilis bacterium has a generation time of approx 33 hours, so for the drug to be effective it must be present in the serum for a sufficiently long period of time to inhibit the generation of new bacteria. Moreover not all bacteria reproduce synchronously in the infected person.
That is the basis of using Benzathine penicillin G, which stays above the required levels for killing treponemes for as long as 10-14 days. This period is usually considered to be safe to kill all the treponemes.
Regards


You are safe
Detailed Answer:
Hi
Jarish Herxheimer Reaction (JHR) is is thought to be the result of an inflammatory response to the destruction of treponemes. It begins soon after treatment and usually subsides within 24 hours but this time duration cannot be concluded that all the bacteria are dead within 24 hours because not all bacteria would be dividing at the same time.
The purpose of giving longer acting Benzathine penicillin G (BPG) rather than shorter acting Crystalline penicillin (CP) is to allow multiple cycles of generation covered during that time till the drug is effective (above tissue levels needed to kill treponemes) so that all the treponemes are killed and that is because not all treponemes are dividing synchronously. Once killed the bacteria won't regenerate.
The person is considered infectious until all sores and lesions heal after treatment. This view is in absolute contrast to Dr. Hansfield in which he says that an individual becomes non-infectious within 24 hours of treatment even in the presence of clinical lesions (sores and moist lesions of syphilis).
The JHR is most intense shortly after treatment because most but not all bacteria are being killed following BPG administration and therefore the intensity during the first 24 hours.
The chemiluminescence method is very sensitive as well as specific for syphilis.
Regards


No further testing needed
Detailed Answer:
Hi.
I think there is no requirement for any further testing, neither in you nor in your wife. Your wife never contracted syphilis neither did you.
The chemiluminescence method is as sensitive as well as specific for syphilis as other specific tests.
Regards

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