In the developed world, syphilis infections declined throughout the 1980s and 1990s due to widespread use of antibiotics. Since the year 2000, the rates of syphilis have been increasing again in the USA, UK, Australia, and Europe. Much of the increase has occurred among men who have sex with men and is attributed to higher rates of unsafe sexual practices.
To contract syphilis, it is necessary, first of all, to contact a patient with clinical manifestations of syphilis. The best “transportation” is serous separation of syphilids, i.e. appearance of syphilis on skin surfaces and mucous membranes.
The second necessary condition for contracting the infection is breaking up the skin which creates the portal of entry for pathogens. The chance of getting the infection depends on the frequency of sexual contact, character and localization of syphilids, the site of entry in the healthy partner, the number of Treponema pallidum microorganisms invading the body, hygiene after sexual intercourse and many other factors. The fact of contracting the infection is usually reflected by manifestations of primary and secondary stages. Of great danger is hard chancre, painless ulceration formed during the primary stage of syphilis. Erosive and vegetative papules discharge serous fluid with numerous Treponema pallidum microorganisms. The word chancre means ”little ulcer” in Old French. Related to the English canker, both coming from the Latin cancer, meaning crayfish, which is a translation from the Greek word karkinos, also meaning crayfish.
Transmission of the infection may also result from transfusion of infected blood or may occur vertically from the infected mother to the fetus. There infection may be transmitted in home conditions from close relatives both directly (kissing, bites, breastfeeding, etc.) and indirectly (via household articles and devices that had contact with mucous membranes of the infected individuals). This results from the stability of Treponema pallidum in the environment and its invasive abilities. Infection of health providers is also possible (e.g. of obstetricians, gynecologists, surgeons, pathologists, dentists, etc.).