Syphilis: A Case Study

Syphilis is spread through contact with a syphilis sore (Syphilis). It has a wide range of side effects, and if left untreated can turn into a serious problem. There are several tests for syphilis, including blood, tissue, and fluid (from syphilis sores) tests. The rapid plasma regain test (RPR test), for example, tests blood or spinal fluid for syphilis antibodies (or T Pallidum antibodies), but because these antibodies are nonspecific to syphilis, this can result in a false positive. The enzyme immunoassay (EIA) test is the second test used to confirm syphilis in someone who tested positive in the RPR test. It also tests for syphilis antibodies. Its treatment has evolved a lot. In the 1940s, it was treated primarily by penicillin, which is most likely what Henrietta Lacks would have used to be treated for this disease if she got proper treatment (Progress). Now, a variety of antibiotics are used to treat syphilis, including penicillin. The dosage is small in the early stages but increased later. Harm done in the third stage cannot be reversed though

In 1932, the Public Health Service (PHS) began a study in the Tuskegee Institute to record the natural history of syphilis in hopes for finding treatment programs for blacks. It was called “Tuskegee study of untreated syphilis in the negro male”. The experiment was conducted on a group of 399 poor and illiterate African American sharecroppers. This disease was not however, revealed to them by the US government. The sharecroppers were told they were going to receive treatment for bad blood. The study that was carried out proved to be one of the most horrifying studies carried out that disregarded the basic ethical principles of conduct, it disregarded human life especially the African American life, blacks were not considered patients but subjects, they were considered as clinical materials instead of sick people. The Tuskegee experiment was identified as “the longest non-therapeutic experiment on human beings in medical history”.

Syphilis is a harsh sexually transmitted disease. It can be contracted through intercourse and orally with any age or gender. The infection is a spiral shaped bacteria that grows on the mucus of the genitals or mouth. Syphilis has three stages, the first stage is the presence of painless ulcers, also know as chancre. The open sore can develop anytime within ten to ninety days after you have contracted it, which at this time is very contagious. The next stage is where the symptoms really start to show,

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Syphilis is a sexually transmitted disease (STD) that is characterized by sores known as chancres. These sores are typically found on the external genitals. There are three stages to the disease: Primary, Secondary and Latent/Late. Syphilis can also spread to the neurological systems as well as the ocular system. In the primary stage one or more of the chancres may appear where the infection has entered the body. The sores aren’t painful and may last three to six weeks (Centers for Disease Control and Prevention, 2015). The

.The study consisted of a total of “ 600 African- American men; 399 that were previously identified with having syphilis and 201 were uninfected” (“USPHS Syphilis Study” 1). Throughout the entire study the men were never told that they had syphilis, only told that have a condition known as “bad blood”.

In 1932, the U.S. Public Health Service (USPHS) initiated a study entitled the “Tuskegee Study of Untreated Syphilis in the Negro Male” in Macon County, Alabama to record the natural course of latent, untreated syphilis in Black males and explore treatment possibilities (Center for Disease Control and Prevention [CDC], 2017). Macon County, Alabama, in which the town of Tuskegee is located, was selected as the location of this study because earlier studies conducted in the rural South by the USPHS to determine the prevalence of syphilis among Blacks found this county to have the highest syphilis rate of the six counties surveyed (Brandt, 1978).

During sexual intercourse, the bacteria is transferred from the sore of the person and enters the moist membranes of the sexual partner’s penis, vagina, mouth, or rectum. Once the bacteria enter the body, it multiplies at a fast rate. The bacteria enter the lymph circulation, which carries the bacteria to adjacent lymph glands, which swells as a response to the infection. During the first stages of the disease, which is called primary syphilis and lasts for a few weeks, sores and ulcers begin to develop, particularly in the genital area of the victim. Blood tests during this stage may not reveal the disease yet, but the bacteria can be scraped from the sores. Eventually, the sores will heal, and the victim may recover from the disease without any treatment.

"Thirty years ago today, the Washington Evening Star newspaper ran this headline on its front page: "Syphilis Patients Died Untreated."

1. As each of you proceed in your careers, you will be faced with opportunities to read, evaluate and perform research. Read the USPHS Syphilis Study and pages 39-41 in Module 3. Describe what happened in the USPHS Syphilis study. What were the violations of human rights and ethics? What are your reactions to the events? Keeping in mind some of the information discussed on pages 39-41, what can you do to make sure vulnerable groups (uneducated, minors, disabled, etc.) are protected in research? If you discover a violation what can you do?

According to the CDC, syphilis is a sexually transmitted disease that can have long-term irreversible complications if it is left untreated. The symptoms of syphilis is categorized into stages, which are primary, secondary, latent, and late syphilis (CDC). If you are in the late stage of syphilis your body organs are permanently damaged (Syphilis). If syphilis is caught in the earlier stage it is easy to cure (CDC). An antibiotic, such as Penicillin is injected into the muscle. According to the National Institute of Allergy and Infectious Diseases, Injection into the muscle is considered to be the best treatment for the sexually transmitted disease. If there is an allergy to Penicillin then your healthcare provider may prescribe you a different

From a sociological perspective, I do not think that hypothesis, “The rate of progression of Syphilis may differ by race when comparing African American males to Whites” is valid as is. Race is a social construct, however the experiences that which we go through because of race is very real. That leads me to believe the hypothesis could be valuable if it were framed differently. Because of environmental factors, cultural factors, and health disparites, certain races may be at risk for a particular disease than others. I feel that maybe if the hypothesis would have been framed as “The rate of progression of Syphilis may differ by race when comparing African American males who have (certain health problem) to Whites males who have (certain health problem)” it could have been valid. However, these men would have had to receive the same exact treatments and likely be from the same SES.

Tuskegee’s study of untreated syphilis is a notorious clinical study that was initiated in 1932 and ended in 1972. This study was initiated by the US Public Health Department and performed by the government physicians. The main purpose of this study was to assess the natural progression of the untreated syphilis. They included 399 men who had syphilis and 201 men who hadn’t have syphilis. Initially the study started to treat the syphilis, but even after there was no enough budget, they didn’t stop the study. The physicians had promised that the study participants were given free treatment of the syphilis but the fact was that the physicians and “US Public Health Department” were assessing the progression of the syphilis and not giving the treatment to the participants. Participants were unaware about this clinical research. In addition to this, participants were told about insurance, but they hadn’t been provided insurance.

Syphilis is one of the oldest sexually transmitted diseases in the world. The first recording of Syphilis was in Europe in 1495, but there is believed to be earlier cases that weren’t recognized. “The transatlantic origin of syphilis is still controversial as there was evidence of an endemic syphilis in Asia Minor before 1492” (JG, 1990) . There has not been a definitive origin for this disease and there were several different hypotheses on how it came to the United States. There have been 2 main theories proposed. The first was the New World or Columbian theory and the Old World or pre-Columbian theory. The first theory holds that the syphilis endemic started in the part of the world now known as Haiti and was then acquired and carried to Europe by Columbus in the 1400s. The second theory, pre-Columbian theory implies that syphilis began in central Africa and was brought to Europe prior to the voyage by Columbus. Recent studies have shown genetic differences between these organisms. Regardless of where the beginning of syphilis started, by 1495 a widespread syphilis epidemic had spread throughout Europe, and then on to India in 1498 and China in 1505. Since its discovery in Europe there have been many speculations that many famous ranging from political figures, musicians and some literary greats may have had syphilis. Some of those were Adolf Hitler, Ivan the Terrible, Henry VIII, Shakespeare, Napoleon, Abraham Lincoln, Lenin (Vladimir Ulyanov), Friedrich Nietzsche,

Syphilis affects the body in four stages: primary, secondary, latent, and tertiary. The first stage, the primary stage, begins to show symptoms approximately 3 weeks after contraction (“STD Facts-Syphilis” 2010). The first stage is marked by the appearance of a chancre sore, which usually appears at the sight of contraction of the bacteria. A chancre is a “small, hard, circular lesion” and this is where the bacteria grows and is highly contagious (Shmaefsky, Brian 2009). After about 3 weeks of the presence of the chancre sores, the sores go away, however, syphilis is still present in the body. Several weeks later, approximately 3-6 weeks, the secondary stage of syphilis begins to show, the skin rash. Characteristics of the rash include “rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet”, also it can spread to other parts of the body (“STD Facts-Syphilis” 2010). The symptoms of secondary syphilis will go away in a few weeks, but without proper treatment, the disease will continue to advance. The next stage of syphilis is the latent stage, or the “hidden” stage, this stage happens after the primary and secondary stage of syphilis. Without