[DoctorTan]

In terms of a clinical disease, Syphilis is more serious than either Gonorrhea or Chlamydia. Nobody (or at least exceedingly rarely) people die from either Gonorrhea or Chlamydia. But people still die from complications of Syphilis.

The issue with Syphilis is that it is always missed. First it causes a painless ulcer which goes away on its own. So most patients would forget about it. Even most doctors who see it will probably just prescribe some cream. And since it disappears anyway, they think that they have treated it.

About 6 weeks after that, it causes a rash. This rash is known classically as "the great imitator". So not surprisingly, it is often misdiagnosed. Again, without any treatment, it disappears on its own.

The Syphilis infection then goes into a latent stage. During this stage, the patient does not have any symptoms. However, the Syphilis bacteria continues to damage the brain and blood vessels.

Many years down the road, the patient can go crazy (neuro-syphilis) or the major blood vessel in his/her chest or abdomen can expand and burst (aortic aneurysm).

The other big issue with Syphilis (this is in relation to blood donation), is that we do not have great tests to prove that it has been eradicated from the body. Syphilis tests remain positive for years (sometimes even for a lifetime) after a person has been infected EVEN IF he has been successfully treated. The way to determine treatment success is a complicated analysis of the non-treponemal test titer over a period of 2 years.

This makes it very challenging for blood banks to know if a person's blood is safe from Syphilis or not if he/she has ever been infected with Syphilis EVEN IF he has been successfully treated.