Syphilis and travellers

It is estimated that 30% of short-term travellers have casual sex whilst abroad and the majority of these encounters are without condom. Syphilis is a risk to students and business travellers who engage in sexual activity whilst abroad. Frequently the initial signs go unnoticed and it is only after return from overseas that the disease presents itself. It is likely to infect a regular sexual partner once acquired. General advice for business travellers and students should be :- Consider avoiding sexual contact whilst abroad Consider vaccination for Hepatitis A and B  (and HPV) Use barrier methods such as condoms sourced from a familiar and reliable manufacturer possibly in the home country before travelling. Avoid sexual situations where alcohol or drugs have been consumed Dont assume apparently asymptomatic partners are safe to have sex with. There are rare cases of occupational  transmission to clinicians and through human bites.

The primary syphilis lesion is a painless one on the mouth, anus or genitals. The individual is infectious at this stage. The secondary symptoms include fever, headache and sore throat and macular papular rash especially on the hands and feet (differential skin diagnosis dyshydrotic excema, hand foot and mouth) . Both doxycycline and azithromycin has been shown in studies to be effective as the traditional injected benzylpenicillin. Many clinics still prefer the injected drug however. The latent stage follows the secondary stage and precedes the tertiary stage (if it occurs). there is some debate as to whether individuals are infectious during this period. An individual is highly infectious whilst he or she exhibits lesions. It is currently uncertain whether individuals are infectious in the silent periods of the disease. An infectious individual has about a 1.5% chance of transmitting the infection to a sexual partner during one episode of sexual intercourse.(see source below). Syphilis is transmitted in utero and (unsurprisingly) through blood and organ donation.