Syphilis is most infectious during the primary and secondary stages, when there are moist skin or mucosal lesions. As written by Albert Heyman, the genital condylomas and the oral mucosal lesions contain large numbers of spirochetes and are more infectious than the dry skin lesions.
The transmission of he disease by individuals or marital partners who deny having had open lesions is probably by way of small mucosal lesions which appear during the recurrent episodes of spirochetemia. Some secretions, such as saliva and semen, are frequently in contact with infectious mucosal lesions and may thus contain T. pallidum. The blood of patients with early syphilis has been shown to contain spirochetes and should not be used for transfusion.
The serologic test is not always an indication of the infectiousness of the blood, since transfusion syphilis can be transmitted from patients in the incubation period or in the seronegative primary stage of the disease. The danger of transmitting syphilis either by transfusion or by direct contact is greatest in the first 4 years of the disease and is negligible after this period of time. In pregnancy, however, the disease can apparently be transmitted to the fetus for as long as 10 years or more after the onset of the disease, although the vast majority of congenital infections are acquired during the first 4 years of maternal infection.
It is important that the physician make an effort to determine the source of infection of the patients with syphilis, particularly those with primary and secondary manifestations. It is equally important that the individuals to whom the patient may have transmitted the infection be located. They should be followed with physical examinations and serologic tests for several months before being dismissed. Well, thank you for reading. I hope this information help you understand about the infectiousness and epidemiology of syphilis.
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