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Friday, 18 May 2012

What is difference to Lyme and Syphilis?

Lyme disease and Syphilis are both spirochetes, the two most commonly associated with human disease in that family. Borellia burgdorferii and Treponema palladium are the species names of these two organisms, respectively. Now, you might expect there to be some similarities in their infectious symptoms, and there are. Both are spiral, “corkscrew” shaped organisms. Other diseases caused by spirochetes are: leptospirosis, tick-born relapsing fever and a few substrains of T. palladium, which cause yaws, bejel and pinta.
Because of the differences in their DNA, you wouldn’t necessarily expect the two diseases to cause similar symptoms, and yet…

If I tell you that you have the following symptoms what could you conclude?

1. Rash, followed by flu like symptoms, sore throat, fever 101, achiness
2. Headaches, stiff neck, irritability
3. Mental/cognitive disturbances, cardiovascular issues.

The disease occurs in three distinct phases, an initial “infection,” followed by middling level symptoms or perhaps a reprieve from all symptoms, then leading to a third stage that is, in some cases, utterly debilitating. A fourth stage, consisting of a dormancy which can last from 2 to 50 years, is also often included. This stage precedes the “tertiary” stage.

Before we examine that question, let’s start with a history lesson. Syphilis is a very old disease. It has been shown to exist in the New World since prior to Columbus hitting the shores in 1492. Columbus, himself, may have taken it back to Europe upon his return. Other famous sufferers include: Napoleon Bonaparte, Franz Schubert, Henry VIII to name just a few (there are lots of rumors about who else might have had it, but I have tried to stick with known cases). Karen Blixen, aka Isak Dinesen mentions her battle with syphilis in “Out of Africa.”

The disease itself was very difficult to treat until the advent of antibiotics. It has mostly ceased to exist, except in places now where it has resurfaced due to concurrent HIV/AIDS infections. What else do we know about syphilis?

Does anyone remember the Tuskegee experiments? That was syphilis. In 1932, the Public Health Service recruited about 400 black men from Alabama with syphilis. They wanted to watch the “natural progression” of the disease in African-Americans (many people still believed at that time that the physiologies of blacks differed from whites). So, they did. And they watched for over 40 years. But remember, syphilis is a disease that is susceptible to penicillin, which has been on the scene since the 1940s. If the men heard about the cure and they tried to get it, and they were talked out of it, by a nurse who ran the program, named Miss Eunice Rivers, an African American nurse. (watch the movie “Miss Evers’ Boys” based on the same story). What they discovered was totally predictable. 128 of these men died either directly or indirectly of syphilis. Forty of them infected their wives and 19 had children who were congenitally infected. In 1973, the story finally broke into the news. Only 74 of the men were still alive. They sued and were compensated ($37,500 for the living; $15,000 to the families of the deceased), but that compensation surely could not be worth the disease they had to suffer through!

The epidemic peaked in about 1945, with 600,000 infected individuals. It has been called “The Great Pox” and “The Great Imitator” (more about that later). Ninety percent (90%) of cases are acquired by sexual transmission, with the remainder being mostly acquired via placental infection of fetuses. The disease progresses in three-four stages, the first being a rash and flu-like symptoms. The second stage progresses with more systemic symptoms, such as headaches, stiffness and irritability. And the third stage, referred to as tertiary syphilis, the spirochete invades the cardiovascular or neurological system and causes all kinds of havoc.

So, now do you know the answer to the hypothetical symptoms I mentioned above? Don’t be so sure.

Now to get back to Lyme disease and syphilis. There are differences between syphilis and Lyme disease: the infection site of syphilis starts with a chancre, either vaginal or on the penis (gross, you don’t want to see pictures). In Lyme disease, the famous bullseye rash at the site of the tick bite is diagnostic, but is only visible in 40-50% of cases. The syphilitic rash starts at the site of the chancre and spreads over the entire body: “…usually consists of reddish brown, small, solid, flat or raised skin sores that are less than 2 cm across. But the rash may look like other more common skin problems.”
Syphilis is principally transmitted via sexual intercourse; Lyme disease by the bite of a tick. Both have been called “the great imitator” or “the great pretender”, because their range of symptoms is so vast it can be (and often is) misdiagnosed. The key to preventing the secondary and tertiary stages of syphilis are early diagnosis and treatment.

Symptoms of Lyme disease can include:

Early Symptoms:

• Rash

• Fatigue

• Fevers, chills, body aches

• Migrating Arthralgias (joint pains)

Later symptoms:

• Brain and Central Nervous System: migraines, dizziness, brain fog, poor
memory, poor sleep, lack of verbal fluency, confusion or disorientation,
decreased ability to concentrate, facial nerve tics or paralysis, sore jaw, sinusitis,
mood swings, difficulty chewing or swallowing, sore throat, hoarseness, muscle
twitches, numbness and tingling, shooting pains, and lower back or neck pain.
Lyme has also been found to mimic all the psychiatric disorders.

• Muscles, joints, and bones: pains that come and go (with or without swelling),
cramps, stiffness.

• Circulation: too fast or two slow heart rate, irregular heartbeat (palpitations),
inflammation of the heart muscle or arteries, and chest pain.

• Breathing: sinusitis, difficulty breathing, and pneumonias.

• Skin: rashes, itching, crawling sensations, benign cysts and nodules, and skin
discoloration.

• Eyes: pain, inflammation, blurred or double vision, retinal damage, floaters,
flashing lights, light sensitivity, dry eye, and blindness.

• Ears: itching, earache, buzzing, ringing, and sound sensitivity.

• Digestive tract: nausea, vomiting, diarrhea, constipation, loss of appetite, mild
liver function abnormalities, and liver and spleen tenderness and enlargement.

• Genitourinary tract: inflammation of the urethra and bladder, pelvic pain,
testicular pain, and loss of sexual desire.

• General: tiredness, lack of stamina, fever, vague discomfort, irritability,
nervousness or anxiety, and weight loss or gain.

A person could have all of these late stage symptoms or none of them. Take a look at the symptoms! It is no wonder that it has been misdiagnosed by as many as 350 other conditions. Lyme spirochetes travel from the site of the bite to anywhere in the body via the skin, lymph system, and blood. They can ultimately cause problems in all body systems.

And, of course, many of these symptoms are vague and can occur with any other mild infection. Syphilis, too has many of the same symptoms, including:

• Fatigue
• Fever
• Flu-like symptoms
• Headache
• Patchy hair loss
• Skin rashes
• Sore throat
• Swollen glands
• Weight loss
• Gradual loss of vision
• Loss of muscle coordination
• Numbness
• Paralysis
• Meningitis
• Cardiovascular symptoms
• Neurological symptoms include tabes, a myelin degeneration around nerves, which can result in: unsteady gait, lighting pains and incontinence.
Other neurological symptoms include: palsy, seizures, ataxia and paralysis. Neurosyphilis used to be called “general paralysis of the insane”, the result of a debauched and intemperate life!
• A progressive dementia characterized by memory problems, disorientation
• Mood disturbances
• Personality changes, apathy, poor judgment. About 10% to 20% of people
with neurosyphilis experience psychosis symptoms that include hallucinations
and paranoia.

In researching this diary, I ran across a limerick about syphilis, I quote it here, in part:

There was a young man of Back Bay,
Who thought syphilis just went away,
And felt that a chancre,
Was merely a canker,
Acquired in lascivious play.

With symptoms increasing in number,
His aorta's in need of a plumber,
His heart is cavorting,
His wife is aborting,
And now he's acquired a gumma*.


Though treated in every known way,
His spirochetes grow day by day,
He's developed paresis,
Converses with Jesus,
And thinks he's the Queen of the May.

Theodor Rosebury, 1971

*Gumma: soft, non-cancerous growth resulting from the tertiary stage of syphilis. It is a form of granuloma. Gummas are most commonly found in the liver (gumma hepatis), but can also be found in brain, heart, skin, bone, testis, and other tissues, leading to a variety of potential problems including neurological disorders or heart valve disease.

(for those who want to read the entire limerick, let me know. )

The last stanza describes neurosyphilis, with delusions and psychosis. Many people have been assumed to have had syphilis, based on their behavior, for example, Idi Amin.

For those of you who are dying to know the answer to my above hypothetical, it could be either disease. I kept the symptoms general enough that, from those symptoms alone, you couldn’t diagnose which one with certainty. The only thing that makes it more likely to be Lyme disease is that syphilis is rarely a concern any longer, unless you have a pre-existing immune system deficiency, such as HIV.

I am a scientist. I believe in evidence, not supposition, not hypotheses, not theories…facts and the reasonable conclusions that can be drawn from them. But based on what I know about syphilis is seems to me that several conclusions, while not “evidence” in and of themselves, are suggestive and worthy of scientific study and debate.

1. If a tick can become infected with the spirochete, why can’t a mosquito or a
flea?
2. If other diseases, including syphilis and TB, can “hide” in an encysted form,
making chronic disease difficult, near impossible, to treat, why can’t Borrelia?
3. The classic “herx” that you’ve read about was first observed in syphilis! Why
does it get such short shrift in Lyme mainstream?
4. If syphilis can be sexually transmitted, why can’t Lyme?
5. Given the fact that Syphilis can go dormant for decades and them re-emerge
with horrible CNS symptoms, does the supposedly “self limiting” and “minor
consequence” attitude towards Lyme by many, represent a disaster waiting to
unfold?

We may, eventually discover that there are more differences than similarities between these two diseases. We know that they are not “kissin’ cousins,” but they may share much more than the current medical community is willing to even consider. What can we learn from the lessons of syphilis? I am guessing a great deal.
http://www.dailykos.com/story/2011/0...-is-Different-