Mr. Zhao from Hangzhou donates blood every year. However, during the routine laboratory tests for this year’s blood donation, he tested positive for syphilis serology, and the staff at the blood station asked him to go to the hospital for further tests, which confirmed that he had syphilis. The second hospital of Zhejiang University School of Medicine, Department of Dermatology and Venereal Diseases, Laolimin, who lives a decent life and has a decent style, how could he be related to STDs? Mr. Zhao was confused for a moment. After careful recollection, he remembered that 3 months ago he was scraped on the ear during a haircut and there was a lot of blood. Could it be related to this? The Second Hospital of Zhejiang University Medical College Dermatological Venereology Department, chief physician Laolimin said that this could happen. “If the customer with syphilis in front of the haircut bleeds during the haircut, but the haircutting equipment is not disinfected or disinfected, and then give the next customer a haircut, there is a possibility of spreading the disease.” Reporter: Similar to Mr. Zhao’s experience are not a few people, some people in the wedding test, accidentally found to be positive for syphilis seropositive; others are hospitalized for a comprehensive examination of the disease, only to learn that they are positive for syphilis seropositive. These people are neither infected with syphilis nor have they ever shown signs and symptoms of syphilis, how do these occult syphilis arise? Lakemin: Syphilis is a unique human disease and one of the most common sexually transmitted diseases, caused by the infection of syphilis spirochetes, and there are two types of acquired and fetal transmission. The vast majority of acquired syphilis is transmitted sexually, followed by kissing, breastfeeding, blood transfusions and other routes, and less indirectly through objects. Syphilis is classified as stage I, II and III in terms of disease course. After the syphilis spirochete invades the human body, it first appears as single or multiple painless dark red spots on the glans, foreskin and coronal sulcus in men, the labia, clitoris, fingers, lips and tongue, breasts and eyelids in women, and then the spots turn into hard nodules (called hard chancre), which can erode and ulcerate. The symptoms of untreated stage II syphilis tend to subside spontaneously into the asymptomatic phase, which becomes recessive syphilis. Occult syphilis has no clinical symptoms for the time being, but it is not cured. In fact, there are still syphilis spirochetes in the blood of patients with recessive syphilis, and there are no clinical manifestations because, firstly, the patient’s immunity is strong and temporarily suppresses the syphilis; secondly, through treatment, the syphilis spirochetes are partially eliminated or controlled and temporarily cannot make waves. Irregular treatment and the special constitution of the patient are the reasons for the existence of occult syphilis. Although occult syphilis is asymptomatic, it can be very harmful. When the patient’s immunity decreases, the recessive becomes dominant and the patient then develops signs and symptoms. In addition, if a woman with recessive syphilis is pregnant, she can pass it to her fetus through the placenta, causing miscarriage, premature birth, stillbirth or the birth of a child with congenital syphilis. Reporter: You just talked about the possibility of syphilis transmission in non-sexual contact, what are the main ways of transmission? Laurimin: In daily life, there are many men who like to shave at hairdressers and often share razors with others. This is very dangerous, not only unhygienic, the use of the process will inevitably damage the skin, bleeding, incomplete epidermis is unable to resist infection by foreign pathogens. The skin, especially the vulva, is also susceptible to sexually transmitted diseases when in direct contact with common items. Like public bathrooms, saunas, office buildings, toilet seats and toiletries, etc., should avoid direct contact. If you have lesions in your mouth, you can also transmit second-stage syphilis to your baby through chewing and feeding. Reporter: Is syphilis infection fatal? The actual fact is that you can find a lot of people who have been in the business for a long time. When syphilis develops to an advanced stage, it can cause neurological and cardiovascular lesions that can endanger life or leave lifelong disabilities. The more advanced the disease, the more irreversible the organ and nerve damage caused by syphilis. Clinically, there are cases of elderly people who have sudden cerebrovascular accidents or sudden lameness of their legs, only to discover unexpectedly during treatment that it was neurological syphilis. Early syphilis lasts for less than two years and is highly contagious. Among them, Phase I syphilis is the most infectious within about 3 months after infection, which is also the best time for early diagnosis and timely treatment. Clinically, syphilis emphasizes early diagnosis, early treatment, regular course of treatment and adequate dosage. Irregular treatment can not only cause the recurrence of skin and mucous membrane syphilis symptoms and increase the chance of early neurosyphilis, but also contribute to the early occurrence of late stage damage, which not only affects the patient’s prognosis, but also expands the chance of continued transmission of syphilis. Reporter: Can the syphilis epidemic be controlled? What is the difficulty? Lakin: Syphilis is a curable venereal disease, and its spread can be prevented. There are inexpensive, sensitive, and specific serological diagnostic methods, and there is an effective treatment drug penicillin, making early detection, early diagnosis, and early treatment of syphilis possible. There are many obstacles to overcome in controlling the syphilis epidemic. One of the obstacles. With the change of people’s sexuality, love object premarital sex in the increase, “extramarital”, “one-night stand” and other population base in the rise, and the lack of knowledge of safe sex, the necessary protective measures lack. Once the syphilis spirochete enters these groups, transmission is inevitable. Barrier No. 2: Delayed access to medical care affects the timely control of the disease and transmission. Patients with stage I and II syphilis are most infectious to their sexual partners, and the strong infection period can last from 6 months to 1 year. The most common cause of syphilis is the delay in seeking medical attention, which is influenced by cultural, social and economic factors. Even if they are aware of the possibility of the disease, some patients are too ashamed to seek medical treatment due to the sense of shame; what is more difficult is that most patients have hidden syphilis and do not know that they have contracted the disease, so they cannot take the initiative to seek medical treatment. Barrier No. 3: Difficulty in identifying and treating partners who may have been infected in a timely manner. Sexual contact with patients with stage I and II syphilis can occur only after an incubation period of up to three months. If treatment can be initiated before it develops into infectious syphilis, the transmission of syphilis can be interrupted. The problem is that patients often have sex with unknown partners or are reluctant to identify their partners for various reasons.