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INTESTINAL AMEBIASIS: Incidence, and risk factors

*Entamoeba histolytica is spread through food or water contaminated with stools. *This contamination is common when human waste is used as fertilizer. *It can also be spread from person to person -- particularly by contact with the mouth or rectal area of an infected person.

GENITAL HERPES-

- Caused by Herpes Simplex Virus II (HSV-2) and less commonly by HSV-1 (more often associated with cold sores). - Approximately 45 million people in the US aged 12 and older are infected.

a. Ascaris Lumbricoides Transmission:

- If one swallows infective eggs, they pass into the intestines where they hatch into larvae and then begin their journey through the body. • Once through the intestinal wall, the eggs reach the lungs by means of the bloodstream or lymphatic system. • In the lungs, they pass through the air sacs, are carried up the bronchial tree with respiratory fluids and into the throat. • When in the throat, they are re-swallowed and they return to the small intestine where they grow, mature, and mate. -The worms become mature in about 2 months.

GONORRHEA- SYMPTOMS: on Men

- Some men have no symptoms, but most do. -Those that do develop them from 2-5 days after infection (up to 30 days). -Burning urination -White, yellow or green penile discharge -Sometimes orchitis

TRICHOMONIASIS:

-A common cause of vaginitis. -Caused by the protozoan Trichomonas vaginalis. -They produce mechanical stress on vaginal cells and then ingest cell fragments after death of the cells. -Most common site of infection in women is the urethra and the vagina. -Most common, curable STD in young, sexually active women

CHAGAS DISEASE: Expectations (prognosis)

-About 30% of infected people who are not treated will develop chronic or symptomatic Chagas disease. -It may take more than 20 years from the time of the original infection to develop heart or digestive problems. -Abnormal heart rhythms (arrhythmias, ventricular tachycardia) may cause sudden death. -Once heart failure develops, death usually occurs within several years.

AFRICAN SLEEPING SICKNESS: CHAGAS DISEASE:

-Also known as American Trypanosomiasis. It is common in South and Central America.

TRICHOMONIASIS: Symptoms: 2

-Appear 5-28 days after exposure. -Some men may temporarily exhibit symptoms such as an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.

GENITAL WARTS (Condyloma Acuminata)-2

-Approximately 20 million Americans are currently infected with HPV, and another 6.2 million people become newly infected each year. -At least 50% of sexually active men and women acquire genital HPV infection at some point in their lives.

3. ROUNDWORM (Nematoda): Disease a) Ascaris lumbricoides: Definition

-Ascariasis, or roundworm infection of the intestines, is common throughout the world in both temperate and tropical areas where sanitation and hygiene are poor. -In those areas, everyone may be harboring the parasite that causes the infection. -Ascariasis is one of the most common human parasitic infections. -According to the World Health Organization, it infects more than 1 billion people worldwide. -Ascariasis is most common in children between 3 and 8 years old.

GENITAL WARTS (Condyloma Acuminata)-1

-Caused by Human Papilloma Virus (HPV). -The most common STI (Sexually Transmitted Infection-NOT disease). -Over 100 strains of HPV-more than 40 infect the genital areas including skin of the penis, vulva and linings of vagina, cervix and rectum.

GONORRHEA-

-Caused by Neisseria gonorrhoeae bacteria. -Approximately 700,000 cases per year in the US.

SYPHILIS

-Caused by Treponema pallidum spirochete bacteria. -Approximately 40,000 cases per year in the US. -Called "the great imitator."

CHLAMYDIA- Definition

-Caused by extremely small Chlamydia trachomatis bacteria (also causes Lymphogranuloma Venereum). -Most frequently reported STD in the US. -Approximately 4 million cases per year in the US (1/68 people), 20 million currently infected. 75% of all cases in people 15-29 years old. -Annual cost of treatment is more than $2 billion.

CHAGAS DISEASE: Causes, incidence, and risk factors

-Chagas disease is caused by Trypanosoma cruzi, a parasite related to the African trypanosome that causes sleeping sickness. -It is spread by reduviid bugs (chiggers) and is one of the major health problems in South America. -Due to immigration, the disease also affects people in the United States.

GIARDIA CYST

-Chief pathways of human infection include ingestion of untreated sewage, a phenomenon particularly common in many developing countries; contamination of natural waters also occurs in watersheds where intensive grazing occurs. -Giardia is protected by an outer shell that allows it to survive outside the body for long periods of time and makes it tolerant to chlorine disinfection.

Congenital syphilis possible

-Congenital syphilis possible. -Causes delays in development, seizures, deformities, Hutchinson's teeth.

c. PINWORM: Diagnosis

-Diagnosis of pinworm infection is done by simply finding the eggs. -The most common way to collect the eggs involves swabbing the anal area with the sticky side of a piece of transparent cellophane tape (Graham's Scotch Tape Test). -The tape is then put on a slide and looked at for the eggs under a microscope.

INTESTINAL AMEBIASIS: Causes

-Entamoeba histolytica can live in the large intestine without causing disease. -However, sometimes, it invades the colon wall, causing colitis, acute dysentery, or chronic diarrhea. -The infection can also spread through the blood to the liver and, rarely, to the lungs, brain or other organs.

GENITAL WARTS (Condyloma Acuminata)- SYMPTOMS 2

-Genital warts usually appear as small bumps or groups of bumps, usually in the genital area. -They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. -Sometimes soft, moist, flesh-colored lesions. -They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh.

GIARDIASIS: Definition

-Giardia lamblia (synonymous with Giardia intestinalis, Lamblia intestinalis and Giardia duodenalis) is a flagellated protozoan parasite that colonizes and reproduces in the small intestine, causing giardiasis. -The Giardia parasite attaches to the epithelium by a ventral adhesive disc, and reproduces via binary fission.

GIARDIASIS: Definition 2 :

-Giardiasis does not spread via the bloodstream, nor does it spread to other parts of the gastro-intestinal tract, but remains confined to the lumen of the small intestine. -Giardia trophozoites absorb their nutrients from the lumen of the small intestine, and are anaerobes. -The common name for infection with Giardia lamblia is "Beaver Fever." -If the organism is split and stained, it has a very characteristic pattern that resembles a familiar "smiley face" symbol.

GENITAL WARTS (Condyloma Acuminata)- SYMPTOMS:

-HPV types are often referred to as "low-risk" (wart-causing) or "high-risk" (cancer-causing; the types that Gardasil® is used for-6,11,16,18), based on whether they put a person at risk for cancer. -In 90% of cases, the body's immune system clears the HPV infection naturally within two years. -This is true of both high-risk and low-risk types.

3. ROUNDWORM (Nematoda): Disease e) HOOKWORM: Definition

-Hookworm disease is one of the most common parasitic roundworm infections of the intestines. -This disease is widespread in tropical and subtropical countries where people may defecate on the ground and where the soil moisture is most favorable for hookworm eggs to develop into larvae (immature worms). -The World Health Organization estimates hookworm disease affects 740 million people worldwide. -Once a big problem in the southeastern United States, hookworm disease is now largely controlled in this country.

GENITAL HERPES- SYMPTOMS 4

-If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. -Fortunately, infection of a baby from a woman with herpes infection is rare. -Possible premature rupture of embryonic membranes. -Herpes may play a role in the spread of HIV, the virus that causes AIDS. -Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.

3. ROUNDWORM (Nematoda): Disease c) PINWORM: Definition

-In the United States, pinworm infection, or enterobiasis, is the most common of all parasitic roundworm infections. -It primarily affects school-age children. -Because pinworm infection is spread mainly by children, it is found most often in family groups, daycare centers, schools, and camp settings.

GONORRHEA- SYMPTOMS: on Women

-In women symptoms are mild and often non-specific, but 50% have no symptoms. **Those women that do have symptoms: -Painful or burning urination -Vaginal discharge -Vaginal bleeding between periods

1. Malaria

-Malaria is caused by a parasite (Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae) that is transmitted from one human to another by the bite of infected Anopheles mosquitoes. -In humans, the parasites (one stage of the life cycle called sporozoites) travel to the liver, where they mature and release another form, the merozoites.

TRICHOMONIASIS: Treatment:

-Metronidazole. -Sexual partners, even if asymptomatic, should be treated as well. -Associated with an increased risk of HIV and cervical cancer. -Possibly also an increased risk of prostate cancer in men.

Naegleria fowleri

-Naegleria fowleri (commonly referred to as the "brain-eating amoeba" or "brain-eating ameba"), is a free-living microscopic ameba. -It can cause a rare and devastating infection of the brain called primary amebic meningoencephalitis (PAM). -The ameba is commonly found in warm freshwater (e.g. lakes, rivers, and hot springs) and soil. -Naegleria fowleri usually infects people when contaminated water enters the body through the nose.

GENITAL HERPES- Treatment

-No medications can cure the disease. Medications shorten outbreaks and reduce their intensity and frequency. -The virus "hides out" in the dorsal root ganglia of nerves in the dermatomes of the infected areas.

GONORRHEA- DIAGNOSIS:

-Nucleic acid amplification tests (NAAT) -Nucleic acid hybridization test (DNA probe test, molecular probe test) -Gonorrhea culture -Gram stain -Enzyme-linked immunosorbent assay (ELISA, EIA)

GONORRHEA - TREATMENT:

-Ofloxacin, Cefixine, and Ceftriaxine. -A high proportion of men and women with gonorrhea also have chlamydia so antibiotics for both are needed in those cases.

a. Ascaris Lumbricoides Diagnosis

-Once mature female roundworms are in the intestines, a healthcare provider can diagnose the infection by finding the eggs (or live worms) in the stool. -Lung infection is more difficult to diagnose, but the healthcare provider can confirm it by finding evidence of the larvae in lung or stomach fluids.

Naegleria fowleri (other things)

-Once the ameba enters the nose, it travels to the brain where it causes PAM, which is usually fatal. -Infection typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. -In very rare instances, Naegleria infections may also occur when contaminated water from other sources (such as inadequately chlorinated swimming pool water or heated and contaminated tap water) enters the nose. -You cannot get infected from drinking water contaminated with Naegleria.

e. HOOKWORM: Transmission

-One can get hookworms by walking barefoot over contaminated soil. -In penetrating the skin, the hookworm larvae (immature worms) may cause an allergic reaction. -It is from the itchy patch at the place where the larvae entered the body that the early infection came to be known as "ground itch." -Once larvae have broken through the skin, they enter the bloodstream and are carried to the lungs. -Unlike ascarids, hookworms do not usually cause pneumonia. -The larvae migrate from the lungs to the trachea and are then swallowed and carried back down to the small intestine.

GENITAL HERPES- SYMPTOMS: 2

-Other signs and symptoms during the primary episode may include a second crop of sores, and flu-like symptoms, including fever and swollen lymph nodes. -However, most individuals with HSV-2 infection never have sores, or they have very mild signs that they do not even notice or that they mistake for insect bites or another skin condition. -Genital herpes can cause recurrent painful genital sores in many adults, and herpes infection can be severe in people with suppressed immune systems.

GONORRHEA- COMPLICATIONS:

-PID in women who don't know they have it and don't get treated. -In men, Epidydimitis.

3. ROUNDWORM (Nematoda) 2

-Parasitic roundworms can live on or in humans where they can cause a variety of health problems. -Most parasitic roundworm eggs or larvae (immature form) are found in the soil and enter the human body when a person picks them up on the hands and then transfers them to the mouth. -The eggs or larvae also can enter the human body directly through the skin.

c. PINWORM: Transmission

-Pinworms enter the body when one swallows their eggs. -One female pinworm may expel thousands of eggs into the environment. -As the eggs are moist and rather resistant to drying, they can infect humans even after being distributed in dust for several days.

CHLAMYDIA- DIAGNOSIS:

-Pus sample tests -Vaginal discharge tests -Urine analysis

GENITAL HERPES- SYMPTOMS:

-Recurrent, painful sores, pain in the legs, buttocks or genital area. - The first outbreak is usually the most pronounced and occurs within 2 weeks after viral transmission. -There are usually four or five outbreaks in the first year. -Over time the recurrences decrease in frequency. -It is possible that a person becomes aware of the "first episode" years after the infection is acquired.

GENITAL HERPES- SYMPTOMS 3

-Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected. -In addition, genital HSV can lead to potentially fatal infections in babies. -It is important that women avoid contracting herpes during pregnancy because a newly acquired infection during late pregnancy poses a greater risk of transmission to the baby.

3. ROUNDWORM (Nematoda)

-Roundworms, or nematodes, are a group of invertebrates (animals having no backbone) with long, round bodies. -They range in size from those that can be seen by the naked eye to those several hundredths of an inch long that can only be seen under a microscope.

GENITAL WARTS (Condyloma Acuminata)- TREATMENT 2

-Some individuals choose to forego treatment to see if the warts will disappear on their own. -No one treatment is better than another. -Cervical cancer is most treatable when it is diagnosed and treated early. -Prevention is always better than treatment.

3. ROUNDWORM (Nematoda): Disease d) STRONGYLOIDIASIS: Definition

-Strongyloidiasis is a parasitic disease. -It is found in tropical and subtropical areas, but also can be found in temperate regions, including the southern United States. -The disease usually occurs in rural areas, institutional settings, and among lower socioeconomic groups. -Strongyloidiasis is caused by a parasitic roundworm called Strongyloides stercoralis that mainly infects humans.

TAPEWORM (Cestoda): Symptoms

-Tapeworm infection usually does not cause any symptoms. -People often realize they are infected when they pass segments of the worm in their stool, especially if the segments are moving. Weight loss may occur.

c. PINWORM: Transmission 2

-The female pinworm deposits her eggs in the area around the anus. -One can be exposed to the infective eggs by scratching the contaminated area. -The eggs then attach to the fingertips and from there go into the mouth. -When swallowed, the eggs travel to the intestines. -The eggs also may be scattered into the air from bed linen and articles of clothing. -They are capable of clinging to surfaces such as bedding, clothing, toys, doorknobs, furniture, and faucets for up to 2 weeks.

INTESTINAL AMEBIASIS: Expectations (prognosis)

-The outcome is usually good with treatment. -Usually, the illness lasts about 2 weeks, but it can come back if treatment is not given.

AFRICAN SLEEPING SICKNESS: 3

-The parasites concerned are protozoa belonging to the Trypanosoma genus. -They are transmitted to humans by tsetse fly (Glossina genus) bites which have acquired their infection from human beings or from animals harboring the human pathogenic parasites.

Malaria symptoms and more

-The parasites multiply inside the red blood cells, which then rupture within 48 to 72 hours, infecting more red blood cells. -The CDC estimates that there are 300-500 million cases of malaria each year and more than 2 million people die. -THIS DISEASE KILLS MORE PEOPLE WORLDWIDE EACH YEAR THAN ANY OTHER DISEASE.

e) HOOKWORM: Definition continues

-The parasitic roundworm, known as hookworm, causes hookworm disease. Necator americanus is the most common type of hookworm that causes infection in the United States. • Hookworm eggs are passed in human feces onto the ground where they develop into infective larvae (immature worms). • When the soil is cool, the larvae crawl to the nearest moist area and extend their bodies into the air. • The larvae stay in the soil—waving their bodies to and fro—until they come into contact with human skin, usually when stepped on by a bare foot, or until they are driven back into the ground by the heat.

GENITAL WARTS (Condyloma Acuminata)- TREATMENT 3

-There are new forms of surgery, radiation therapy, and chemotherapy available for patients, but women who get routine Pap testing and follow up as needed can identify problems before cancer develops. -Other HPV-related cancers are also more treatable when diagnosed and treated early. -There are new forms of surgery, radiation therapy, and chemotherapy available for patients.

GENITAL WARTS (Condyloma Acuminata)- TREATMENT:

-There is no treatment for the virus itself, but a healthy immune system can usually fight off HPV naturally. -There are treatments for the diseases that HPV can cause: -Visible genital warts can be removed by patient-applied medications, or by treatments performed by a health care provider.

1. Malaria 2

-These enter the bloodstream and infect the red blood cells. Once in the cells they are gametocytes (male and female). -The majority of symptoms are caused by the massive release of merozoites into the bloodstream, the anemia resulting from the destruction of the red blood cells, and the problems caused by large amounts of free hemoglobin released into circulation after red blood cells rupture.

INTESTINAL AMEBIASIS: Causes 2

-This condition occurs worldwide, but it is most common in tropical areas with crowded living conditions and poor sanitation. -Africa, Mexico, parts of South America, and India have significant health problems associated with this disease.

GENITAL HERPES-2

-This represents a decrease over the last decade. -Annual cost of treatment is approximately 96 million dollars. -HSV-2 is more common in women than in men (1 in 4 vs. 1 in 8). -The disease is spread by virus coming from open sores and through skin that shows no signs of sores.

d. STRONGYLOIDIASIS: Strongyloides stercoralis roundworm

-This roundworm has different types of life cycles. -At times, the larvae (immature stage) of the parasite may develop rapidly into the infective stage in the intestine where they penetrate the intestinal lining instead of passing out of the body in the feces, as occurs normally. -This modification of the life cycle, called internal autoinfection, explains persistent strongyloidiasis, which can last as long as 40 years in people who have moved to areas where the infection is not generally found.

3. ROUNDWORM (Nematoda): Disease b) Trichinosis Definition

-Trichinosis is a parasitic roundworm disease. - Human cases of trichinosis have been associated with eating undercooked homemade sausage that contains pork or horse meat, as well as eating walrus or bear meat. -Because many states have adopted laws requiring that all garbage fed to hogs be sterilized, fewer people get trichinosis today. -Although trichinosis is very uncommon in the United States today, it is found occasionally in rural areas.

b. Trichinosis Cause

-Trichinosis is caused by the larvae (immature form) of a highly versatile parasitic roundworm, Trichinella spiralis. - The larvae encyst in the muscle fibers, where they can live a long time. -This parasite can infect virtually every meat-eating mammal. The parasite is especially common in rats and in swine that feed on uncooked garbage.

2. TAPEWORM (Cestoda):

-Two most common are beef tapeworm (Taenia saginata) and pork tapeworm (Taenia solium). -In the human intestine, the young form of the tapeworm from the infected meat (larva) develops into the adult tapeworm -- which can grow to longer than 12 feet and can live for years.

TRICHOMONIASIS: Symptoms:

-Typically only in women. -Cervicitis, urethritis, vaginitis, itching, burning, discomfort during intercourse and urination, yellow-green, itchy, frothy, foul-smelling discharge. -Possible reduction in vaginal elasticity.

TRICHOMONIASIS: Diagnosis

-Usually done by observing trichomonads collected during an exam under the microscope.

SYPHILIS • Tertiary syphilis symptoms:

-Usually many months or years later. -Less than a third of cases progress to tertiary syphilis • Greatly varied symptoms depending on organs affected by syphilis • Multiple non-cancerous tumors (gummae) throughout body and in organs

GENITAL WARTS (Condyloma Acuminata)- DIAGNOSIS:

-Visual inspection and a history of sexual activity (anal, genital and oral).

GENITAL HERPES- DIAGNOSIS:

-Visual inspection of lesions, laboratory testing of material from a sore, blood test to detect HSV antibodies (not always conclusive).

GENITAL WARTS (Condyloma Acuminata)- SYMPTOMS 3

-Warts may appear within weeks or months after sexual contact with an infected person. -Or, they may not appear at all. If left untreated, genital warts may go away, remain unchanged, or increase in size or number. -They will not turn into cancer.

3. ROUNDWORM (Nematoda) Exceptions

-With the exception of the parasitic roundworm that causes trichinosis, mature adult roundworms eventually end up or live in human intestines and cause infection and disease. -In trichinosis, it is the movement of the larvae through the body from the intestines and their encystment (becoming enclosed in a capsule) in muscle tissue that creates serious problems.

INTESTINAL AMEBIASIS:

Also known as amebic dysentery.

GENITAL WARTS (Condyloma Acuminata)- SYMPTOMS 4

Cervical cancer does not have symptoms until it is quite advanced. -For this reason, it is important for women to get screened regularly for cervical cancer. -Other less common HPV-related cancers, such as cancers of the vulva, vagina, anus and penis, also may not have signs or symptoms until they are advanced.

SYPHILIS TREATMENT:

First treatment was Salvarsan 606 (Dr. Paul Ehrlich 1910), an arsenical compound. Worked, but had many side effects. • procaine penicillin • benzathine penicillin • doxycycline • amoxicillin

GONORRHEA- SYMPTOMS: Rectal infection

Rectal infection in both men and women includes: -Rectal discharge -Itching -Soreness -Bleeding -Painful defecation

SEXUALLY TRANSMITTED DISEASES

SEXUALLY TRANSMITTED DISEASES

SYPHILIS • Late syphilis symptoms:

after severe progression of tertiary syphilis • Mental illness • Blindness • Neurologic problems • Charcot Joints • Heart disease

GENITAL HERPES- Treatment 2

• Acyclovir (Zovirax): This is the oldest and there is a generic of this medication so it is cheaper. • Famcyclovir (Famvir) • Valcyclovir (Valtrex)

CHLAMYDIA- TREATMENT:

• Azithromycin-best for pregnant women • Doxycycline (drug of choice)-not during pregnancy • Erythromycin-not during pregnancy • Ofloxacin-not during pregnancy • Amoxicillin • Avoid sex during treatment • Treatment of any sexual partners • Avoid douching during treatment

CHAGAS DISEASE: Complications

• Cardiomyopathy • Enlargement of the colon (megacolon) • Enlargement of the esophagus (megaesophagus) with swallowing difficulty • Heart disease • Heart failure • Malnutrition

SYPHILIS Primary syphilis symptoms:

• Chancre - a painless open genital sore usually on penis or vagina; rarely hands, mouth or anus; sometimes inside vagina or on cervix. • Penis ulcer • Vaginal ulcer • Internal vaginal ulcer • Cervix ulcer

SYPHILIS • Late syphilis symptoms: 2

• Death • Neurosyphilis o Headache o Stiff neck o Fever o Seizures o Paralysis

SYPHILIS Secondary syphilis symptoms: about a third of untreated patients 2

• Genital wart-like lumps • Mouth lining rash • Flu-like symptoms • Mild fever • Fatigue • Headache • Sore throat

SYPHILIS Primary syphilis symptoms:2

• Hand ulcer • Mouth ulcer • Very contagious • Enlarged groin lymph nodes • Enlarged lymph nodes - all over the body • Chancre disappears - the chancre will disappear with or without treatment • Enlarged lymph nodes return to normal

a. Ascaris Lumbricoides Transmission: 2

• In the lungs, they pass through the air sacs, are carried up the bronchial tree with respiratory fluids and into the throat. • When in the throat, they are re-swallowed and they return to the small intestine where they grow, mature, and mate. -The worms become mature in about 2 months.

CHLAMYDIA- Symptoms 2

• Light vaginal bleeding • Vaginal bleeding after intercourse • Symptoms of a milder chronic infection: • Lower abdominal pain • Lower back pain

INTESTINAL AMEBIASIS: Complications

• Liver abscess • Medication side effects, including nausea • Spread of the parasite through the blood to the liver, lungs, brain, or other organs

SYPHILIS Secondary syphilis symptoms: about a third of untreated patients 3

• Loss of appetite • Muscle aches • Tiredness • Patchy hair loss • Swollen lymph nodes throughout body • Intermittent symptoms - the symptoms of secondary syphilis can come and go for up to 2 years • Very contagious

CHLAMYDIA- Symptoms 3

• Lower abdominal pain worse during menstruation • Lower back pain worse during menstruation • Spotting • Spotting after sex

SYPHILIS • Latent syphilis symptoms:

• No symptoms • Not contagious

CHLAMYDIA- Symptoms

• No symptoms - many cases are asymptomatic (as many as 85% of female cases and 40% of male cases) • Vaginal discharge • Penile discharge • Anal discharge • Pain while urinating

CHLAMYDIA- COMPLICATIONS:

• Pelvic inflammatory disease (PID) - about 20-40% of untreated chlamydia cases get PID. • Scarring of the fallopian tubes • Ectopic pregnancy • Epidydimitis • Infertility

AFRICAN SLEEPING SICKNESS:

• Sleeping sickness occurs only in 36 sub-Saharan Africa countries where there are tsetse flies that can transmit the disease. • The people most exposed to the tsetse fly, and therefore the disease, are in rural populations dependent on agriculture, fishing, animal husbandry or hunting. • Mother-to-child infection: the trypanosome can cross the placenta and infect the fetus.

SYPHILIS DIAGNOSIS:

• Swab of chancre - in primary and secondary syphilis phases • Swab/scraping test • Syphilis blood tests • VDRL (Venereal Disease Research Laboratory) test • RPR (rapid plasma reagin) test • Syphilis antibody tests • CSF syphilis tests

AFRICAN SLEEPING SICKNESS:2

• Trypanosoma brucei gambiense (T.b.g.) accounts for 95% of reported cases of sleeping sickness. • Diagnosis and treatment of the disease is complex and requires specifically skilled staff. -Human African trypanosomiasis, also known as sleeping sickness, is a vector-borne parasitic disease.

SYPHILIS Secondary syphilis symptoms: about a third of untreated patients

• Will progress • These symptoms appear 3-6 weeks after the chancre • (Or 1 to 6 months later.) • Skin rash • Small, brown, penny-sized sores (especially on the palms and soles) • Wart-like lumps