YOUR HEALTH
Syphilis: still here, still destructive
DR. DONOHUE

DEAR DR. DONOHUE: What happened to syphilis? I don't hear about it anymore. Is it still around? When I was in the Army, we had mandatory instructions on how to avoid getting it. Has it been eradicated? Will you review the syphilis facts, please? -- C.S.

ANSWER: Syphilis is still here and still doing damage. A war to wipe it out has been declared, and syphilis cases reached a low point in 2000, but since 2001, the numbers have increased. I don't know your age or when you were in the Army. If it was during World War II, that was before penicillin was widely available, and the only effective treatment for syphilis was avoidance. Avoidance is still a good way to deal with it, but penicillin has made it less of a scourge.

Three to 90 days after being infected, a person -- man or woman -- breaks out with a chancre (SHANK-ur), a sore found most often on the genital area. It's not painful. Along with the sore, lymph nodes in the groin enlarge. Both chancre and enlarged nodes resolve on their own without any treatment, but the syphilis germ disseminates throughout the body.

Two to eight weeks later, an untreated person manifests secondary syphilis, an illness with a body rash that can break out on the palms and soles. Not many rashes do that. Fever is present, and lymph nodes throughout the body swell. Secondary syphilis also goes away without treatment.

The illness then enters a latent phase without signs or symptoms. Many, many years later in life, about one-third of infected people develop the third stage of syphilis, with signs and symptoms demonstrating brain, heart, aorta or skin damage.

None of this need happen if syphilis is treated early with penicillin.

DEAR DR. DONOHUE: A strange thing happened to me last week. I was at my weekly poker club, and I went completely blank. I didn't know where I was or who I was with. My friends called 911 because they thought I had had a stroke. At the hospital I went through all sorts of tests. I could talk and move, but I was still in a dense fog. I stayed overnight. By morning, I was myself again. The doctors said I had transient global amnesia, and they recommended that I see a neurologist. I haven't done so yet. What is it? Is it stroke-related, or does it indicate a stroke is coming? I am 57. -- L.N.

ANSWER: Transient global amnesia is something that happens to people in their middle ages. They suddenly lose their bearings. They don't know where they are, why they're where they are, what they're doing or who they are with. They're able to converse, and they have full use of their arms and legs. They can't remember anything before the episode started. Onlookers are baffled and scared by their behavior.

No one is sure what causes this or what goes on in the brain. It is not a stroke, and it's not a warning that a stroke will occur. In around 25 percent of those who have had transient global amnesia, a second episode will take place.

Do see the neurologist. You want to be sure of the diagnosis.

Stroke is a devastating malady. The booklet on that subject deals with its signs, symptoms, treatment and prevention. Readers can order a copy by writing: Dr. Donohue -- No. 902, Box 536475, Orlando, FL32853- 6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475. Readers may also order health newsletters from www.rbmamall. com. 2006 North America Syndicate Inc. All Rights Reserved