[Question #5373] Household /work

21 months ago
I wasnt sure if I would be allowed to ask another question so I emailed the site and Sharon was nice enough to respond. I belueve Im in clear from last event but 
I was wanting to know if someone was infected with sifilis which would be the test to show past infections?
Would it be TPPA TPHA what I understand is the RPR is used more for current / active infections . 2Once the inital sore is healed how easy is it to spread from 2ndar y sore.
3 If its on hand could shaking hands or hugging passive skin on skin .4What do they look like. 
5 I work with homeless /high risk population just want make sure.
Part of the job is where clients stay a week or longer if they have rash or sore how easily could it spread. I know the rash and sores can vary in sizes so they might go unnoticed
Would the other person have to have a cut or be exsposed to mucus membrane to catch it?.
How common is to have it spread to the eyrs.
When does it usually become remote.
Thank you

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
Welcome back to the forum. FYI, the point of limiting repeated questions is to not keep addressing the same sort of concern -- in this case, inappropriate fears by people at little or no risk of STD. This is a different topic in the information you seek, but the basic problem you face is the same, as revealed by your comment about working with homeless populations and the title of your question. The main point is that there is never risk of any STD or HIV until and unless you have sex (meaning intercourse) with potentially infected persons. Nobody ever gets HIV just from being around or having nonsexual contact with people at high risk. And anyway, homeless persons are not at especially high risk of STDs or HIV. That's your apparent hang-up, not test performance. That said, I'll briefly answer these questions -- but until and unless you actually are exposed in a meaningful way, this definitely is your last question on the forum (as you were warned in your most recent previous thread).

1) RPR, and increasingly IgG ELISA tests, are used to initially diagnose syphilis. TPHA and related tests are used to confirm positive results with RPR or ELISA.

2-4) Open syphilitic sores easily transmit syphilis, but only by sex. It is rare for someone to have infective (open) syphilitic sores on the hands or anywhere else other than the genital area. Without genital contact, there is no significant risk of catching syphilis. So it doesn't matter what such sores might look like.

5) As noted above, most homeless populations are not believed to be at especially high risk of syphils or other STDs. There are exceptions, but without sex with such persons, it doesn't matter. STDs almost never are spread nonsexually, to the eyes or anywhere else.

If fears like this continue, consider finding a job that doesn't require personal interaction with persons and populations that make you nervous or you don't trust. Or consider professional counseling. From a mental health standpoint, fears like this are not normal!