In biology and medicine, there are many named reactions, but everyone has heard about Wasserman's analysis of syphilis. And although today these samples are very different from what the German physician Augustus Wasserman invented in 1906, his name was retained for this analysis. Syphilis remains one of the most dangerous infections, an analysis form for the Wasserman reaction will be given to you when you undergo a medical examination, and upon admission to the hospital, and especially during pregnancy.
What is known to the average person about syphilis
For most of us, knowledge of this disease is limited to the well-known poem by Vladimir Mayakovsky and the novel “Pit” by Ivan Kuprin.
Actually luez, or syphilis, is a dangerous sexually transmitted disease that is caused by the presence of the pale treponema bacteria (Treponema pallidum) in the blood . And this disease is dangerous because in the first stages of its development a person does not feel it at all. And the parasite, meanwhile, penetrates into all mucous membranes, internal organs, bones, and the nervous system. And it is precisely Wassermann’s analysis that can detect the presence of pale treponema in the very early stages of the disease. We will please the reader: today this disease is treated, and regardless of stage. And only congenital syphilis remains a medical problem, which is why during pregnancy, the analysis of Wasserman is mandatory.
Not a marginal disease at all
So, syphilis is a systemic sexually transmitted disease that is transmitted exclusively through sexual contact or through the blood. The disease has been known to mankind since ancient times, but only from the end of the 19th century the etiology of the disease was established, and blood tests for RW appeared, which made it possible to start specific treatment from the very early stages of infection.
The disease has a wave course, secrete primary, secondary, tertiary syphilis. In this case, from the moment of infection to the tertiary period of the development of the disease, several years can pass. The incubation period of the disease is 3-5 weeks, no symptoms at this stage.
This is a dangerous disease. The absence of unpleasant sensations, even in the initial stage, leads to the transition of the disease into a chronic form. Moreover, it is in the early stages of the disease that has a high contagiousness. According to modern estimates, the incidence of syphilis today is 70-80 people per 100 thousand.
Flow periods
- Primary syphilis is the stage of development of the disease when the first syphilitic chancre appears. This is a painless sore or tubercle at the site of penetration of pale treponema into the body. At this stage, there is an increase in lymph nodes, but it is also painless and does not bother a person. Sometimes this stage of the disease is generally asymptomatic, without chancres.
- Secondary syphilis - begins on the 9-12th week from the moment of infection. It is characterized by the fact that pale treponema already overcomes the barrier of the lymphatic system and enters the bloodstream, with which it is carried throughout the body. As a result, rashes expressed in varying degrees (roseola) appear throughout the body, which do not itch and pass, appearing elsewhere.
- Tertiary syphilis is the last stage of the disease, characterized by the appearance of tertiary chancres, roseola, tubercles and gum. But the worst thing: at this time, internal organs are already beginning to be affected.
Treatment of the disease includes the use of penicillin antibiotics, the dosage and duration of treatment is determined only by a dermatovenerologist.
Syphilis test
Wasserman reaction is the only effective diagnosis of syphilis. And although it is not used in its original form today - it was replaced by more sensitive tests (RMP, RPR), but the principle of diagnosis remains the same. And the inscription on the RW blood test form remained a medical tradition.
The essence of the reaction is as follows. Artificial antigens (aggressor proteins), which today are synthesized from a bovine heart, and complement (a binding protein) are added to the patient's blood serum, which is supposed to have antibodies (protective proteins) to pale treponema.
If antibodies in the patient’s blood are suitable for pale treponema antigens, they bind and precipitate. Accordingly, if there is no sediment, then there is no pale treponema in the patient's blood.
Wasserman analysis results look like this:
- ++++ precipitate, sharply positive reaction;
- ++ there is a precipitate, but not so much, a weakly positive reaction;
- +/- partial flakes fall out, dubious reaction;
- - lack of sediment, negative reaction.
But not everything is so simple with the decoding of Wasserman's analysis.
The dubious result is also the result
A blood test for syphilis (Wasserman reaction) is considered to be insensitive, since it is not treponema itself that is used, but its substitutes. This means that quite often it gives a false positive result (the probability of error is 5-7%). This is a method of screening non-treponemal examination, the main purpose of which is a mass examination of the population.
A positive Wasserman analysis in the absence of the disease may appear in the presence of the following factors:
- Systemic diseases.
- Pregnancy and menstruation.
- Pneumonia and tuberculosis.
- Oncological diseases.
- Diabetes mellitus of any type.
- Parasite infestations.
- Alcohol intake.
In addition, there is a dubious result that requires rechecking.
Statistics say that in 4-6% of healthy citizens, the Wasserman reaction gives a consistently false positive result. So do not immediately despair, having received an analysis form for the Wasserman reaction with a mark "+/-".
The basis of medical examinations and not only
A blood test for syphilis (Wasserman reaction, or RW) is mandatory in the following cases:
- Screening medical examinations for workers in the food industry, medicine and pedagogy.
- Upon admission to inpatient treatment and in preparation for surgery.
- A syphilis test is required for pregnant women. At the same time, they do it at least three times - when registering, in the second trimester and immediately before childbirth.
- When checking into dormitories and during periodic inspections.
- If a person wants to be a donor.
In addition, you should be aware that the treatment in this case is exclusively voluntary and should be carried out only in public institutions. The Criminal Code provides for liability for persons who know that they have syphilis and who refuse treatment.
How it's done
This is a fairly simple analysis, but you need to prepare for it. The day before blood sampling, it is necessary to exclude alcohol and do not eat for at least 4 hours before analysis. These simple rules will help minimize the possibility of false positives.
In addition, it is not recommended to take a test for syphilis at elevated body temperature, in newborns in the first two weeks of life, in the presence of injuries and after vaccination.
For analysis, 10 ml of blood is taken from the cubital vein. Within no more than 2 days, serum is made from the blood in the laboratory.
An express analysis for syphilis gives results within 2 hours. Conventional tests take from 1 to 7 days. How much Wasserman analysis is done depends largely on the particular hospital.
Who will the doctors tell?
Answer: to no one. In relation to this disease, the rules of medical confidentiality remain. The doctor has no right to disclose the results of the patient examination to either employers or relatives. But at the same time, the infected person himself must remember that syphilis is a contagious disease, and therefore take the following recommendations of doctors very seriously:
- A member of the infected family and all sexual partners must definitely get to a dermatovenerologist.
- Even if their tests for syphilis are negative, the doctor will advise you to take preventive therapy with penicillin antibiotics. Do not refuse it.
- If the patient agrees to inpatient treatment, he is issued a sick leave, which indicates only the code of the disease.
- Cured syphilis is not at all dangerous and cannot be the reason for dismissal.
- After treatment, the patient is given a document that should be saved and taken for all physical examinations. For a long time, the result of the Wasserman reaction can be false positive, and this certificate will save the patient from close attention from the medical staff.
- For information: adolescents can independently apply to leather dispensaries. If syphilis is detected in them, the doctor will not inform parents, and treatment is free.
Congenital syphilis
Despite the free observation and management of pregnancy in antenatal clinics, the problem of congenital syphilis remains relevant. And this happens because many women neglect registration and come to the hospital immediately to give birth.
Pale treponemas can cross the placental barrier and enter the bloodstream of the fetus in the presence of syphilis in the mother during pregnancy. Fetal lesions occur in the 16th week of pregnancy, but in most cases a miscarriage occurs before that. If treatment is started before this period, then it is entirely possible to prevent the development of congenital syphilis of the fetus.
Until the end of the second trimester (28 weeks), a woman has the right to decide on the extension of pregnancy herself if congenital syphilis is already established. In the third trimester (after 28 weeks), pregnancy can be interrupted for medical reasons if the fetus has significant signs of a congenital pathology.
What will this turn out for a child
If the baby is infected with syphilis in the womb, then the development of events goes according to several scenarios:
- Earlier infection of the fetus leads to miscarriage or stillbirth.
- Early congenital syphilis occurs in an infant under the age of 2 years. The symptoms of this pathology include the appearance of syphilitic blisters and skin infiltration, which are more often located on the palms and soles of the child, the appearance of syphilitic rhinitis.
- Late congenital syphilis can occur at an older age. In symptomatology, reliable and probable signs are distinguished. Reliable - Getchinson’s teeth, labyrinth deafness, parenchymal keratitis (clouding of the cornea of the eyes). Probable - a hydrocephalic skull with enlarged frontal lobes, Robinson-Fournier scars (radiant scars in the corners of the lips), arachnid fingers.
If the child was diagnosed in the first months of life and an adequate and qualified treatment was carried out, then treatment of syphilis gives very good results.
Summarize
Syphilis is a scary word that is very scary. But today this disease is completely treatable. You should not panic right there, having received the dubious results of Wasserman's analysis. Everything may be completely wrong, and it is necessary to confirm this with additional examinations.
But do not forget that pale treponema is quite widespread in the human population. And it is the asymptomatic course of the initial stages of syphilis that leads to its spread. And since the main route of infection is still sexual, how to protect yourself from infection is clear to every adult.