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Yes, anyone you had sex with or shared needles with in the last three months should be checked if you develop primary syphilis. If you are diagnosed with secondary syphilis, all of your partners in the last six months should be checked. If you are diagnosed with tertiary syphilis, all of your recent and past partners should be checked. Positive tests for syphilis must be reported to Public Health, so a Public Health nurse may contact you to ensure that you and your partners have been treated for this infection. Do not have unprotected sex with an untreated partner because you can be re-infected.

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Syphilis is curable and can be easily treated with penicillin injections (or other antibiotics if you are allergic). It is very important to have all of your treatments; otherwise you may develop the later stages of syphilis. It is very important to have follow-up checkups done to make sure you don’t develop the later stages of syphilis. Talk to your doctor about how often you should have check-ups.

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A study published in the August
issue of Obstetrics & Gynecology, the official publication of the American
College of Obstetricians and Gynecologists (ACOG), finds that Mission
Pharmacal’s Tindamax(R) (tinidazole) is an effective and well-tolerated
treatment for bacterial vaginosis (BV), the most common vaginal infection
among women of childbearing age in the United States. BV affects almost
one-third of women in the United States and is one of the main causes of
the 10 million doctor visits for vaginitis in the country annually.
    The randomized, double-blinded study found that a 1 gram once daily,
five- day course of treatment with Tindamax resulted in a therapeutic cure
rate of 36.8 percent, significantly greater than the rate of 5.1 percent
seen with placebo (P<.0001). Tindamax also was shown to have a safety and
tolerability profile comparable to placebo.
    While previous studies evaluating BV therapies have defined cure as
resolution of only three or four of Amsel’s criteria used to establish BV
diagnosis at study entry, this study used rigorous FDA-recommended criteria
to define therapeutic cure as resolution of all 4 of Amsel’s criteria plus
a microbiological cure with the return of the vaginal flora to normal
(Nugent’s score, defined as < 4). More traditional definitions of cure
based only on clinical criteria produced substantially higher cure rates
for the five-day regimen of Tindamax in this study.
    “The results of this study clearly demonstrate Tindamax’s ability to
effectively treat BV in a shorter course of therapy without the side
effects typically associated with older therapies,” said Charles H.
Livengood III, M.D., the primary investigator of the study and an associate
professor of obstetrics and gynecology at Duke University, Durham, North
Carolina. “Both of these advantages are likely to lead to patients
finishing the full course of treatment, which is important when treating a
bacterial condition like BV.”
    Many women with BV do not experience any symptoms; when they do,
symptoms include abnormal vaginal discharge with an unpleasant odor,
burning during urination, or itching in the genital area. Left untreated,
BV can increase a woman’s susceptibility to sexually transmitted diseases
such as chlamydia, gonorrhea and HIV if she is exposed to these diseases,
according to the Centers for Disease Control and Prevention (CDC).
    Approved earlier this year as the first new oral therapy for the
treatment of BV in a decade, Tindamax provides a shorter course oral
treatment, with fewer doses per day and a better tolerability profile, than
the current standard of care. Unlike intravaginal treatments, Tindamax
treats the entire reproductive tract, including the upper tract, where BV
has been shown to migrate.
    “The publication of these data in the ACOG journal marks another
important milestone for Tindamax, which was approved by the FDA to treat
bacterial vaginosis in May of 2007,” said Neil Walsdorf, Jr., president of
Mission Pharmacal. “With its shorter course of therapy and better
tolerability profile, we are confident that Tindamax will be the new
standard of care in oral therapy for the treatment of BV.”
    Tindamax is the only FDA-approved treatment for both BV and
trichomoniasis, two conditions which are highly prevalent and often
overlap. Trichomoniasis is the most common curable sexually transmitted
disease in the United States.
    About the Study
    A total of 235 women, enrolled at 10 geographically diverse centers in
the United States, participated in the study. Two different regimens of
Tindamax were compared to placebo to evaluate efficacy, safety, and
tolerability in the treatment of BV at 21 to 30 days after treatment. A
regimen of Tindamax 2 grams once daily for two days demonstrated a cure
rate of 27.4 percent (p < 0.0002), using the rigorous FDA-recommended
criteria. Nausea was significantly more frequent among patients receiving
this regimen of Tindamax than those receiving placebo.
    Overall, Tindamax was well-tolerated the study, as evidenced by the
high compliance with therapy in both Tindamax treatment arms. No patient
withdrew from either Tindamax arm of the study, and compliance with study
therapy, tolerability, and safety were comparable in the three arms of the
study. Dysgeusia (metallic taste) was the only adverse event reported
significantly more frequently among patients receiving the five-day
Tindamax regimen. All gastrointestinal symptoms were comparable in the
Tindamax and placebo groups.
    About Tindamax
    Tindamax, a second-generation 5-nitroimidazole compound, is indicated
in the United States for the treatment of bacterial vaginosis,
trichomoniasis, the intestinal infections giardiasis and intestinal
amebiasis, and amebic liver abscess. It has been approved for use in the
United States since May 2004 and is recognized as one of the drugs of
choice for the treatment of trichomoniasis by the Centers for Disease
Control and Prevention (CDC).
    Tindamax has been found to have a favorable side effect profile with a
low incidence of nausea and vomiting. In clinical trials of patients
treated with a single 2 gram dose of tinidazole for trichomoniasis and
giardiasis, adverse effects experienced by more than one percent of
patients included metallic or bitter taste, nausea, anorexia, abdominal
discomfort, vomiting, constipation, diarrhea, general weakness or fatigue,
dizziness, and headache.
    Carcinogenicity has been seen in mice and rats treated chronically with
metronidazole, another nitroimidazole agent. Although such data have not
been reported for tinidazole, the two drugs are structurally related and
have similar biologic effects. Use should be limited to approved
indications only.
    The use of tinidazole in pregnant patients has not been studied.
Tindamax should not be administered to women in their first trimester of
pregnancy.
    To reduce the development of drug-resistant bacteria and maintain the
effectiveness of Tindamax and other antibacterial drugs, Tindamax should be
used only to treat or prevent infections that are proven or strongly
suspected to be caused by bacteria.
    About Bacterial Vaginosis
    As the most widespread form of vaginal infection, affecting nearly one-
third of women in the United States, BV is one of the main causes of the 10
million doctor visits for vaginitis in the country annually. Approximately
4.5 million prescriptions are written for BV treatment each year in the
United States.
    BV symptoms include a foul or fishy odor in varying degrees and a milk-
like vaginal discharge. Signs of BV also include a vaginal pH level
exceeding 4.5 and the presence of clue cells seen in a microscopic
evaluation of vaginal discharge. Clue cells are vaginal epithelial cells
coated with bacteria. BV is caused by an overgrowth of anaerobic bacteria
in the vagina, with a concomitant decrease in protective lactobacilli.
    About Mission Pharmacal
    Mission Pharmacal, the maker of Citracal(R), is a family-owned
pharmaceutical company based in San Antonio, Texas. For more than 60 years,
the company has been dedicated to identifying unmet health needs in the
marketplace and developing innovative prescription and over-the-counter
products to meet them. Currently, Mission Pharmacal provides physicians and
consumers with pharmaceutical, nutritional and diagnostic products

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How is it diagnosed? If a chancre is present, a swab of the sore will show the bacteria when examined in the laboratory. Blood tests are also used to diagnose syphilis, however it may be two to twelve weeks after infection before these tests will be able to detect syphilis infection. In addition to these physical and laboratory tests, your doctor may also ask you about your medical and sexual history in order to make a diagnosis. Are there any complications? Syphilis can have severe complications and cause permanent damage to the nervous system. Untreated mothers may deliver a baby who is stillborn or has serious birth defects. If a chancre is present, it also significantly increases your risk of getting other sexually transmitted infections like HIV.

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What is it?

A bacteria called Treponema pallidum caused syphilis. This bacteria is usually transmitted sexually, and then carried through the bloodstream to every organ of the body. Because it lives in the blood, intravenous drug users who share needles are also at risk. The bacteria do not survive outside the body for long; this infection is rarely if ever passed from one woman to another during sex. A pregnant woman with untreated syphilis may transmit the infection to her fetus before birth.

What are the symptoms?

Syphilis occurs in three stages.1^st stage - Symptoms of primary syphilis begin ten to 90 days after infection. An ulcer or sore called a chancre appears on the genitals, lips, anus or inside the mouth. It is painless and usually disappears on it own. Sometimes people do not even notice the blister or chancre. 2^nd stage - Secondary syphilis may begin four to ten weeks after the chancre appears, if primary syphilis is not treated effectively. A rash may appear on the hands or the soles of the feet, or elsewhere on the body. Other possible symptoms include:

• patchy hair loss
• muscle and joint pain
• swollen glands
• fever

Again these symptoms may disappear without treatment 3^rd stage - Tertiary syphilis is a serious illness that may occur several years after infection. It can lead to dementia and permanent damage to the nervous system, heart or brain. It may also cause debilitating arthritis.

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Should my partner be checked or treated?

You should tell your partner about your infection, so they can watch for signs of infection.

How can I protect myself from Molluscum contagiosum?

Never touch a Molluscum contagiosum sore. Always practice safer sex to reduce your risk of this and other infections.

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How is it diagnosed?

A doctor can diagnose Molluscum by looking at the rash.

Are there any complications?

Sometimes Molluscum contagiosum sores can get infected with bacteria.

How is it treated?

Often the rash may disappear on its own, although it may also recur - even if you have been treated. One treatment is podophyllin, an ointment that can be applied to the sores. Liquid nitrogen can be used to freeze off the bumps, or they can be surgically removed if they are resistant to treatment. Laser surgery may also be an option. There is a cream that can be prescribed by a physician but it is very expensive.

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Molluscum contagiosum is a virus that causes a skin infection. It can be spread sexually or through non-sexual contac. It does not seem to be spread from a pregnant woman to her child during delivery. Children who play together can spread the virus.

What are the symptoms?

Tiny pinpoints appear on the skin, one week to six months after infection. They grow into small, pinkish-white bumps that look smooth and shiny. They have a dip in the middle and a milky-white fluid inside. They can appear anywhere on the body. They can disappear and then reappear at a later date.

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Should my partner be checked or treated?

Men are not tested for HPV but may have visible warts treated. HPV can be spread easily during intercourse or other genital-to-genital contact. Men may have warts inside the urethra, and women may not be aware of warts or changes inside the vagina. Fingers from vagina to vagina can spread the HPV virus.

How can I protect myself from HPV?

HPV is mainly spread through body fluids, but it can also spread through skin contact. A latex condom may help protect the vagina and cervix during intercourse, but there is still a risk of developing warts in other areas.

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Cervical cancer is a risk with some strains of HPV. Cervical cancer can be prevented by having regular Pap smears and exams so abnormal cells can be removed before they spread or become cancerous. To help your body cope with the virus:

• use condoms
• stop smoking
• limit number of sexual partners
• get a pap every year

How is it treated?

Treatment can remove warts and/or abnormal cells but it will not necessarily rid your body of the virus. Medications such as podophyllin, trichloroacetic acid or aldara cream can be applied directly to the warts if they are on the outside of the body. Used once or twice a week, these medications will make about 60 percent of warts disappear. Another 20 percent of warts will disappear without treatment. For some women with HPV infection on the cervix or for warts that are resistant to medication, other treatments are available by a gynecologist:

• cryotherapy uses liquid nitrogen to freeze off warts
• laser therapy can be used to destroy warts or abnormal cells

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