e. Treatment of Primary and Secondary Syphilis. Penicillin is the treatment of
choice in these stages of infection. Treatment of these patients can usually be carried
out in a duty status. Favorable results may be anticipated in over 90 percent of the
cases discovered and treated in the primary state and in 75 to 85 percent of those
treated in the secondary stage.
a. Genital herpes is a sexually transmitted disease caused by the herpes virus.
Although the disease has been recognized for many years, physicians have noted a
great increase in the number of cases seen. Some epidemiologists believe that genital
herpes may be as common as gonorrhea.
b. Herpes usually begins as a crop of small red patches on the outside of the
genitalia. These form tiny blisters which eventually slough off and form ulcers. These
blisters and ulcers will cause pain on urination and a burning sensation. These painful
lesions disappear within a week, but may reappear at any time, usually when the
individual is undergoing some sort of stress. Herpes is transmitted by direct contact
with the lesions. Herpes infections are not necessarily sexually transmitted.
c. Presently there is no cure for genital herpes. Treatment consists of soothing
ointments. Antiviral drugs inhibit replication of herpes simplex viruses and when applied
topically may decrease viral shedding. Genital herpes can be prevented by avoiding
contact with active lesions. The use of a condom will substantially reduce the risk of
transmission. No intercourse should be permitted when lesions are active.
Section III. OTHER SEXUALLY TRANSMITTED DISEASES
One of the less common venereal diseases is chancroid (chancre-like).
Chancroid is characterized by a local rapidly developing, pus-filled vesicle which
ruptures and becomes multiple, painful, dirty sores. It is caused by the Ducrey bacillus
(Hemophilus ducrey) and is diagnosed by direct microscopic examination of stained
smears from the lesion, or by cultures. The incubation period is short, being from 3 to 5
days. The lesion are very painful and are accompanied by a painful and tender swelling
of the regional lymph nodes in about 50 percent of the cases. Almost any portion of the
genitalia and perineum may be involved.
Lymphogranuloma venereum is a systemic virus disease which sometimes starts
with a small transitory primary sore on or around the genitalia. It is a disease of the
lymph nodes and channels primarily and usually shows bubo formation and sometimes
ulceration. In neglected cases, it may cause rectal stricture and great swelling of the
testicles. The incubation period varies from 5 to 21 days.