Q: I had an oral exposure without a condom two months back. I am yet to be tested. I got VDRL and Gonorrhoea/Chlamydia STD test done, which is negative. Does syphilis have any window period before being tested? How valid is the VDRL test after 2 months? Is is true that there have been no records of people getting infected by receiving oral sex as per CDC and Thebody.com? How has been the Indian scenario? I know its not risk free but why aren't people infected? Or they may be infected but not recorded.

A:VDRL and TPHA are the tests performed to detect Treponema pallidum infection i.e. Syphilis. None of the tests are completely foolproof in detecting the primary stage of syphilis. However, secondary syphilis can be diagnosed with 100 per cent accuracy with blood tests. In the primary stage of syphilis, usually a painless sore appears about 2-4 weeks after exposure at the site of the entry of the bacterium and disappears even without any treatment within 4-6 weeks. Signs and symptoms of secondary syphilis appear any time between one week to six months after the disappearance of primary stage. In my practice in India I see very commonly STD manifestations in oral cavity, which are a result of oral sex (Fellatio or Cunnilingus).