What is it?

Syphilis is a sexually transmitted infection caused by a bacteria called Treponema pallidum. It goes through three distinct stages after infection, with different symptoms at each stage of the disease. Syphilis can be treated with antibiotics.

How is it spread?

A person can be infected by direct sexual contact with syphilis sores and rashes from an infected person’s body. Sometimes, they can’t see these symptoms (eg. inside the mouth, vagina or rectum), so they may not know that they or their partner has syphilis.

Apart from sexual contact, intravenous drug users sharing needles are also at high risk of getting syphilis. Pregnant women with untreated syphilis can spread the infection to their child before birth.

However, in Canada, a syphilis test is part of routine pre-natal screening and newborns are routinely given antibiotic eyedrops at birth to treat possible infection.

What are the symptoms?

Many people who have syphilis have no symptoms. Those who do have symptoms may experience the following:

Primary stage:

During the first or primary stage, a small ulcer or "chancre" appears in the genital area (penis, urethra, vulva, vagina, cervix) or on the anus or mouth. The chancre is usually painless.

During this stage, people are highly infectious to their sexual contact(s) and can easily pass it on to other people.

The chancre usually appears two to four weeks after a person picked up the infection, though in some cases it may take up to three months to appear. It remains for another three to six weeks, then will disappear on its own without treatment. However, the person will still have syphilis.

Secondary stage:

After the chancre disappears, there is a period with no symptoms lasting three to six weeks. Then, the second stage begins. There may be a rash on the palms, soles of the feet, or chest and back. The rash is usually not itchy.

Other symptoms might include persistent fever, sore throat, patches of hair loss, and flat, wart-like growths on the vaginal opening, penis, scrotum or anus.

During this stage, a person is also very infectious to their sexual partner(s). Secondary symptoms disappear after a few weeks, without treatment, but may return.

Late (tertiary) stage:

A long period with no symptoms follows the secondary stage, during which a person is not infectious. However, this does not mean the infection is over.

Symptoms of late syphilis may take from 10 to 30 years to develop. They can be very serious resulting in blindness, heart or brain damage, and in some cases, even death.

Fortunately, syphilis can be detected and treated before it reaches this stage.

How is it diagnosed?

The most common means of detecting syphilis is through a blood test. This test becomes positive anywhere from two weeks to three months after infection. Your doctor or the lab may also be able to examine fluid from the primary chancre under a microscope.

If you are HIV+, it may be more difficult to detect syphilis in your blood. In this case, your doctor should ask for a confirmatory test as well.

How is it treated?

If detected within one year of infection, syphilis is easily treated with penicillin injections, or with doxycycline or erythromycin for people allergic to penicillin.

If syphilis is detected later than one year after infection, longer courses of treatment are needed. It is currently felt that HIV+ people may need a longer course of treatment to successfully cure a syphilis infection.

What about sexual partners?

All sexual partners should be told that they may have been exposed to syphilis and should be tested. You should not have sexual contact during treatment and until all symptoms disappear.

Prevention

Using condoms can prevent syphilis transmission, as long as the sore is covered by the condom.