Syphilis

Straight to the Facts: Syphilis

Caused by sexual contact with an infected person
Symptoms can be very hard to recognize, but include:
- One or several firm, round, painless sores that last 3 to 6 weeks
- Sores in your mouth, genitals, or anus
- A rash on one or more areas of your body, typically on the palms of your hands
- Fever, patchy hair loss, headaches, weight loss, muscle aches, among others
Not treating syphilis can lead to serious health complications including bone infections, paralysis, numbness, blindness, dementia, and death
Treatable with the right antibiotics
Can be spread from mother to baby during childbirth

How Do I know I have it?

Symptoms of syphilis in adults can be divided into stages:

Primary Stage:

During the first (primary) stage of syphilis, you may notice a single sore, but there may be multiple sores. The sore is in the location where syphilis entered your body. The sore is usually firm, round, and painless. Because the sore is painless, it can easily go unnoticed. The sore lasts 3 to 6 weeks and heals regardless of whether or not you receive treatment. Even though the sore goes away, you must still receive treatment so your infection does not move to the secondary stage.

Syphilis is a bacterial STI caused by the microbe Treponema pallidum. It is spread by sexual contact with another person who has syphilitic sores, called chancres, through vaginal, anal, and oral sex. In the US in 2016, about 89,000 people had active syphilis infections and in recent years the number of people with syphilis infections has been going up.

Symptoms usually occur about 21 days after infection but can occur between 10 and 90 days after you are exposed. Syphilis also occurs in several stages which have very different symptoms and require different treatment. After a few months, symptoms can go away making you think you are not infected anymore; but, the bacteria will still be in your system and can come back years later to cause serious complications like brain and bone infections.

Men who have sexual contact with other men, people whose partner(s) has/have tested positive for syphilis and people living with HIV should be tested for syphilis. Pregnant women should be tested in the first trimester.

Secondary Stage:

During the secondary stage, you may have skin rashes and/or sores in your mouth, genitals, or anus, also called mucous membrane lesions. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can look like rough, red, or reddish brown spots typically on the palms of the hands and/or the bottoms of the feet. The rash usually won’t itch and it is sometimes so faint that you won’t notice it. Other symptoms you may have include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue or feeling very tired. The symptoms from this stage will go away whether or not you receive treatment. However, without the right treatment, your infection will move to the latent and possibly late stages of syphilis.

Latent and Late-Stages:

The latent stage of syphilis begins when all of the symptoms you had earlier disappear. If you do not receive treatment, you can continue to have syphilis in your body for years without any signs or symptoms. Most people with untreated syphilis do not develop late-stage syphilis. However, if late-stage syphilis does happen, it is very serious and occurs 10–30 years after your infection began. Symptoms of late-stage syphilis include bone infections, difficulty coordinating your muscle movements, paralysis which is not being able to move certain parts of your body, numbness, blindness, and dementia which is a mental disorder where you forget things and your personality may change significantly. In the late stages of syphilis, the disease damages your internal organs and can result in death.

How can I get it?

You can get syphilis by direct contact with a syphilis sore during anal, vaginal, or oral sex. Sores can be found on the penis, vagina, anus, in the rectum, or on the lips and in the mouth. The US has seen a recent rise in the number of cases of syphilis, particularly in men who have sexual contact with other men. You can reduce your risk of syphilis by using condoms every time you have sex with a new partner and any partner who has sexual contact with people other than you or has tested positive for syphilis. Syphilis can also be spread from an infected mother to her unborn baby.

How can I get treated?

Syphilis can be cured with the right antibiotics from your health care provider. However, treatment will not undo any damage that the infection has already done.

What happens if I do not get treated?

If left untreated, late-stage syphilis can cause bone infections, brain damage, paralysis, heart disease, and death. Having untreated syphilis increases the chances of getting HIV since HIV can enter the body more easily through the syphilis sores.

What if I am pregnant?

Pregnant women with untreated syphilis may miscarry or have a still-born baby. Once the baby is born, treatment must occur immediate for syphilis, otherwise the baby may develop serious neurological problems including seizures, developmental delays or even die.

It is important to get tested for syphilis early in pregnancy. If you test positive, you should receive treatment as soon as possible. You may also need to get tested again if you are at high risk for syphilis, live in an area with high syphilis infection or tested positive earlier in your pregnancy.