Syphilis

General Info

If you think you have a Sexually Transmitted Infection (STI) or that you have been exposed to an STI, such as Syphilis, STOP having sex immediately until you are tested and/or treated by a medical provider.

For more information about Sexually Transmitted Infections, visit: http://www.cdc.gov/std/default.htm

What is it?

  • Syphilis is a bacterial sexually transmitted infection (STI).
  • It is an infection caused by a bacterium ("germ") called Treponema pallidum.
  • Pregnant women with the infection can pass it to their unborn children.
  • It has often been called "the great imitator" because so many of the signs and symptoms are indistinguishable from those of other diseases.
  • Syphilis can cause long-term complications and/or death if not adequately treated.
  • Syphilis is easy to cure in its early stages.

How do I get it?

How is Syphilis spread?
  • Syphilis is transmitted from person to person by direct contact with the syphilis sores of an infected person.
  • Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth.
  • Syphilis can be transmitted during vaginal, anal, or oral sexual contact.
  • Although transmission occurs from persons with sores, many of these sores are not recognized. Transmission may occur from persons who are unaware of their infection.
  • Pregnant women with the disease can pass it to their unborn children.
If I have Syphilis and I'm pregnant, can I spread it to my baby?
  • A pregnant woman with Syphilis can pass the infection to her unborn baby; this is called congenital Syphilis.
  • Pregnant women with Syphilis are more likely to have low birth weight babies, babies that are born too early (premature or preterm delivery), or are even born dead (stillborn).
  • Untreated Syphilis in a pregnant woman can infect and kill her developing baby.
  • Babies born with Syphilis can have many health problems.
  • An infected baby may be born without signs or symptoms of disease. If not treated immediately, the baby may develop serious problems within a few weeks.
  • Untreated babies can have many health problems including cataracts, deafness, and seizures; and they can die.
  • See your healthcare provider about testing and treatment of Syphilis during pregnancy.

How common is it?

  • The Centers for Disease Control and Prevention (CDC) estimated that over 55,000 people in the U.S. get new Syphilis infections each year.
  • 72% of new cases of Syphilis occur among men who have sex with men (MSM).
  • Most Syphilis cases occur in persons 20 to 39 years old:
    • Syphilis is highest in women 20 to 24 years old.
    • Syphilis is highest in men 35 to 39 years old.
  • Cases of congenital Syphilis in newborns increased to 360 reports in 2011.

What happens if I get it?

  • Many people infected with Syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.
  • Although transmission occurs from persons with sores, many of these sores are unrecognized. Transmission may occur from persons who are unaware of their infection.
  • Oral, anal, vaginal, or penile sores (chancres) caused by Syphilis make it easier to transmit and acquire HIV - the virus that causes AIDS. A person is 2-5 times more likely to get HIV if exposed when Syphilis sores are present.
  • Over the past several years, increases in Syphilis in MSM have been reported in various cities. In the recent outbreaks, high rates of co-infection with HIV were documented.

Signs and Symptoms

The average time between infection with Syphilis and appearance of the first symptom is 21 days, but it can range from 10 to 90 days.

The symptoms of the three stages of Syphilis in an adult are listed below:

Primary Stage of Syphilis
  • The appearance of a single sore marks the first (primary) stage of Syphilis symptoms, but there may be multiple sores.
  • The sore(s) appear at the location where Syphilis entered the body.
  • The sore is usually firm, round, painless, and doesn't bleed. Because the sore is painless, it can easily go unnoticed.
  • About half of infected women and one-third of infected men don’t even know the sore is there.
  • The sore lasts 3 to 6 weeks and heals regardless of whether or not a person is treated.
  • If the infected person does not receive adequate treatment, the infection progresses to the secondary stage.
Secondary Stage of Syphilis
  • Skin rashes and/or sores in the mouth, vagina, or anus mark the secondary stage of symptoms.
  • This secondary stage usually starts with a rash on one or more areas of the body.
  • Rashes associated with secondary Syphilis can appear from when the primary sore is healing to several weeks after the sore has healed.
  • The rash usually does not cause itching.
  • The rash may appear as rough, red, or reddish brown spots both on the palms of the hands and/or the bottoms of the feet.
  • This rash may look different on other parts of the body and can look like rashes caused by other diseases.
  • Large, raised, gray or white lesions may develop in warm, moist areas such as the mouth, underarm or groin region.
  • Sometimes rashes associated with secondary Syphilis are so faint that they are not noticed.
  • Other symptoms of secondary Syphilis include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue.
  • The symptoms of secondary syphilis will go away with or without treatment.
  • Without appropriate treatment, the infection will progress to the latent and possibly late stages of the disease.
Latent and Late Stages of Syphilis
  • The latent (hidden) stage of Syphilis begins when primary and secondary symptoms disappear.
  • Without treatment, the infected person can continue to have Syphilis in their body even though there are no signs or symptoms.
  • This latent stage can last for years.
  • About 15% of people who have not been treated for Syphilis develop late stage syphilis, which can appear 10–30 years after infection began.
  • Symptoms of the late stage of Syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia.
  • In the late stages of Syphilis, the disease damages the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints.
  • This damage can result in death.

Diagnosis and Treatment

How is Syphilis diagnosed?
  • Healthcare providers may suspect Syphilis if they see the chancre (sore) or rash.
  • A blood test is the most common way to determine if someone has Syphilis. Shortly after infection, the body produces syphilis antibodies that can be detected by an accurate, safe, and inexpensive blood test.
  • Some healthcare providers can diagnose syphilis by examining material from a Syphilis sore using a dark-field microscope. If Syphilis bacteria are present in the sore, they will show up when observed through this special microscope.
  • Because untreated Syphilis in a pregnant woman can infect and kill her developing baby, every pregnant woman should receive prenatal care and be tested for Syphilis during pregnancy and at delivery.
  • IWTK does NOT perform testing for Syphilis.
Who should be tested for Syphilis?
  • Women who are pregnant
  • Men who have sex with men
  • People who have HIV infection
  • People who have partner(s) who have tested positive for Syphilis
Is Syphilis treatable?
  • Syphilis is simple to cure with appropriate antibiotics (medicine) from your healthcare provider.
  • No home remedies or over-the-counter drugs will cure Syphilis.
  • Treatment will kill the Syphilis bacterium and prevent further damage, but it will not repair damage already done.
  • Persons treated for Syphilis must abstain from sexual contact with new partners until the Syphilis sores are completely healed.
  • Persons with Syphilis must notify their sex partners so that they also can be tested and treated if necessary.
  • Follow-up testing is recommended to be sure that treatment is successful.
  • Having Syphilis once does not protect a person from getting it again. Even following successful treatment, people can still be re-infected.
  • Because Syphilis sores can be hidden in the vagina, anus, mouth, or under the foreskin, it may not be obvious that a sex partner has Syphilis.
  • Unless a person knows that their sex partners have been tested and treated, they may be at risk of getting Syphilis again from an untreated sex partner.

Prevention

Can Syphilis be prevented?
  • Abstain from sexual intercourse; or use a latex condom properly, every time you have sex (vaginal, anal, or oral), with every partner.
  • Limit your sexual partners. The more sex partners you have, the greater your risk of encountering someone who has this or other STIs.
  • If you are infected, your sexual partner(s) should be notified so they can be tested and treated. This will prevent you from getting reinfected.
  • Be in a mutually monogamous, long-term relationship with a partner who has been tested and is not infected.
  • Any unusual discharge, sore, or rash (particularly in the groin area) should be a signal to stop having sex and to see a healthcare provider immediately.
  • Stop having sex while any sore is present in the genital, anal, or oral area. Contact with a sore outside of the area covered by a condom can still cause an infection with Syphilis.
  • Transmission of Syphilis can NOT be prevented by washing the genitals, urinating, and or douching after sex.
  • Avoiding alcohol and drug use may also help prevent transmission of Syphilis because these activities may lead to risky sexual behavior.
  • Get a prenatal blood test if you’re pregnant, so you don’t infect or kill your developing baby.
  • There is no vaccine to prevent Syphilis.
Once I have had Syphilis, am I immune?

No. Having Syphilis once does not protect a person from getting re-infected. You can get Syphilis again.