Updated December 2014

Definition

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum.

Causes

Syphilis can be passed on through unprotected vaginal, anal or oral sex. It is transmitted through direct contact with a syphilis sore. The bacteria can enter the bloodstream through a tear in the skin or mucous membrane. Syphilis can also be passed on through sharing needles when injecting drugs. Pregnant women can also pass syphilis on to their developing fetus.  Rarely, syphilis can also be passed on through sharing needles when injecting drugs.

Signs and Symptoms

Most people who have syphilis have no symptoms. They can pass on the infection to their sexual partner(s) without even knowing it. When the bacteria enter the body, the disease goes through a few stages.

Primary stage: 3-90 days after you have been exposed, a painless sore called a chancre may appear on the penis, anus, vagina, throat or any other part of the body where the bacteria entered. Many people do not notice the sore because it is painless and goes away on its own without treatment. However, without treatment, the infection will continue to the next stage.

Secondary stage: 2-12 weeks after the chancre appears, a rash may develop on the palms of the hands, soles of the feet or on any part of the body. In some cases, there is patchy hair loss, muscle or joint pain or swollen glands. Again these symptoms may disappear without treatment. Without treatment the infection will continue to the next stage.

Early latent and late latent: There are no symptoms. Once a person has had the infection for one year or more, they are in the late latent stage. They are no longer able to pass the infection on to others, but the infection may begin to damage their own body.

Tertiary stage: Some people who have never received treatment may enter the tertiary stage of syphilis 10 to 20 years after they were first infected. However, if a person also has HIV these tertiary stage symptoms can appear earlier. The tertiary stage of syphilis can cause serious heart, brain, liver, eye and bone disease.

Diagnosis and Tests

A blood test is used to diagnose syphilis. It can take 2 to 12 weeks for the infection to appear in the blood. Syphilis is not a routine blood test. If you think you may have been infected, ask your health care provider for a syphilis blood test.

Complications

Without treatment, the symptoms will go away, but the disease may continue to spread through the body. Many years later it may cause severe damage to the heart, brain, liver, bones and eyes.

A pregnant woman can pass the infection to her unborn baby.  If not treated, the baby can have serious health problems.  It can also make it more likely that the baby will be born early or stillborn.

Treatment

It is important to treat syphilis as early as possible. Treatment will prevent serious complications. It will also keep you from passing the infection to someone else. Antibiotics will cure syphilis. Even though you have been treated, if you have syphilis blood tests in the future they will always appear “positive”.

Prevention/Self-care Tips

Follow-up blood tests for syphilis are very important. The results of these blood tests will show if the treatment was effective or if you need further treatment. They will also indicate if you have been infected again, either from an untreated partner or a new partner.

Here are a few important points to remember:

  • Avoid anal, vaginal or oral sex with anyone who has a sore(s) in the genital or mouth area.
  • If you already have syphilis, avoid anal, vaginal or oral sex, even with a condom until 7 days after treatment.
  • If you have an untreated STI like syphilis, it is easier to get HIV from a person who has it.
  • Do not share needles.
  • Pregnant women should have blood tests done prenatally testing for syphilis.
  • It is possible to have more than one infection at a time, so it is important to be tested for other STIs.
  • Use condoms correctly every time you have sex to lower your chance of getting an STI.

Information for Sexual Partners

All sexual and needle-sharing partners need to be tested and then treated if they are infected. A public health nurse can help an infected person notify their partner(s). Your name will be kept confidential.

  • In the primary stage, it is important to tell partners within the past 17 weeks, even if they have no symptoms.
  • In the secondary stage, all partners within the past 8 months need to be told.
  • In the early latent stage, all partners within 1 year of diagnosis need to be told.
  • In the late latent stage, long-term partners should be told. Children may also need to be checked and tested.

More Information

Call the AIDS and Sexual Health InfoLine at 416-392-2437

SAFER SEX: To reduce your risk of getting a sexually transmitted infection (STI),
use a condom every time you have vaginal, anal or oral sex.