Syphilis

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent, and tertiary). Each stage can have different signs and symptoms.

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Babies can also get syphilis. Congenital syphilis is the disease that happens when women pass syphilis to their babies during pregnancy.

Symptoms and Stages

There are four stages of syphilis (primary, secondary, latent, and tertiary). Each stage has different signs and symptoms. Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the disease’s stages.

Primary Stage

Typically lasts 1 to 6 weeks
One (or multiple) firm, painless sores in or around genitals, or in the lips or mouth.

Secondary Stage

Typically lasts 1 to 3 months
Non-itchy rashes in/around genitals, mouth, hands (palm), feet (soles)
Other symptoms include fever, sore throat, swollen lymph nodes, patchy hair loss

Latent Stage

No visible signs or symptoms; can last several years without treatment.

Tertiary Stage

Typically lasts 10 to 30 years
Without treatment, syphilis may evolve to this stage, when the disease affects different organs and systems and can result in death

Diagnosis and Treatment

Syphilis is typically diagnosed through blood tests, but in some cases, testing the flid from a sore may be done.

Regular testing for syphilis is recommended if you are sexually active and:

Are a gay or bisexual man
Have HIV
Are taking pre-exposure prophylaxis (PrEP) for HIV prevention
Have partner(s) who have tested positive for syphilis
Have certain risk factors for syphilis, like living in a community with high rates of syphilis

All pregnant women should receive syphilis testing at their first prenatal visit. Some pregnant women need to receive syphilis testing again during the third trimester at 28 weeks and at delivery.

Syphilis can be successfully treated with antibiotics, although treatment might not undo any damage the infection can cause.

Call the HIV/STD Hotline 800-243-2437 to learn about a testing location near you.

Prevention

The only way to completely avoid syphilis and other STIs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting syphilis:

Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have syphilis.
Using condoms the right way every time you have sex.

Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

Pregnancy

If you are pregnant and have syphilis, you can give the infection to your baby. Having syphilis can lead to a low-birth-weight-baby. It can make it more likely you will deliver your baby too early or stillborn (a baby born dead). To protect your baby, you should receive syphilis testing at least once during your pregnancy, and receive treatment right away if you test positive. Screening for syphilis during pregnancy is recommended at 28 and 32 weeks of gestation, and at delivery for women who are at high risk for syphilis.

At birth, a baby with a syphilis infection may not have signs or symptoms of disease. However, if the baby does not receive treatment right away, the baby may develop serious problems within a few weeks. These babies can have health problems, such as cataracts, deafness, or seizures, and can die.

Resources

IDPH: Syphilis
IDPH: Sexually Transmitted Diseases (STD)
IDPH: Syphilis Info Sheet
IDPH: Syphilis FAQ
IDPH: Congenital Syphilis FAQ
CDC: Syphilis
CDC: Congenital Syphilis
CDC: How to Prevent STIs
CDC: Condom Use

American Sexual Health Association