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A illustration of the Syphilis bacterium

Syphilis

What is syphilis? 

Syphilis is a sexually transmissible infection caused by a bacteria called Treponema pallidum.  It is not as common in Australia as in some countries, but cases are increasing.  

Syphilis is easily treated with antibiotics. Without treatment serious health problems can occur. The infection has different stages: primary syphilis, secondary syphilis, latent syphilis, and tertiary or late syphilis.  

How do you catch syphilis?

  • Syphilis is passed on through skin-to-skin contact. You can catch it by having oral, vaginal, or anal sex with someone who has syphilis. 
  • It is highly infectious when symptoms are present.
  • Syphilis can also be transmitted from the mother(or pregnant person) to the baby during pregnancy, and this can have severe effects on the baby. 

What are the symptoms?  

Not everyone who has syphilis will have symptoms, and sometimes, the infected person may not notice them. So you can have syphilis and not know it. If you do get symptoms, they will vary depending on the stage of syphilis. 

Stages of syphilis

Primary syphilis 

  • Sometimes there may be no symptoms, but a hard, usually painless sore appears. This sore most often appears on the genitals; however, it can occur elsewhere, such as the mouth or anus. 
  • The sore usually appears about 3 to 4 weeks after infection but can appear up to three months later. 
  •  Because these sores are usually painless, you may not notice it, especially if it is in a part of the body not easily seen, like the anus or cervix. These sores are highly infectious. 
  • The sore usually heals after 2-6 weeks, but the infection remains in your body if you have not had treatment and can then progress to the next stage. You can pass the infection on to others even without symptoms. 

Secondary syphilis

  • Symptoms of secondary syphilis occur about 2 to 4 months after infection if you have not had treatment. 
  • The most common symptom at this stage is a red rash on your chest, back, hands, and feet, including palms and soles. This rash is highly infectious.  
  • You may also have flu-like symptoms, such as swollen lymph nodes in the groin and armpits, tiredness, hair loss, and a genital rash. If you do not have treatment, these symptoms can come and go for up to two years.  

Latent syphilis

  • If syphilis is not treated in the primary or secondary stage, it then becomes latent. In latent syphilis, there are no symptoms.
  • Latent syphilis is infections in the first 12 to 24 months. After this, it is usually not infectious. 
  • If syphilis is diagnosed and treated early in this latent phase, there are usually no problems. 

Tertiary syphilis  

  • If syphilis is not treated, it can progress to tertiary syphilis in about a third of infected people. 
  • Tertiary syphilis can cause severe problems in almost any part of the body, but mainly in the heart and brain, and can be fatal. 
  • Tertiary syphilis is no longer infectious and can still be treated.

How can I avoid getting syphilis? 

You can avoid getting syphilis by using condoms or dams correctly every time you have sex and also by you and your sexual partner/s having regular testing for sexually transmissible infections.  For valuable tips on condom use, check out our condom fact sheet.

How do you test for syphilis?

  • The test for syphilis is a blood test. 
  • Sometimes more than one test is needed. Blood tests are also used to check your response to treatment if you are diagnosed with syphilis.
  • If a sore or a rash is present, swabs can be collected to look for the presence of the bacteria. 
  • Blood tests which are done routinely during pregnancy include a test for syphilis. 

How is syphilis treated? 

  • Syphilis is treated with penicillin given as an injection. 
  • Latent syphilis may require a longer course of treatment than the other stages.  
  • If someone with syphilis has a penicillin allergy, other antibiotic treatment is available.

Some people, especially those in the early stages of infection, are likely to experience a flu like illness when they are treated. If this occurs it usually does so within 24 hours after treatment.

Symptoms may include fever, headache, sweats, and joint pain. It lasts for several hours, and simple supportive treatment of analgesia such as paracetamol, fluids, and rest is usually all that is needed.

After treatment, you will need to avoid any sexual contact until the rash or skin lesion has healed and until at least one week after your treatment has finished.

Your partner/s may need treatment, and it is essential to wait for one week after they finish their treatment before having any sexual contact, so you don’t become re-infected. 

Follow-up blood testing at 3 and 6 months (and sometimes 12 months) is usually recommended to ensure the effectiveness of your treatment.  

Do I need to let my sexual partners know?

If you have been diagnosed with syphilis,  all your sexual partners in the last few months need to be informed, as they will require testing and treatment.

If they do not have treatment, they could end up with severe problems and may also re-infect you.  You will need to discuss this with your nurse or doctor. 

There are websites that you can use to help contact your partners; letthemknow.org.au or thedramadownunder.info

Syphilis and HIV

The presence of syphilis can make HIV transmission more likely, and if you have been diagnosed with syphilis, you may want to consider using HIV pre-exposure prophylaxis (PrEP) if you are in a risk group. Talk to your sexual health doctor about this.  Testing for syphilis and HIV is usually done at the same time or during the follow-up after treatment. 

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References 

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