What is Syphilis?
Syphilis is a common sexually transmitted infection (STI) caused by bacteria. It is passed through oral, vaginal/front hole, or anal sex. A pregnant person with syphilis can pass it onto their child, sometimes causing serious complications. Although less common, it can also be transmitted through injection drug use or through broken skin.
Stages of Syphilis Infection
Not everyone infected with syphilis will develop symptoms. That is why it is important to know the risks, get tested, and take measures to prevent syphilis. Left untreated, syphilis moves through four stages:
- Primary: The first sign of syphilis is a small, usually painless, sore (called a chancre) that appears at the spot where the bacteria entered the body (usually the throat, genital or anus area). The chancre will heal on its own within 3 to 6 weeks. If left untreated, syphilis progresses to secondary syphilis.
- Secondary: After the chancre has healed, a person may experience a rash, usually covering the entire body, but rarely itchy. At this stage, a person may experience hair loss, muscle aches and pains, a fever, sore throat and swollen lymph nodes that can come and go for as long as a year.
- Latency: At this stage there are no longer visible signs or symptoms of syphilis. You can continue to have syphilis in the body for years without any signs or symptoms.
- Tertiary: During the latency stage, syphilis may progress into a tertiary infection. Not all untreated syphilis reach this stage. However, if it does reach this stage, it can cause serious damage to organ systems. At the tertiary stage, syphilis can affect the brain, blood vessels, the heart and bones. It can eventually lead to death.
Transmission
Syphilis is infectious mostly during the primary and secondary stages (less than one year after contracting syphilis). It is typically passed through direct contact with a chancre through oral, vaginal/front hole, or anal sex. Sometimes, syphilis can be passed through sharing sex toys, sharing drug injection equipment, or deep kissing.
Syphilis can be passed to an infant through the placenta during pregnancy (known as vertical transmission) and can cause miscarriage, premature birth, stillbirth, or newborn death. Syphilis can also be passed to an infant if they come into contact with a syphilis chancre during childbirth. Infants who have contracted syphilis will need immediate treatment to avoid developing serious health concerns.
Ways to minimize transmission of syphilis include:
- Learning about safer sex and safer injection practices
- Speaking openly and honestly with your sexual partner(s) about STIs, your STI status, and methods of preventing STIs
- Using barrier methods such as internal and external condoms and dental dams to reduce risk of syphilis transmission
- Getting tested for syphilis and other STIs regularly (every 3 months) if you are sexually active
- Adhering to your treatment if you do contract syphilis, and avoiding sexual activity until your treatment is complete
Testing
The only way to know if you have syphilis is to get tested. Syphilis is often referred to as “the great imitator” because of the wide range of symptoms that a person with syphilis may experience. These symptoms can easily be confused with those of other conditions, so it is important to get tested for syphilis regularly if you are sexually active.
Syphilis is typically tested for via a blood test. If you have a sore that you are concerned about, a healthcare provider may be able to test for syphilis by taking a swab of fluids from the sore. For more information on STBBI testing in NL, please visit our page on HIV/STBBI Testing.
Treatment
Syphilis can usually be cured with one round of an antibiotic like penicillin. It is important to wait until your treatment is finish and your symptoms have cleared up to engage in sexual activity that could pass the infection. You should follow up with your healthcare provider after completing treatment to ensure that the infection has been cured.
It is also important that you or someone from your public health department notify any of your sexual or needle-sharing partners who may have also been exposed to syphilis. They will also need to be tested and possibly treated.
Syphilis and HIV
The interaction between syphilis and HIV is of particular concern. Individuals with the genital ulcers that appear in primary syphilis are 3 to 5 times more likely to contract HIV. Furthermore, people who are living with HIV and also have syphilis are at greater risk of passing the infection to others. It can be difficult to successfully treat HIV patients who have syphilis.