WHAT IS SYPHILIS?
Syphilis is a sexually transmissible infection caused by a bacteria called Treponema pallidum. It is not as common in Australia as it is in some other countries, however it is a serious infection and cases are on the rise.
Syphilis can be easily treated with antibiotics, but without treatment it can cause serious health problems. It has three stages: Early infectious syphilis, late latent syphilis, and tertiary or late syphilis.
HOW DO YOU CATCH SYPHILIS?
Syphilis is transmitted through skin-to-skin contact. You can catch it by having oral, vaginal, or anal sex with someone who has syphilis. It is most infectious when early symptoms are present.
Using a condom for all sexual contact will greatly reduce the risk of transmission.
Syphilis can also be transmitted from mother to unborn baby during pregnancy. This is called congenital syphilis and can have very serious effects on the baby.
WHAT ARE THE SYMPTOMS?
About 50% of the time there are no symptoms. When symptoms do occur, they will vary depending on the stage of syphilis.
STAGES OF SYPHILIS
In this stage there may be no symptoms, but typically a hard, painless sore called a chancre, appears about 3-4 weeks after infection (although this can occur between 10 and 90 days after infection).
The sore most often appears on the genitals, however, it can occur elsewhere. Because these sores are usually painless they may not be noticed, especially if they in a part of the body not easily seen, for example the anus, cervix, or mouth. These sores are highly infectious.
The sores usually heal after 2-6 weeks, but the infection remains in the body if you have not had treatment and can progress to the next stage. The infection can be passed on to others even if there are no symptoms.
Symptoms of secondary syphilis occur about 2-4 months after infection if there has been no treatment.
The most common symptom is a painless flat red rash on the chest, back, hands, and feet, including the palms and soles. This rash is highly infectious. There may also be flu like symptoms, swollen lymph nodes in the groin and armpits, tiredness, hair loss, and a genital rash. These symptoms can come and go for up to two years if you are not treate
If syphilis is not treated in the primary or secondary stage it then becomes latent. In latent syphilis there are no smptoms, and it is not infectious. If syphilis is diagnosed and treated early in this latent phase there are usually no problems.
If syphilis is not treated it can progress to tertiary syphilis in about a third of infected people. Tertiary syphilis can cause serious problems in almost any part of the body, but mainly in the heart and brain, and can be fatal.
HOW CAN I AVOID GETTING SYPHILIS?
Syphilis can be prevented by using condoms correctly every time you have sex, and also by you and your sexual partner/s having regular testing for sexually transmissible infections with early treatment when infection is found. For useful tips on condom use, check out our condom fact sheet.
HOW DO YOU TEST FOR SYPHILIS?
A blood test can diagnose syphilis and is also used to monitor your response to treatment. Sometimes more than one test is needed. If a sore is present swabs can be collected to look for the presence of the bacteria. Blood tests which are done routinely during pregnancy include syphilis testing.
HOW IS SYPHILIS TREATED?
Syphilis is treated with penicillin given as an injection. Latent syphilis may require a longer course of treatment then the other stages.
If someone with syphilis has an allergy to penicillin other antibiotic treatment is available. Some people, especially those with 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 an analgesia such as paracetamol, fluids and rest is usually all that is needed
After treatment, sexual contact of any type should be avoided until the rash or chancre has healed, and until at least one week after your treatment has finished.
Your partner/s may need treatment, and it is important to wait for one week after they finish their treatment before having 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 treatment has been effective
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 told as they will need 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.
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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