Syphilis is a sexually transmitted bacterial infection, caused by the bacteria Treponema pallidum, which in adults is categorized into stages; primary, secondary, latent and late.1,2
While syphilis infections in the United States have decreased in women since 2010, the male infection continues to rise. This is most notable in men who have sex with men.2
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You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions.
Fast facts on syphilis
Here are some key points about syphilis. More detail and supporting information is in the main article.1-3
- In 2008 in the United States, there were approximately 55,400 new cases of syphilis with a total of 117,000 combined new and existing cases of the disease.
- Sharing toilets, bathtubs, clothing or eating utensils does not spread syphilis nor does touching door knobs or using the same swimming pools or hot tubs.
- Syphilis will not come back after treatment, however, you can become reinfected with the bacteria again through exposure to a new syphilis sore.
- Those most at risk of contracting syphilis include those who have unprotected sex (anal, vaginal and oral), men who have sex with men, those with HIV and those with numerous sexual partners.
What is syphilis?
Syphilis is an infection that is transmitted by direct contact with a syphilitic sore via skin and mucous membranes such as the vagina, anus, rectum, lips and mouth, most commonly during oral, anal or vaginal sexual activity. Although rare, syphilis can be spread during kissing.1,2
Syphilis is a bacterial infection that is usually caught by having sex with someone who is infected.
Most commonly, syphilis initially presents as a painless sore on the genitals, rectum or mouth and can become dormant and live within the body for years and at times decades. In the presence of a syphilitic sore, there is an increased risk of contracting HIV.
Causes of syphilis
In addition to spread during sexual activity, syphilis can be spread from mother to baby during pregnancy, referred to as congenital syphilis.
Syphilis during pregnancy can result in a stillborn birth or a low birthweight baby, and if left untreated, a baby with syphilis can develop cataracts, deafness, or seizures. In some cases, infants can die from the disease.
Who is at risk for contracting syphilis?
Those most at risk of contracting syphilis include those who have unprotected sex (anal, vaginal and oral), men who have sex with men, those with HIV and those with numerous sexual partners.1,2
Symptoms of syphilis
Syphilis is categorized by stages with varied symptoms associated with each stage; at times there are no symptoms for several years. Contagious stages include primary, secondary and occasionally during the early latent phase.2
The bacteria that cause syphilis are called Treponema pallidum. They can enter your body if you have close contact with an infected sore.
Primary syphilis symptoms include:1,2
- Initial symptom is one or many painless, firm and round syphilitic sores called chancres
- Incubation period is approximately 3 weeks following exposure to the bacteria
- Chancres self-resolve within 3 to 6 weeks, but resolution treatment is required to prevent phase progression.
Secondary syphilis symptoms include:1,2
- Truncal non-itchy rash, which spreads to the entire body, including the palms of the hands and soles of the feet. The rash may present as rough, red or red/brown in color
- Oral, anal and genital wart-like sores
- Muscle aches
- Sore throat
- Swollen lymph nodes
- Patchy hair loss
- Weight loss
It is important to note that the symptoms of secondary syphilis can resolve a few weeks after its onset or return at various times for a year.2 If left untreated, secondary syphilis will progress to the latent and late stages.1
- Without treatment of secondary syphilis, the disease will progress to the latent stage when symptoms resolve
- This phase, which can last several years, will allow for the body to harbor the disease even without showing symptoms of syphilis
- Even though there are no symptoms during this phase, the disease can at times advance to the late stage of syphilis referred to as tertiary syphilis or the symptoms may never come back.
Late syphilis (tertiary):1,2
- Approximately 15-30% of untreated syphilis will develop into tertiary syphilis
- Tertiary syphilis occurs 10-30 years following onset of the infection
- Symptoms include muscle coordination difficulties, numbness, blindness, dementia, as well as damage to the heart, blood vessels, liver, bones and joints
- Death can at times occur due to organ damage.
- Infection is transferred in utero via the placenta and also during the birth process
- Most newborns are asymptomatic
- Symptoms include rash, deafness, teeth deformities, and nasal bone collapse referred to as saddle nose.
On the next page we look at tests and diagnosis of syphilis, prevention and the available treatment options for the condition.