What is Syphilis and how is it passed on?

Syphilis is caused by a bacteria called Treponema Pallidum. The infection is easily spread from one to person to another through vaginal, anal and oral sex. It can also be passed on through sharing sex toys and through direct skin to skin contact from someone who has infected sores or an infectious rash. Anyone who is sexually active can catch it.

What are the symptoms of Syphilis?

Often there are no signs or symptoms; however, if you do get symptoms you may notice the following.

Stage 1: Primary syphilis

Within 9 – 90 days of catching the infection sores may appear where the bacteria entered the body – for example inside the mouth, on the genitals, in the vagina or rectum or around the anus.. These are very infectious and may take up to 6 weeks to heal. By this time the bacteria will have spread to other parts of the body.

Stage 2.  Secondary syphilis

This stage can last up to 2 years. During this time the infection can be passed on easily as described earlier.

Symptoms might include:-

  • Vague flu-like symptoms – for example fever, unexplained tiredness, night sweats, loss of appetite shooting pains, headache and neck ache.
  • More specifically, a rash may appear on the body together with the flu-like symptoms. It is not normally itchy and can appear on the palms of the hands and the soles of the feet.
  • Wart-type growths may appear on the genital and/or the anus, and sometimes white patches and ulcers in the mouth may also occur. Some people experience patches of hair loss (patchy alopecia).
  • Not everyone gets all of these symptoms – in fact many people have no symptoms at all. Because the symptoms are so vague and can be mistaken for the flu or glandular fever this stage of syphilis is often misdiagnosed. Taking a syphilis blood test is the only way to know for sure whether your symptoms are being caused by syphilis.

Latent Syphilis

When syphilis remains untreated but is without any signs and symptoms, it is known as latent syphilis. Treatment is still required in order to prevent long-term health problems, but because there are no symptoms the only way of knowing if you have latent syphilis is to take a syphilis test

Stage 3: Tertiary Syphilis

If syphilis remains untreated for many years then it can start to cause serious damage to the bones, skin, heart, brain and nervous system. This is very rare in the UK but is on the increase because we are seeing more syphilis than we used to in the past.

If you have any of the symptoms listed above and feel you may have been at risk from syphilis you should see a doctor or nurse at your local clinic. You may require an examination, extra tests and/or treatment.

How will I know if I have syphilis?

The only way of knowing for sure is to have a syphilis blood test. Although it is less common than other bacterial STIs such as chlamydia and gonorrhoea, there has been an increase in syphilis rates in the UK over the last 10 years so it’s worth taking the test if you are or have been sexually active.

How Accurate are the tests?

No test is 100% accurate. However, the syphilis blood test is a screening test which should pick up all syphilis infections even if a person has been infected for a long time. If you have had a new risk in the last 8 weeks you may wish to repeat the test if the first one is negative as syphilis can sometimes take a while to show up on tests

What is the treatment for syphilis – can it be cured?

First, second and latent stage syphilis is normally treated with a single antibiotic injection. Before you are treated the doctor or specialist nurse may want to check if you have any symptoms and may want to carry out an examination. They will also take further blood tests and ask you some questions to check the stage of the infection. You will need to have blood tests following treatment to check that the treatment has worked. These follow up blood tests need to be done at a sexual health clinic as online tests only check for the presence of an infection and cannot be used to measure levels.

If you have a partner or partners with whom you have regular sex they will also need treatment in order to prevent you becoming re-infected following treatment.

If you are diagnosed with symptomatic late syphilis (tertiary) the treatment may last longer and you may need further investigations. Tertiary syphilis is very rare – it can be treated however any damage to the body which has already occurred will not be reversed.

What about if I am pregnant?

Syphilis treatment is safe during pregnancy. Women are routinely tested for syphilis during pregnancy to help reduce the risk of undiagnosed syphilis passing to the unborn baby. Where syphilis is found, treatment is given to reduce the risk of miscarriage, stillbirth and damage to the unborn baby which can be caused by syphilis.

How Can I protect myself from Syphilis?

Use a condom each time you have vaginal or anal sex.

If you have oral sex use a condom to cover the penis or a latex or polyurethane square to cover the female genitals or male or female anus.

Avoid sharing sex toys and if you do share them, wash them with soapy water and dry them before putting them away. If you use dildos or other insertive sex toys cover them with a fresh condom if you are sharing.

If you are starting a new relationship, get tested together before you start having unprotected sex.

Regular testing – for example when you have a change in sexual partner – will reduce the risk of developing the complications associated with syphilis.

If you don’t have any symptoms but think you may have been at risk from syphilis you can take your own test via this service.