Syphilis

Topic Overview

What is syphilis?

Syphilis is a sexually transmitted infection (STI) or sexually transmitted disease (STD) that, when left untreated, can progress to a late stage that causes serious health problems. The infection alternates with periods of being active and inactive (latent). When the infection is active, symptoms occur. But when the infection is latent, no symptoms appear even though you still have syphilis.

Anyone who comes into close physical contact with a person who has syphilis can develop syphilis. You don't have to have sexual intercourse to get syphilis—exposure can result from close contact with an infected person's genitals, mouth, or rectum.

What causes syphilis?

Syphilis is caused by a type of bacterium (Treponema pallidum) that usually enters the body through the mucous membranes. An infected person can pass the disease to others (is contagious) whenever a sore or a rash is present.

What are the symptoms?

Symptoms of syphilis may not be noticed or may mimic those of many other diseases. This may cause an infected person to delay seeking medical care and can make diagnosis difficult.

The four stages of syphilis have different symptoms.

  • Primary stage: During this stage of syphilis, a painless open sore called a chancre (say "shanker") develops. Because syphilis is usually passed from person to person through sexual activities, chancres are often found in the genital area, anus, or mouth, but they may also be found wherever the bacteria entered the body.
  • Secondary stage: A skin rash and other symptoms occur during the secondary stage, which begins 4 to 10 weeks after the initial infection. Secondary syphilis is highly contagious through direct contact with the mucous membranes or other surfaces affected by the skin rash.
  • Latent stage: This stage is often called the hidden stage of syphilis because usually no symptoms are present. The latent stage is defined as the year after a person becomes infected. A person in early latent stage may be contagious. Many times, latent-stage syphilis is detected in a mother only after she gives birth to a child infected with syphilis (congenital syphilis).
  • Late (tertiary) stage: If syphilis is not detected and treated in the early stages, problems can develop because of damage caused by having the syphilis bacteria in the body for so many years. These may include heart disorders, mental disorders, blindness, other problems associated with the nervous system, and even death.

How is syphilis diagnosed?

The first steps in diagnosing syphilis are discussing the history of your symptoms and sexual activities with a health professional and having a physical examination. The diagnosis of syphilis is usually confirmed with one of several blood tests.

How is it treated?

If detected and treated, syphilis can be cured with antibiotics. If not treated, syphilis may linger and may progress to the late stage where more serious health problems, such as blindness, heart disorders, mental disorders, nervous system problems, and even death, can occur.

Treatment is needed to cure the infection, prevent complications, and prevent the spread of the infection to others. It is critical to treat a pregnant woman who has syphilis—without treatment, syphilis can cause a miscarriage or stillbirth or cause a baby to be born with the disease (congenital syphilis). Antibiotics effectively treat syphilis during any stage. Antibiotic treatment cannot reverse the damage caused by the complications of late-stage syphilis, but it can prevent further complications.

How widespread is syphilis?

Syphilis is one of the most common reportable infectious diseases in Canada.1

The development of antibiotics and the routine screening of pregnant women for the disease has dramatically decreased the overall incidence of syphilis. But since 2000, syphilis infection has been on the rise, especially among men who have sex with men.2

Frequently Asked Questions

Learning about syphilis:

Being diagnosed:

Getting treatment:

Ongoing concerns:


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Author: Kathe Gallagher, MSW
Maureen Shea
Last Updated: November 16, 2007
Medical Review: Kathleen Romito, MD - Family Medicine
Jeanne Marrazzo, MD, MPH - Infectious Disease
Andrew Swan, MD, CCFP, FCFP - Family Medicine

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