What is syphilis?

Syphilis is a sexually transmitted disease (STD) caused by a bacteria. It progresses in stages and, without treatment, can lead to death.

How is syphilis spread?

Syphilis can be spread during vaginal, anal, or oral sex through contact with an open sore or contact with a skin rash. The bacteria can enter the body through the penis, anus, vagina, mouth, or through broken skin. An infected pregnant woman can also pass the disease to her unborn child. Syphilis is not spread by contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.

What are the symptoms of syphilis?

Each stage of syphilis has different symptoms. Syphilis can be spread during the first two stages of the disease.

Primary Stage
A single, painless sore, called a chancre, appears in the first, or primary stage, about 10 days to 90 days after infection. The sore can appear on the vulva, vagina, cervix, tongue, lips, or other parts of the body, including inside the body. Twenty-one days after infection is the most common time frame in which the sore appears. The sore heals with or without treatment. In this stage, syphilis can be passed to others through contact with an open sore during vaginal, anal, or oral sex. If the infection is not treated, it moves to the next, or secondary, stage.

Secondary Stage
In the secondary stage, which starts three to six weeks after the sore appears, some or all of these symptoms can appear:

  • skin rash with rough, red or reddish-brown spots both on the palms of the hands and bottoms of the feet. The rash usually does not itch. Rashes with a different appearance may occur on other parts of the body.
  • sores on the throat, mouth, or cervix
  • fever
  • sore throat and swollen lymph glands
  • patchy hair loss on the head and other parts of the body
  • headaches and muscle aches
  • weight loss
  • tiredness

During vaginal, anal, or oral sex, contact with open sores or contact with the rash can spread the infection to others. The symptoms of secondary syphilis will resolve with or without treatment. But without treatment, the infection will progress to the latent and late stages of disease.

Latent Stage
The next stage is called the latent or hidden stage. This stage can start from two years to over thirty years after initial infection. After symptoms from the secondary stage disappear, a relapse of the second stage of syphilis can happen, when those symptoms come back. If a relapse happens, the disease can be passed to others. Otherwise, the disease cannot be passed to another person. Even without treatment, some people with latent syphilis do not go on to develop late stage syphilis. But others will go on to develop late stage syphilis.

Late Stage
In the late stage of syphilis, some people suffer damage to the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Complications may include small bumps or tumours on organs, blindness, insanity, or paralysis. This stage can last for years. Some people may die from the disease. You will only reach this stage if you have not received treatment earlier. If you have syphilis, get treated as soon as possible to avoid these problems.

How is syphilis diagnosed?

A doctor can diagnose syphilis in a number of ways:

  • Recognizing its signs and symptoms and taking the correct tests.
  • Looking at the fluid from a syphilis sore or swollen lymph node under a microscope. This can only be done during primary and secondary syphilis when a patient has sores.
  • Testing the patient's blood.
Can syphilis be cured? How is syphilis treated?

Yes, syphilis can be cured. Penicillin is the preferred drug to treat syphilis at all stages. The dose and length of treatment depends on the stage of syphilis and symptoms of the disease. If a person can't take penicillin, another medicine may be available. But in late syphilis, damage already done to body organs cannot be reversed. You can get syphilis again after being cured if you are exposed to it. Taking antibiotics does not protect you from getting syphilis again.

What should I do if I have syphilis?
  • Avoid having any sexual activity while you are being treated for syphilis. Don't have sexual contact until the syphilis sores are completely healed.
  • Be sure to tell your sexual partners, so they can be tested and treated if necessary.
  • After you have completed treatment for syphilis, get retested after six months and 12 months. Some doctors recommend more frequent follow-up tests.
Can syphilis cause problems during pregnancy?

Yes. Pregnant women can pass syphilis to their babies during pregnancy and childbirth. It can cause miscarriage, stillbirth, or death soon after birth. An infected baby may be born without signs of disease. However, if not treated right away, the baby may have serious problems within a few weeks. Babies born with syphilis may develop skin sores, rashes, fever, jaundice (yellow skin), anemia (a blood problem), or a swollen liver and spleen. Untreated babies may become developmentally delayed, have seizures, or die.

All pregnant women should be tested for syphilis. Pregnant women with syphilis are treated right away with penicillin. For women with an allergy to penicillin, there is no alternative medicine that has proven effective for treatment. Penicillin will prevent passing syphilis to the baby, although treatment during the second half of pregnancy may not eliminate the risk for premature labor and fetal distress.

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