Published by Bupa's Health Information Team, April 2010.
This factsheet is for people who have syphilis, or who would like information about it.
Syphilis is a sexually transmitted infection (STI) that often has no symptoms. If untreated, it can lead to serious complications. It's almost always passed on through unprotected sex (sex without a condom).
Syphilis is caused by a bacterial infection, which can be passed on through sexual contact. Syphilis used to be relatively rare in the UK, but has recently become more common - almost 2,500 people were diagnosed at genitourinary medicine (GUM) clinics in 2008. Worldwide, it's very common; between 10 and 12 million new infections occur every year.
Women between the ages of 20 and 24 and men between 25 and 30 have the highest rates of syphilis. The infection is particularly common among men who have sex with men.
Although syphilis can have serious complications, it can be treated easily with antibiotics.
Syphilis causes a number of different symptoms that usually depend on how long you've been infected for. The infection occurs in three distinct stages called primary, secondary and tertiary (late) syphilis.
If you become pregnant when you have syphilis, you can pass the infection on to your unborn child. This is called congenital syphilis.
This is the first stage of the infection. If you have contact with someone who has syphilis you may develop a sore, or sometimes lots of sores, on the area where you were exposed. This can be on your penis, anus, in your vagina or rectum (back passage), in your mouth or on your lips. The sore, sometimes called a chancre (pronounced 'shanker'), can develop anywhere between 10 days and three months after you were initially infected.
Syphilis sores are usually painless and can often go unnoticed if they aren't in a visible area. They are firm, round and small - measuring about 1 to 2 cm across - and if left untreated will heal naturally within six weeks. This doesn't mean, however, that the syphilis infection has gone - it will remain in your body and develop into secondary syphilis.
If you think you may have the symptoms of primary syphilis, see your GP. It can be cured with a course of antibiotics before it develops further.
At this stage, the infection starts to spread throughout your body. It usually begins with the appearance of a rash on one or more areas of your skin between six weeks and six months after you first develop a syphilis sore.
Secondary syphilis can cause a wide range of symptoms that vary from person to person as it may affect any organ. You may get some, but not necessarily all, of the symptoms below.
Without any treatment, most people will notice the symptoms of secondary syphilis disappear in around three to six weeks. However, for about one in four people, the rash, sores and fever may keep coming back from time to time for up to two years.
After the symptoms of secondary syphilis have gone away, you may have no further problems, but enter a 'latent period'. During this stage of the infection, you will not have any signs or symptoms. This doesn't mean, however, that the infection has gone. Your blood will test positive for syphilis antibodies (proteins produced by the immune system that usually fight against bacteria and viruses). If you're not treated with antibiotics, you may remain in the latent period for the rest of your life. About one in six people who aren't treated in the latent period go on to develop tertiary (late) syphilis.
If you think you may have the symptoms of secondary syphilis, see your GP. It can be cured with a course of antibiotics before it develops further.
Tertiary (late) syphilis can cause three serious syndromes: neurosyphilis, cardiovascular syphilis and gummatous syphilis. Most people will not develop tertiary syphilis as the infection is usually noticed and treated in the primary or secondary stages of the disease.
Neurosyphilis
Neurosyphilis develops when the syphilis infection reaches your brain or spinal cord. It tends to develop between 10 and 20 years after you were originally infected. It causes serious problems such as:
Cardiovascular syphilis
Cardiovascular syphilis affects your heart and blood vessels. It can cause the following problems, usually around 15 to 30 years after you were originally infected:
Gummatous syphilis
Gummata are small, rubbery, tumour-like swellings that may develop around three to 15 years after you were originally infected. The gumma nodules can form on almost any part of your body, but most commonly affect the skin (especially below the knee) and bones.
Syphilis infection is caused by the bacterium Treponema pallidum.
You can catch syphilis by having direct contact with someone who has syphilis sores. The sores are usually found on your external genitals, vagina, anus, or in your rectum. They can also occur on your lips and in your mouth. You can spread the infection through vaginal, anal, or oral sex.
Your risk of catching syphilis can be reduced by using a condom during sex, but this doesn't guarantee complete protection. This is because the condom may not cover the part of the body where the infectious, syphilis sore is.
If you have syphilis and become pregnant, you can pass the infection on to your unborn child.
If you think you may have syphilis you can see your GP, visit a genitourinary medicine (GUM) clinic, or a sexual health clinic to be tested. Your GP or nurse may test also you for other STIs at the same time. You don't have to ask your GP to refer you to a GUM or sexual health clinic - you can make your own appointment. All visits are confidential and you don't have to give your real name. Details won't be sent to your GP without your consent.
Your GP or nurse will ask about your symptoms and examine you. He or she may also ask you about your medical and sexual history. Your GP or nurse may take a sample of your blood to determine whether you have syphilis, especially if you don't have any symptoms. If you have a syphilis sore, he or she may take a sample of fluid from it.
The samples may be sent to a laboratory for testing, or your GP may look for the bacterium that causes syphilis under a microscope and give you the result immediately.
If the tests show that you have syphilis, it's important to contact your previous partners who may be at risk to prevent them from spreading the infection to other people. Clinics can send anonymous letters on your behalf if you're willing to provide contact details.
Syphilis is treated with antibiotics. If you have been infected for less than a year, your GP will give you a single injection of penicillin. However, you may need some extra injections over the course of several days if you have had syphilis for a year or more. Sometimes your GP may prescribe antibiotic tablets for you instead of injections. If you are allergic to penicillin, your GP will give you an alternative antibiotic.
If you have syphilis and become pregnant, you may pass the infection on to your unborn baby. This is especially likely to happen in the early stages of infection and increases your risk of having a miscarriage, a stillbirth, or your baby not living for very long after birth.
About one in three babies who are conceived by mothers with syphilis are born with the infection (this is called congenital syphilis). If this happens, your baby may or may not develop symptoms, but the condition can be life-threatening. Congenital syphilis can cause rashes, nasal discharge and growth problems within the first two years of life. Later on, your baby may have developmental problems with his or her bones and teeth. If your baby has symptoms similar to those of tertiary syphilis, this means the infection may have reached his or her nervous system.
Congenital syphilis can easily be prevented by screening for the infection when you are pregnant and by having antibiotic treatment before your baby is born. If you think you may have syphilis and become pregnant, see your GP.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
See a Private GP in confidence to discuss any concerns you may have about your health or your family's health or call 0845 600 3458 quoting ref. HFS GP.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: April 2010
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