Syphilis

What is syphilis?

Syphilis is a sexually transmitted infection (STI) caused by a bacteria called Treponema pallidum. Syphilis infection has four stages with different symptoms at each stage. It is common that a person who has syphilis will not notice any symptoms. If syphilis is not treated, it can lead to serious health problems over time.

How is syphilis transmitted?

• Through direct sexual contact (oral, genital, anal) or close physical contact with a contagious lesion or rash.
• To an unborn baby during pregnancy or delivery.

Primary Stage:

• Painless lesion(s) or sore(s) close to or inside the mouth, genitals (penis or vagina), and/or anus and rectum.  These may or may not be noticeable.
• Swollen lymph nodes.

Secondary Stage:

• A rash on one or more area(s) of the body, including stomach, extremities, palms of the hands, soles of the feet.
• Raised lesions or white patches in the mouth, genitals, or anal regions.
• Swollen lymph nodes.
• Flu-like symptoms (headache, muscle and joint pain, loss of appetite, fever).
• Patchy hair loss.

Early Latent Stage:

• No signs or symptoms, but the infection can still be transmitted to sexual partners

Late Latent Stage:

• After a period of 1-2 years, if syphilis has not been treated it can progress to a late latent stage. During this phase symptoms will not be present. The infection cannot be transmitted, but it can still affect a person’s health. Left untreated, syphilis can damage the heart, liver, brain, bones, or eyes. 

Neurosyphilis:

• Neurosyphilis can occur at any time after the initial infection.
• Symptoms of neurosyphilis can include changes to vision or hearing, severe headache and/or stiff neck, confusion, nausea, or vomiting.
• A neurological examination is performed to assess for neurosyphilis.
• If neurosyphilis is suspected, you will be referred to a specialist.

• A blood test is used to test for syphilis.
• It may take up to 4 weeks for syphilis to be detected in your blood test.  If you’ve been in contact with someone with syphilis you should get tested right away. If needed, repeat the test in 4 weeks.
• Syphilis can also be detected in the fluid from a syphilis lesion or sore.
• Staging of syphilis is based on your symptoms, physical assessment, testing history, and test results. 

What happens if I have a positive test result?

• You will be contacted by a public health nurse who will provide you with resources, counselling, and information.
• Your sexual partner(s) should also be tested and treated for syphilis before you resume sexual activity.
• If you are living with HIV, your healthcare provider will complete a neurological examination on you to rule out possible complications from syphilis.
• If you are diagnosed with syphilis while pregnant, you may be referred to a specialist
• Even though a person is treated for syphilis, part of your test result will remain positive for life. This does not mean you have an active syphilis infection. When seeing a new healthcare provider, it is important to let them know if you have had previous treatment for syphilis. 

How is syphilis treated?

• Syphilis is treated and cured with antibiotics.
• First choice is intra-muscular injections of Penicillin G.
• If you are unable to take Penicillin, an alternative treatment is oral Doxycycline.
• The only treatment option for syphilis in pregnancy is Penicillin G.
• After you have been treated for syphilis, you will need to have follow-up blood tests to ensure treatment success.

• Use an internal or external condom, every time you have sex.
• Use water-based or silicone-based lubricants.
• If you share sex toys, cover the toy with a condom and clean after each use.
• Get tested for STBBIs regularly.