Syphilis

Syphilis is a sexually transmissible infection (STI) caused by a bacterium called Treponema pallidum. It can affect both men and women. Syphilis is transmitted through close skin-to-skin contact and is highly contagious when a syphilis sore or rash is present. You can catch syphilis through oral, vaginal or anal sex with a person who has recently acquired the infection.

Since 2002, the number of people with infectious syphilis in Victoria has increased rapidly, mainly among men who have sex with men (MSM).

Early treatment is effective, but people may not have any symptoms or may not notice the symptoms of early syphilis. Sexual health check-ups are recommended. The frequency of the check-ups depends on the STI risk of the person. For example it is recommended that MSM who have a number of partners are checked every three months whereas a MSM who has one partner may choose to be checked once a year. Many years after it is acquired, untreated syphilis can be fatal and may lead to chronic brain or heart disease.

Symptoms

There are three stages of syphilis. Only the first two stages are infectious and symptoms vary according to the stage. Having symptoms of syphilis can make you more at risk of HIV infection during sexual contact.

First stage (4 to 12 weeks)
The first stage of syphilis can be missed as there may be no symptoms or it may occur as a sore (ulcer) on the genital area (including the penis or vagina), anus or the mouth. The sore:

• May be hidden from view, in the rectum or on the cervix
• Is usually painless
• Appears three to four weeks after infection – however, it can occur any time between one and 12 weeks after infection
• Normally heals completely within four weeks.

If a person is not treated for syphilis at this stage, they may go on to develop the second stage of the disease.

Second stage (0 to 24 months)
During the second stage of syphilis, there may be:

• A flat, red skin rash on the soles of the feet or palms of the hands, and may cover the entire body. The rash is contagious This rash may mimic other common skin conditions such as measles and the diagnosis may be missed if a syphilis blood test is not done.
• Swollen lymph nodes
• Hair loss
• Lumps on the genitals
• Flu-like illness.

If you are infected with syphilis and do not seek treatment at this stage, you may develop the third stage of the infection.

Third stage (may occur years later)
The third stage of syphilis can affect various organs, especially the brain and the heart. This stage occurs in about one-third of untreated people. Severe brain or heart complications may occur during this stage.

How it is spread

Syphilis is spread (transmitted) through close skin-to-skin contact with an infected area. You can catch syphilis by having oral, vaginal or anal sex with a person who is in the first two stages of the infection. Syphilis is highly contagious when the sore or rash is present.

Although rare in Australia, pregnant women who have syphilis can pass on the infection to their unborn baby. It can also be passed through infected blood. However, blood used in blood donations is routinely screened for syphilis in Australia.

Screening

A regular sexual health check-up with your local doctor or sexual health centre can detect syphilis using a blood test. If you are a man having sexual contact with other men (including oral sex), it is important to be screened. Just ask your doctor or nurse for a test. Test results are normally available within a week.

Diagnosis

Syphilis is easy to detect using:

• A simple blood test
• A swab test, if there are sores present.

Treatment

Penicillin is a very effective treatment for syphilis. Other treatments are available if you are allergic to penicillin or you may be able to undergo a procedure that safely allows you to be given penicillin.

Treatment early in the infection is needed to help prevent further complications and avoid transmission to sexual partners.

Avoid sex until the infection is cured

You should avoid sexual contact until your treatment has finished and follow-up blood tests have confirmed the infection is cured.

Sexual partner notification

It is important to let your sexual partner or partners know that you have syphilis. Most people appreciate being told they may have an infection and it is an important step in preventing further infection in the community. Your local doctor and sexual health centre can help you inform your partners. This process is called ‘partner notification’. It can be done anonymously and your confidentiality is always respected.

Reduce your risk of infection

Ways you can reduce your risk of catching syphilis include:

• Always have safe sex – use a condom, dam and water-based lubricant.
• Remember that syphilis may be spread through oral sex.
• If you are a man who has sex with other men, get a syphilis test and other STI checks at least yearly and up to four times a year if you have a number of partners.
• Seek early advice if you notice oral, genital or anal sores, or rashes on your body, hands or feet related to recent sexual contact.

Where to get help

• Your local doctor or nurse
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
• Victoria AIDS Council/Gay Men’s Health Centre Tel. (03) 9865 6700 or 1800 134 840
• Education and Resource Centre at The Alfred Tel. (03) 9076 6993
• The Centre Clinic, St Kilda Tel. (03) 9525 5866
• Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100
• The Action Centre (for young people 25 years and under) Tel. (03) 9660 4700 or 1800 013 952
• Sexual Health Clinic Ballarat Tel. (03) 5338 4540
• Bendigo Community Health Tel. (03) 5434 4330
• Geelong Sexual Health Clinic Tel. (03) 5250 5366
• STD Clinic Wodonga Tel. (03) 6051 7535
• STD/AIDS Clinic Traralgon Tel. (03) 5173 8111

Things to remember

• There are three stages of syphilis. The first two stages are infectious.
• Syphilis is curable but, if left untreated, syphilis can lead to serious complications.
• A simple blood test can detect syphilis.
• It is important to let your sexual partner or partners know that you have syphilis. Your local doctor and sexual health centre can help you to do this.

You might also be interested in:

• Sexually transmissible infections - avoid the risk.
  
• Sexually transmissible infections - overview.
  
• Sexually transmissible infections - signs and symptoms.
  

Want to know more?

Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

(Logo links to further information)

Melbourne Sexual Health Centre

Last reviewed: March 2011

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

If you would like to link to this fact sheet on your website, simply copy the code below and add it to your page:

<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Syphilis?open">Syphilis - Better Health Channel</a><br/>
Syphilis is a sexually transmissible infection (STI) that can be easily treated. Syphilis may have no symptoms so regular sexual health check-ups are recommended for individuals at risk. Currently these include men-who-have-sex-with-men (MSM) and people who have sex in countries where there are high rates of syphilis. Condoms and dams reduce the risk.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

For the latest updates and more information, visit www.betterhealth.vic.gov.au

Copyight © 1999/2012  State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.