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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 the sore or rash is present. You can catch syphilis through oral, vaginal or anal sex with a person who has the infection.
Since 2002, the number of people with infectious syphilis in Victoria has increased rapidly, mainly among homosexually active men. Those most at risk are men who have sex with other men and people who have had sex in countries where there are high rates of syphilis.
Early treatment is effective, but people may not notice the symptoms of early syphilis. Regular sexual health checks are recommended. 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 6 weeks)
The first stage of syphilis occurs 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 10 and 90 days after infection
- Normally heals completely within four weeks.
If a person is not treated for syphilis at this stage, they will 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 – this is very contagious and may occur on the soles of the feet or palms of the hands, or may cover the entire body. This rash may mimic other common skin conditions and the diagnosis may be missed if a syphilis blood test is not done
- Enlarged 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 has the infection. Those most at risk are men who have sex with other men and people who have had sex in countries where there are high rates of syphilis. 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. Many people are unaware that they have the infection. If you are a man having sexual contact with other men (including oral sex), it is important to be screened regularly. 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 symptoms 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 desensitisation to 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 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 ‘contact tracing’. It can be completely anonymous 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 is commonly 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 twice, and up to four times, a year.
- 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) 9276 6993
- The Centre Clinic, St Kilda Tel. (03) 9525 5866
- Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952
- Action Centre (for youth 25 years and under) Tel. (03) 9654 4766 or 1800 013 952
- The Annex Sexual Health Clinic Ballarat Tel. (03) 5338 4540
- BBV/STI Clinic Bendigo Tel. (03) 5434 4330
- Geelong Sexual Health Clinic Tel. (03) 5221 4735
- 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’s important to let your sexual partner(s) 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.
Sexually transmitted infections in Victoria 2000.
Want to know more?
Go to More information for support groups, related links and references.
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