Syphilis is a sexually transmitted infection (STI) caused by the bacteria Treponema Pallidum. It is not as common as most STIs, but it is easily passed on and picked up through sex. It is curable, but if left in the body long term it can lead to serious medical problems.
How do I get it?
Syphilis can be easily passed from person to person during sex. Most people with syphilis get no symptoms and so it is often passed on unknowingly. It can be passed on through vaginal, anal or oral sex, or by sharing sex toys. Using a condom correctly can reduce your chance of getting or passing on syphilis.
Syphilis can also be passed on by sharing needles if you are an injecting drug user. Syphilis can pass through blood transfusions, but in the UK all blood products are screened so this is rare. Syphilis can pass to a baby by its mother during pregnancy This is serious and is called congenital syphilis. Fortunately, all pregnant women in the are offered screening as part of their care.
You cannot catch syphilis from hugging, toilet seats or from sharing cups, plates, baths, spas or towels.
What might I notice if I have it (Symptoms)?
Most people with syphilis get no symptoms at all (latent syphilis) and are often diagnosed by screening blood tests at a sexual health clinic or antenatal (when they are pregnant). If symptoms do occur, they occur at certain times according to certain stages:
Early (primary) symptoms include a painless fleshy ulcer (break in skin), usually just one on the genitals or anus but can also be elsewhere on the body e.g. the nipple if bitten during sex. It occurs in the first 3 months of infection and less than 1 in 10 people with syphilis will get or notice this.
Early (secondary) symptoms occur up to 2 years from initial exposure and include a rash over the body. Classically this is flat and bump red patches varying from 1-5cm wide over the trunk and limbs and often on the palms of the hand and soles of the feet. Secondary symptoms are not very common, but this stage can involve inflammation and irritation of almost any part of the body. If you are generally unwell and have had sexual risk, we would advice a syphilis and HIV blood test.
Late (tertiary) syphilis occurs many years or even decades after initial infection, if the person has not received treatment. The bacteria slowly attacks the heart, blood vessels and nerves which can lead to many complications including dangerous swellings of the big blood vessels from the heart, nerve problems that can affect sensation and movement and even dementia.
Fortunately, these complications are rare in the UK because most people with syphilis get screened and treated before they can develop.
How do I get tested?
Syphilis is usually diagnosed on a blood test. It can take up to 3 months before signs of infection are present in the blood, so the doctor or nurse may ask you to return to repeat a test at a later date if you have been at risk of getting syphilis. Because syphilis can stay in the body a long time, you may still have it even if your current partner is negative – so it is always good to have it tested as part of a full sexual health screen.
If you have symptoms like unusual genital bumps or skin breaks (ulcers) a doctor or nurse may be able to take a sample to test under the microscope then and there.
What is the Treatment?
Syphilis can be cured with antibiotics. The best choice is an injection of a type of penicillin. This may be just a single injection or a course of injections, depending on what stage of syphilis is found. If penicillin is not suitable e.g. if you are allergic to it, then there are alternative antibiotics.