Syphilis is a bacterial infection, sometimes called ‘the pox’. It has several stages: primary and secondary stages, which are very infectious, and the third or latent stage, which occur if the infection is left untreated. The symptoms of syphilis can be difficult to recognise and can be missed. They can take up to three months to show after sex with an infected person.


Syphilis is a sexually acquired infection caused by Treponema pallidum, a spirochete bacterium.


In the UK syphilis infection was relatively uncommon but figures are increasing again over the last few years.


The condition is especially significant in women in pregnancy where infection can cause miscarriage, still birth, or foetal abnormality.


Who gets Syphilis?

Anyone who has sex can get syphilis. People most at risk are those having unprotected sexual intercourse (i.e. not using a condom), those with more than one sexual partner, and those who change partners frequently.


In 2004, there were 2,254 cases diagnosed in STI clinics (also called genitourinary medicine clinics) in the United Kingdom.


The highest rates of syphilis are seen in women aged 20-24 and men aged 25-34 years.


How do you catch syphilis?


Syphilis is a sexually transmitted infection. It is caught through unprotected vaginal, oral or anal intercourse or genital contact with an infected partner.


An infected person may have no symptoms, but still transmit the infection without knowing.


Syphilis cannot be caught by casual contact (toilet seats, swimming pools and saunas).


A pregnant woman with infectious syphilis can pass the infection to her foetus via the placenta or during birth.


How do you know that you have syphilis?


The symptoms of syphilis are not specific. Though the illness usually begins with one or more painless but highly infectious sores (primary infection) appearing anywhere on the body (but usually at the site of infection), this is not always the case. These sores clear up on their own in two to six weeks.


Secondary symptoms may develop 6 weeks to 6 months after the onset of primary sores. Later symptoms are highly variable, but may include a rash on the palms or soles.


Late syphilis occurs four or more years after an untreated primary infection. Complications may occur in the mucocutaneous tissue, heart, respiratory tract or central nervous system.


How serious is syphilis?


Infectious syphilis in pregnant women usually results in miscarriage, stillbirth or a congenitally infected baby. Maternal infection, however, is detectable and entirely treatable which prevents transmission to the baby.


If left undetected syphilis will eventually cause symptoms in about 40 percent of infected people.


How can you protect yourself against syphilis?


Sexually active young men and women can reduce their risk of syphilis by reducing their numbers of partners and using condoms correctly and consistently during sexual intercourse.


How is syphilis diagnosed?


Syphilis can be diagnosed by detection of the organism in the ulcer. Antibodies to syphilis can also be detected in the blood.


All pregnant women should be tested for syphilis to prevent transmission to the foetus. Genitourinary medicine clinics have the equipment and facilities for testing and for contacting, testing and treating sexual partnersYou can attend one of these clinics at any age (even if you are under the age of consent to sex which is 16).


A person with suspected syphilis should also be tested for other sexually transmitted infections which may be present without symptoms.


How is syphilis treated?


All stages of syphilis can be treated with antibiotics.


All current and recent sexual partners of a person with syphilis should be tested and treated to prevent re-infection and the further spread of disease. Treatment is offered whether or not they show any signs of infection.


This has been adapted from ‘Sexual Health Birmingham’ the authors are Dr S Acharya & Dr J Arumainayagam.


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