Syphilis

Syphilis is a bacterial infection. If it is not treated it can affect the brain, spinal cord and other organs. It is uncommon in Australia, but increasing in some populations. It can be cured with antibiotics.

Last updated: 08 June 2010

What is the syphilis

Syphilis is a highly infectious sexually transmitted disease caused by bacteria. If it is not treated syphilis can cause serious, irreversible damage.

Syphilis is not common in Australia, but it has been increasing in some groups of men who have sex with men, and in some remote Aboriginal communities.

What are the symptoms

The symptoms of syphilis often go unnoticed. A blood test is needed to diagnose the disease.

There are four stages of syphilis: primary, secondary, latent and tertiary. Each stage has its own set of symptoms.

1. Primary syphilis (10 to 90 days after infection)
In this stage of syphilis a sore or ulcer appears in the mouth, anus, penis, vagina or cervix. The sore often goes unnoticed because it:

• is usually painless
• may be hidden from view (for example, in the rectum or on the cervix)
• clears up after 2 to 6 weeks

2. Secondary syphilis (7 to 10 weeks after infection)
Symptoms in the secondary stage of syphilis may also go unnoticed. If symptoms are noticed they may include:

• a red rash on the hands, back, chest or feet (this rash is very contagious)
• fever
• swelling of glands in the groin and armpits
• hair loss
• general tiredness

3. Latent syphilis
This stage has no noticeable symptoms, but the body is still infected. If syphilis is not treated at this stage it may remain latent for life, or it can develop into tertiary syphilis.

4. Tertiary syphilis
Tertiary syphilis develops in about a third (1/3) of all people with untreated latent syphilis. In this stage the bacteria can damage almost any part of your body including your heart, brain, spinal cord, eyes and bones. This damage can happen years or even decades after the primary stage. Late syphilis can result in mental illness, blindness, deafness, neurological problems, heart disease and death.

Syphilis can cause birth defects and even death in an unborn baby.

Women and men may not notice symptoms because sores can be painless and out of sight on the vaginal walls, on the rectum or under the foreskin. Because the sore is not painful, it is often ignored.

In the second stage, a few people sometimes notice a rash on the palms of their hands or soles of their feet, or somewhere else on the body. Second stage symptoms, if they develop, usually occur from seven to ten weeks after infection.

After stage one and two there can also be a long stage where there are no symptoms. This is referred to as latent syphilis. If left untreated for many years, it can lead to serious health complications that can include spine, heart and brain damage.

How is it spread?

Syphilis is usually caught during vaginal, anal or oral sex through skin-to-skin contact. Syphilis is highly contagious during the primary and secondary stages when the sore or rash is present. More rarely, syphilis can be transmitted during pregnancy from a mother to her unborn baby.

Who is at risk?

Syphilis is rare in Australia but increasing some communities. These include:

• Men who have sex with men
• People with HIV/AIDS
• Aboriginal communities that are remote or have poor access to health care services

How is it prevented?

Using a condom for vaginal or anal sex can significantly reduce the risk of catching syphilis and other sexually transmitted infections.

Do not have sex with anyone who has been diagnosed with syphilis or who has symptoms until they have been treated by there doctor, even with a condom.

Avoid sharing sex toys and consider using condoms with sex toys for further protection.
Have regular sexual health checks to identify infections early to prevent passing the infection on to others and before complications develop.

How is it diagnosed?

If a sore is present during primary infection a swab (using a cotton bud) can be wiped over the sore and checked under a microscope. Whether a sore is present or not, a blood test will be ordered to test for syphilis antibodies. Antibodies can take between 3 and 6 months to develop in the blood, so the first tests may be negative.

Pregnant women are routinely tested for syphilis to prevent infection of the unborn child.

People who have had syphilis will always test positive and re-infection can occur, even after treatment. Only blood tests can tell the difference between a current infection and one that has been previously treated.

Previous infection does not lead to immunity.

Sex partners need to be tested to prevent re-infection or passing syphilis on to others.

How is it treated?

Syphilis is easily treated with penicillin injections or tablets. The length of treatment will vary depending on the stage of infection. Follow-up blood tests may be required at 1, 3 and 6 months after treatment to monitor progress.

What is the public health response?

If you have been diagnosed with syphilis you should not have sex until after treatment has been shown to be successful. It is important to tell any sexual partner(s) you had during the 3 to 6 months before you were diagnosed so they can be tested and treated, and so they do not reinfect you or infect anyone else. Your doctor or sexual health clinic can help you decide who may be at risk and help you to contact them. If you wish, this can be done anonymously by your doctor.

Syphilis is a notifiable disease. This means that doctors and laboratory staff are legally required to tell the Department of Public Health about new cases. These notifications are used to help find and treat others who may be at risk before they become ill or infect others. The data is also used for public health planning.

Further Information

Sexual Health Information Line (02) 9382 7440 or freecall 1800 451 624 (outside Sydney).