Syphilis is a potentially life-threatening sexually transmitted infection (STI) caused by a bacterium (germ) called Treponema pallidum. This disease was rare in Canada but is now becoming more common. There has recently been an increase in the number of syphilis infections in New Brunswick.

You can have syphilis and not even know it – not everyone who is infected will have symptoms. Syphilis is also known as ‘the great imitator’ as symptoms can be similar to other illnesses. Symptoms can include swollen glands, fever, muscle aches and a rash on the palms of hands and the soles of feet.

How is syphilis spread?

  • Syphilis is mostly spread by having unprotected vaginal, anal or oral sex with an infected person.
  • It can be passed from person to person through direct contact with a chancre (stage 1) or rash (stage 2) 
  • Pregnant women can pass this infection to an unborn child or at the time of delivery.
  • Although much less common, it may also be spread by sharing infected drug equipment or through broken skin on the body (that is, accidental needlestick injury)
  • Syphilis cannot be spread through contact with toilet seats, doorknobs, swimming pools, shared clothing or eating utensils.
  • After one year of being infected with syphilis, most people will no longer spread the infection.

What are the symptoms?

Not everyone infected with syphilis will have symptoms. You can have syphilis and not know about it. The symptoms are similar for males and females. Without treatment, syphilis progresses in four stages:

Primary syphilis

Three to 90 days after contact - CONTAGIOUS

  • A chancre (sore or ulcer) will appear where the germ entered the body, mainly in the vagina, penis, anus and rectum or on the lips and in the mouth.
  • A chancre is firm, round and small. It is painless so it may go unnoticed.
  • The chancre may be mistaken for genital trauma or genital herpes.
  • A chancre can heal without treatment, but the disease will still progress to stage 2.

Secondary syphilis

Two weeks to six months after contact - MOST CONTAGIOUS

  • The chancre may still be present or may have healed.  
  • A rash may appear as rough, red, or reddish brown spots and can be present on the palms of the hands and the soles of the feet.
  • Other possible symptoms: fever, swollen lymph glands, sore throat, patchy hair loss, weight loss and muscle and joint aches.
  • Symptoms can be mild.
  • Without treatment, the disease progresses to stage 3.

Latent syphilis

Duration varies from months to years - CONTAGIOUS IN EARLY STAGES

  • Hidden stage with no symptoms

Tertiary syphilis

10 to 30 years after contact - NOT CONTAGIOUS

  • Infection stays in the body for years

How is syphilis diagnosed?

Syphilis is diagnosed through a medical examination, blood test or when, possible, a test done on the chancre. Sometimes a spinal tap test is required. If you are infected with syphilis, you may also be tested for other STIs, including HIV.

How is syphilis treated?

Syphilis can be treated, and a person with syphilis should be treated immediately. Syphilis is treated with antibiotics, usually penicillin by injections. After treatment is finished, you must have blood tests to make sure the infection is gone. It is important to not have sex until your doctor or nurse practitioner says that the infection is gone. A person infected with syphilis may need treatment for other STIs.

What happens if syphilis is left untreated?

Untreated syphilis can spread and cause damage to your brain, heart, bones and many other organs in the body and in severe cases, may cause paralysis, blindness, dementia and even death. Pregnant women can pass it to an unborn child, sometimes causing birth defects or death (stillbirth). Skin, bones, teeth, eyes, lymph glands, liver, spleen and brain can be affected. Symptoms can show soon after birth or later in life of a child.

Who is at risk of syphilis?

You are at risk of getting syphilis if you have sex with an infected partner or:

  • A man who has sex with men;
  • Those who have multiple sexual partners;
  • Injection drug users or one of their partners;
  • Sex trade workers or one of their partners;
  • A partner coming from a country where syphilis is common;
  • Someone who has had an STI; and/or,
  • Those with street involvement.

How can syphilis be prevented?

If you are sexually active, you may lower the risk of getting syphilis by:

  • Limiting your number of sexual partners;
  • Knowing you sexual partner’s history;
  • Having protected sex - Condoms and dental dams can reduce the risk of contracting syphilis, but do not eliminate it because syphilis can be transmitted through contact with an infected sore not covered by a condom. Nevertheless, condoms should be used for vaginal and anal sex. A dental dam is a thin square of latex that should be used during oral sex. Dental dams can be bought in some stores, or you can make your own using a condom or a latex glove.
  • Having regular STI check-ups, which are helpful to identify those who have no symptoms.

It is important to tell your sexual partner if you have syphilis.