What is syphilis
Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria called Treponema pallidum.
Syphilis is divided into different stages and this is discussed in greater detail below. Untreated syphilis can cause serious health problems.
How common is syphilis
Syphilis is not very common in Ireland but, since the late 1990s, the number of cases has risen. Most new cases of syphilis in Ireland, especially the early stages of the infection, are among gay, bisexual and men who have sex with men (gbMSM).
How do I get syphilis
You can get syphilis from:
- skin-to-skin contact or coming into direct contact with a syphilis sore
- condomless oral, vaginal and anal sex (sex without a condom)
- mother-to-child during pregnancy (congenital syphilis)
- a blood transfusion (although this is very unlikely in Ireland as all blood donors are tested)
Can I get syphilis from oral sex
Yes.
You cannot get syphilis by:
- hugging
- swimming pools or baths
- toilet seats
- sharing cutlery or towels
How can syphilis be diagnosed
Syphilis is usually diagnosed through a blood test. Sometimes a swab is taken from a sore (ulcer). This is generally done in a sexual health clinic.
If you think you have symptoms, you should attend a sexual health clinic.
Getting tested is the only reliable way of knowing if you have syphilis or not.
What symptoms would I have with syphilis
There are 3 different stages to syphilis infection, these are explained in detail below.
Primary syphilis (early syphilis)
Around 10 days to three months after you have been exposed to syphilis, a small sore or ulcer (called a chancre) appears. The sore will appear on the part of your body where the infection was transmitted, typically the penis, anus, rectum, vagina, tongue or lips.
Most people only have one sore, but some people may have more. For many people, the sore is painless but not always.
You may also experience swelling in your lymph glands (such as in the neck, groin or armpit).
The sore can heal without treatment, but without treatment syphilis will move into the second stage.
Many people don't notice this stage.
Secondary syphilis (early syphilis)
The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore. At this stage common symptoms include:
- a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet
- tiredness
- headaches
- swollen lymph glands
- eye problems like pain or blurring of vision
- hearing loss
These symptoms may disappear within a few weeks, or come and go over a period of months.
Without treatment, syphilis will then move into a stage where you will experience no symptoms, even though you remain infected. This is called 'latent syphilis'. You can still pass the infection on during the first year of this stage, but, after a couple of years, it is unlikely that you would pass syphilis on to others, even though you still have the infection.
Without treatment, the latent stage can continue for many years (even decades) after you first become infected. If you are not treated, you risk latent syphilis moving on to the tertiary syphilis, which can have serious health consequences.
Tertiary syphilis (late syphilis)
The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels. At this stage, untreated syphilis can be serious enough to cause death. You can avoid this stage by getting tested if you are at risk and getting treated early.
Testing and treatment will prevent tertiary syphilis, so it is important to get tested.
How is syphilis treated
Syphilis should be treated at a sexual health clinic. Syphilis can be treated and cured with antibiotics, usually injections of penicillin. If you are allergic to penicillin, there are other treatments available. You can discuss the options with your healthcare provider.
Treatment is usually given by injection and may involve one or more doses, depending on what kind of syphilis you have and the stage of the infection.
Once the treatment has finished, the clinic will carry out further blood tests to make sure the infection has gone. These blood tests are important to monitor how well you have responded to treatment. The clinic will explain when you need to come back for a blood test.
What about my partner
Your partner(s) should also get tested for syphilis. They may have syphilis but not have any symptoms.
It is important that all of the people you have recently been in sexual contact with are given the option to be tested and treated. Your healthcare provider will discuss this with you.
When can I have sex again
Discuss with your healthcare provider when it is okay to have sex again after you have finished treatment.
If a partner also has syphilis and you have sex (even oral sex or sex with a condom) with them before they are treated, you may become infected again.
What happens if my syphilis is left untreated
If syphilis is not treated, it can cause serious problems with your heart, brain, eyes and nervous system. These complications may take many years to develop.
Testing and treatment prevents these problems so if you are at risk, get tested.
How can I prevent myself from getting syphilis again
Having syphilis once does not protect you from getting it again. It is important to make sure that your partner (s) have been tested and treated before having sex with them again.
Use condoms every time you have sex. If you have a new partner, it is a good idea for both of you to have an STI test before any condomless sex.
At the moment, most syphilis cases are happening in gbMSM. If you are a man who has sex with men and are having condomless sex with new partners, it is important to test regularly (for example every three months) for STIs.
Syphilis in pregnancy
Syphilis testing is routinely offered to all women as part of antenatal care. Passing syphilis to the unborn child can be prevented by treating syphilis during pregnancy. Sometimes treating the babies too.