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Syphilis

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Information here is general in nature. You should always consult a health professional for health problems.

Syphilis is bacteria that, if it is not treated, goes through three or four stages: (Some people say five, which includes "early latent" and "late latent".) More on the stages below.

Syphilis is one of the better known STDs, though it was on the decline in North America at least for a while; now reports of Syphilis are going up.

Things to know:

In Canada, Syphilis was pretty rare in the 1990s. But by 2002 the rate was four times what it had been in 1997 and it has continued to go up. You can get tested for Syphilis by your family doctor or at a Public Health Unit (this shows a link to the Region of Waterloo Public Health Unit).

Not everyone who is infected shows symptoms so it's important to know how to lower your risk of getting it and to get tested if there is even a chance you may have contracted an STD.

Sometimes, Syphilis is called the "great imitator" because there are so many symptoms that can appear to be from something else.

People need to be particularly concerned about the interaction between Syphilis and HIV/AIDS. Statistics: people who have Syphilis sores on their genitals are three to five times more likely to get HIV. And those who have both these diseases are more likely to infect others.

How you get Syphilis:

Have sex with someone who is already infected with it. This can be vaginal, anal or oral sexual contact.

A baby can get Syphilis from an infected mother, sometimes causing birth defects or stillbirth (the baby is born dead)

Less common, but possible, is being infected by intravenous (needle) drug use or some other break in the skin.

SYMPTOMS:

Symptoms - if they are noticed - usually show up about three weeks after exposure to the Syphilis bacteria but can take up to three months to be noticed. Because some of the symptoms look like symptoms of other problems, or they don't show up at all, and because Syphilis used to be pretty rare, many times a person, or their doctor will misunderstand the symptoms and Syphilis won't be diagnosed when it should be.

 

There are different stages of a Syphilis infection: (return to top)

Primary:

The infected person is very contagious at this stage; he or she can easily pass it on to other people. Small, painless sores may appear wherever the body got exposed to the bacteria. That could be the genitals, mouth or anus. Usually the sores show up about three weeks after the infection. The sore (or sores) is extremely contagious and usually heal between two and six weeks. This does not mean the person is cured or that they are not infectious! It just means that the sores have healed up.

The good news: treatment at the primary stage can cure the infection and is usually easy to do.

Females:

The sores are likely to show up on the vulva (the outer female genitals), the clitoris (in the upper part of the vulva, under the "clitoral hood" which is near the top of the female genitals). Sores can also show up around the urethra (where urine comes out).

Sores can also occur internally, on the cervix (the neck of the womb), and externally, on the anus, or mouth.

Males:

Sores may be less noticeable on males; they can show up on the penis and foreskin of males, as well as the anus and mouth.

Secondary:

If a person does not get treated, about three to six weeks after the sores show up, the infection goes into "secondary stage". This is also very contagious.

A rash can appear anywhere on the body or just in certain places. It is not itchy.

Both males and females can get a wart-like, flat growth around the anus; females can also get it on their vulva (outer genitals).

There can be flu-like symptoms; remember, Syphilis can look like other conditions! These can be loss of appetite, feelings of tiredness, and swollen glands. This "flu" feeling can last for weeks or months!

A person can also lose hair in patches.

The good news: treatment at the primary stage can cure the infection.

Latent Stage:

 

If the Syphilis infection still remains untreated, it enters the latent (dormant, or quiet) stage. This is called an "asymptomatic" stage. It means that there are no symptoms to be seen, though the disease can still be diagnosed with a blood test. In the early part of the latent stage, a person can still be contagious. This "early stage" is generally felt to be about one year after entering the latent stage. After that point, an infection is in the late latent phase. The bacteria pretty much just hang around inside lymph nodes and the spleen, but they are inactive. (Lymph glands are small bean shaped organs that are part of the immune system. They contain cells that help fight infections.) In this late latency stage, Syphilis is not likely to be contagious.

 

The latent period can last between three years and thirty! If an infected person does not get treated, which is harder to do at this point, the disease may or may not proceed to the last stage, called the Tertiary stage.

Tertiary Stage:

While not everyone goes on to develop Tertiary Syphilis, if someone does, (between 30 and 40%) it's a very nasty thing and at this stage, it is too late. It can no longer be cured. This is what those people in the Tertiary stage face:

Damage to the heart, eyes, brain and nervous system, bones and joints, pretty much any part of the body! This can happen years or even decades after the Primary Syphilis. This stage can result in mental illness, blindness, deafness and memory loss or other neurological problems, heart disease and eventually death. (Hey, with all those other things wrong, you can't expect not to die of it!)

PREVENTION AND TREATMENT

The best way to avoid exposure to syphilis is not to have sex and not to use injections drugs. If you are going to have sex, avoid multiple partners and do not have sex with prostitutes or other sex trade workers.

Get informed about the person you are having sex with! Talk honestly about each other's sexual history but remember that, (a) some people will lie and (b) Syphilis, and some other STDs, don't always show symptoms and your partner may not know they have an infection!

If you do use injection drugs, learn about safer injection practices. This link takes you to different site. Smart2ask.org does not condone or encourage illegal drug use, nor has it evaluated the information on that site. But it is best to know how to reduce the risks of transmitting diseases if you happen to be an injection drug user and you care about your own health and the health of your friends. That site may have helpful information for you.

If you are going to have sex, use a condom and use it properly.

 

This link takes you to a different site and also has some information on condom use.

If you are diagnosed with Syphilis, the Health Department will need to notify anyone you've shared sex, or, if an intravenous drug user, needles with. Those people need to be tested and treated if they have the bacteria, before they can infect someone else.

Do not have any type of sex with anyone if you have contracted Syphilis, until your treatment is finished and your doctor has given you the OK. Even if you haven't been tested yet, don't have any kind of sex if you have any sores where you have had sexual contact. Then get the test!

Testing: Can be done as soon as you know, or think you may have been exposed to Syphylis or any STD. Results take roughly a week. These test methods might be a bit uncomfortable for a few moments but are not painful.

A blood sample will be taken

If you have a sore or sores, a bit of the fluid will be examined under a microscope

You genitals and the rest of your body will be examined by the doctor

Samples will be taken with a bit of cotton or foam swab for testing

A urine sample will be needed

Females will get an internal examination

Treatment:

Treatment is usually a week-long course of penicillin injections. Sometimes antibiotics pills will be prescribed.

IMPORTANT: You must finish the whole antibiotic course. If you don't you may not be cured, and you may also be helping to breed antibiotic resistant bacteria. It also means that you will have to start the treatment again, right from the start.

If you are allergic to penicillin, tell your doctor

If you are, or might be pregnant, or plan to get pregnant, tell your doctor

Once the treatment course is finished you'll have to go back to the doctor to be certain you are cured; more than one visit might be needed.

Pregnancy and Syphilis :

Pregnant girls and women may be given a Syphilis test in pre-natal care. If it is found, the woman can be treated without harming the baby. If it is not treated, miscarriage or stillbirth can result- that is the baby is born dead, either before the full pregnancy (miscarriage), or close to the usual nine months.

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