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Syphilis

Syphilis is very treatable if diagnosed early and it is extremely important to treat all sexual contacts of diagnosed patients. It is also important to carry out a full STI screen as many of those infected are at risk of HIV and other infections.

Description:

It is a bacterial infection.

Effects:

  • You can pass it on to your sexual partner(s)
  • You can pass it on to your baby during pregnancy

Cause:

  • Intimate genital contact
  • Unprotected vaginal, anal or oral sex
  • Unprotected rimming (mouth to anus contact)
  • Kissing an infected person
  • From an infected pregnant mother to her baby

Symptoms:

There are three stages to the infection and the symptoms are the same for men and women

Stage 1 – Primary infection, early infection

Incubation period: 9 to 90 days (Incubation period is the time between exposure to an infectious disease and the appearance of the first signs of symptoms)
Symptoms: Usually appear around three weeks after exposure as a painless ulcer (similar to a cold sore) in the genital, anal or mouth area

Stage 2 – Secondary infection, early infection

Incubation period: 6 weeks to 6 months
Symptoms: Red spotty rash develops, typically on the palms of your hands and the soles of your feet, but it may also appear elsewhere on your body

Stage 3 – Tertiary syphilis

Incubation period: Can happen months or years after initial infection
Symptoms: Rare, but there is a possibility of long-term damage to your heart and brain

Sometimes, people with syphilis have no symptoms at all and are diagnosed on blood testing. A positive syphilis blood test in the absence of symptoms is called latent syphilis.

Can a newborn get syphilis?

Yes. Infection during pregnancy may lead to stillbirths, neonatal death and congenital defects such as deafness, neurological impairment, and bone deformities. If not treated immediately, an infected baby may be born without symptoms but could develop them within a few weeks. These signs and symptoms can be very serious. Untreated babies may become developmentally delayed, have seizures, or die.

Diagnosis

Syphilis can be diagnosed by examining material from infectious sores by dark field microscopy. If syphilis bacteria are present in the sore, they will show up with a characteristic appearance. 

A blood test is another way to determine whether someone has syphilis. Shortly after infection occurs, the body produces syphilis antibodies that can be detected by an accurate, safe and inexpensive blood test. A low level of antibodies will stay in the blood for months or years after the disease has been successfully treated. Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, pregnant woman in Ireland are offered a blood test for syphilis in early pregnancy.

Treatment:

  • Antibiotics  treatment is very effective
  • Your sexual partner(s) also need assessment and may require treatment
  • It is important to abstain from intercourse for at least 2 weeks after treatment
  • Follow-up blood tests to make sure the infection is responding to treatment
  • Those on antibiotic therapy for syphilis must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and if necessary, receive treatment.

Prevention:

  • Condoms can prevent syphilis. Protect your sexual health - always use a new condom correctly and put it on before you have sex

How common is syphilis?

In Ireland, the majority of new syphilis cases are seen in men who have sex with men (MSM). In the early 2000’s there was an outbreak of syphilis amongst MSM in Dublin. Control measures to contain the outbreak were successful initially and were targeted primarily at MSM.  There has been an upsurge in new cases of syphilis in 2007 and 2008. In 2008 there were 347 notified cases to the Dept of Public Health in HSE East with 100 of those diagnosed as being primary, secondary and early latent cases.  About a quarter of early syphilis cases also have HIV. People with syphilis are more likely to pick up HIV if they come in contact it. Furthermore people with HIV are more likely pass on HIV if they have syphilis.

  • The cornerstone of congenital syphilis elimination is early detection of syphilis and treatment with penicillin, which is effective and safe for mother and foetus. This is why all pregnant women are screened for syphilis in pregnancy.

HPSC factsheet about Syphilis