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Syphilis

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 in both men and women.

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 men who have sex with men (MSM).

How do I get syphilis?

You can get syphilis from:

  • skin-to-skin contact or coming into direct contact with a syphilis sore
  • unprotected 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)

If untreated, people with syphilis can remain infectious to others for about two years after they were first infected themselves.

Syphilis makes it easier to become infected with HIV and sometimes having HIV can make syphilis harder to treat.

Can I get syphilis from oral sex?

Yes.

You cannot catch syphilis by:

  • hugging
  • swimming pools or baths
  • toilet seats
  • sharing cutlery or towels

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 will then disappear within two to six weeks and, if the condition is not treated, syphilis will move into its 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

These symptoms may disappear within a few weeks, or come and go over a period of months.

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 remain infected.

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 should avoid this stage by getting tested if you are at risk and getting treated early.

Testing and treatment will prevent tertiary syphilis, so if you are at risk, get tested.

How can I be tested for syphilis?

Syphilis is usually diagnosed through a blood test. Sometimes a swab is taken from a sore (ulcer). This is generally done in an STI clinic.

Getting tested is the only reliable way of knowing if you have syphilis or not.

How is syphilis treated?

Syphilis should be treated at an STI 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 at the clinic.

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 (or partners) should also get tested for syphilis. It can be hard to spot in its early stages and they might not realise they have it. They may be offered treatment anyway.

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 doctor or nurse will discuss this with you.

When can I have sex again?

You can have sex again when you are treated and get a clear test result.

While you are being treated, and until you get a clear test result, you should not have any kind of sex and you must avoid intimate contact with your partner (or partners).

This will stop you from infecting your partner if they do not have syphilis, or stop you from being re-infected if your partner has it. Your doctor or nurse will discuss this with you.

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 has been tested and treated before having sex with them again.

Protect yourself with new partners by using a condom for all anal, oral and vaginal sex. Ensure that both you and any new partners have a sexual health screen before having any unprotected sex (sex without a condom).

At the moment, most syphilis cases are happening in MSM. If you are a MSM and having unprotected sex with new partners, it is important to test regularly (for example every three months) for syphilis and other STIs.

Syphilis in pregnancy

Syphilis testing is routinely offered to all women booking for antenatal care. Passing syphilis to the unborn child can be prevented by treating mothers during pregnancy and sometimes treating the babies too.

Download the Syphilis leaflet here.