What is syphilis?

Syphilis is a bacterial infection. The infection has 4 stages: primary, secondary, early latent and late latent.

How can I get syphilis?

You can get syphilis from close contact or sexual contact with another person who is infected. Syphilis is spread through:

• Skin-to-skin contact with a syphilis sore (lesion) or rash, from external or internal contact with a person's mouth, genitals, or rectum when a sore or rash is present
• Exchange of bodily fluids, such as blood, semen or vaginal fluid
• Sharing sex toys
• Syphilis can also spread to your baby during pregnancy or birth. This is known as congenital syphilis

While anyone can get syphilis, most people diagnosed with syphilis in B.C. are men who identify as gay, bisexual, or men who have sex with men (gbMSM). However, recent rates of syphilis have increased greatly for cisgender women leading to congenital syphilis cases.

Syphilis can be transmitted during any of the 4 stages of infection. Your risk of having syphilis is greater if you already have another sexually transmitted infection (STI).

What are the symptoms?

Each stage of syphilis has different symptoms. They can vary or be so mild that you may not know you are infected.

Primary stage

During the primary stage, a painless sore can develop anywhere on your body that came into contact with an infected person. The sore usually appears between 3 and 90 days after getting the infection. Often, the sore will not be noticeable. The sore will go away on its own within a few weeks, but the disease will progress.

Secondary stage

The secondary stage usually starts about 14 to 90 days after getting infected. In this stage, a non-itchy rash may develop. The rash can appear anywhere, but it is most often on your chest, belly, genitals, palms of your hands and soles of your feet. You may not notice the rash, but you can still infect others. The rash usually disappears but it can come back months later. Other symptoms may include headache, fever, hair loss, swollen lymph nodes and bumps or mucous patches inside the mouth, anus, penis or vagina.

Latent stages

After the rash goes away, and if you are not treated, the disease will progress to the latent, or hidden, stages. This period can last up to 30 years or longer. During this time, you may not have any symptoms.

There are two latent stages of syphilis:

• Early latent stage is when a person has acquired a syphilis infection within the past year. People who have 'early' syphilis can infect others more easily
• Late latent stage is when a person has a syphilis infection for more than 1 year

How to get tested for syphilis

Visit your health care provider to get any syphilis symptoms, like sore(s) or rashes, tested. Your health care provider may give you a referral for lab work to get your blood tested.

It is recommended that anyone who has multiple sexual partners be tested for syphilis every 3 to 6 months or immediately if they have symptoms.

Screening for syphilis for anyone who is pregnant is routinely done as part of initial prenatal screening and additionally at time of delivery. If you are pregnant, speak to your health care provider about your risk of getting STIs, including syphilis. They can help determine if you need STI screening.

To find the nearest testing clinic in B.C. or get tested online, visit Smart Sex Resource at https://smartsexresource.com/sex-talk/talk-about-it and/or Get Checked Online at https://getcheckedonline.com.

What are the complications?

If you are not treated for syphilis, complications may occur early on in the infection or several years later. Complications may be neurologic (hearing or vision loss, dizziness) or cause damage to your brain, heart and other organs in your body, which can lead to death.

Untreated syphilis during pregnancy can cause serious complications, such as miscarriage, premature birth or stillbirth, low birth weight, or cause the baby to be born with syphilis.

What is the treatment?

During any stage, syphilis can be treated with antibiotics. Antibiotic treatment cannot undo the damage already caused by syphilis in the late latent stage, but it can prevent further damage. After treatment, you must have blood tests to make sure the treatment worked.

Your sexual partners within the last 3 to 12 months should be tested and treated for syphilis. This will depend on what stage of syphilis you are diagnosed with. Do not have sex until 2 weeks after you and your partner(s) finish treatment and you have confirmed that the treatment was effective.

Will my birth control pills work if I am taking antibiotics?

There is very little evidence to show that antibiotics reduce how well hormonal forms of birth control work. Examples of hormonal birth control include the pill, the patch, the ring or the shot. If you are being treated with antibiotics, it is important to keep using your birth control. If you have concerns, also use condoms until your next period comes after completing the antibiotics, or speak to your health care provider for more information.

For more information

For more information on how you can reduce your chance of getting an STI, see HealthLinkBC File #08o Preventing sexually transmitted infections (STIs).