Syphilis is a sexually transmitted bacterial infection that is spread through vaginal, anal, and oral sex. Syphilis has existed for thousands of years and has been a health concern since as early as the 15th and 16th centuries.
According to the Journal of Medicine and Life, the name syphilis comes from a fictional character of the same name in the 16th century. The character named Syphilus was created by Italian poet and physician Girolamo Fracastoro in 1530. In one of his written works, Fracastoro told the story of Syphilus, a shepherd who angered the gods of Greek mythology, specifically the god Apollo, by refusing to worship him. Apollo sought revenge by cursing the people with a horrible disease which he named syphilis, after the shepherd. As a sexual, bacterial infection began to plague the people in reality, the infection was called syphilis after the curse in the story, and the name stuck.
While the origin story of the name syphilis might be amusing, syphilis is a serious sexually transmitted infection and should be treated as soon as possible to avoid dangerous health complications.
Syphilis is fairly common in the United States. The Centers for Disease Control and Prevention (CDC)reported over 101,567 new cases of syphilis in 2017. Of those, over 30,644 were diagnosed in the primary and secondary stages of syphilis, when the infection is most likely to be transmitted. The CDC also noted that the majority of primary and secondary syphilis cases occurred in men who have sex with other men.
Syphilis infections are caused by the bacteria Treponema pallidum. Syphilis causes sores called chancre sores to appear around the genitals, in the rectum, and in or around the mouth of those who are infected.
Syphilis is transmitted when an uninfected person comes in contact with a chancre sore while having intimate contact with an infected person. Syphilis is most often spread during its first stage because the symptoms sometimes go unnoticed or are mistaken for another condition. Syphilis bacteria cannot exist on surfaces and objects such as toilet seats and towels, so there is no need to worry about contracting syphilis through casual contact.
Symptoms of syphilis usually appear around three weeks after the infection has been contracted. However, this varies from person to person. In some cases, symptoms have shown as early as 10 days and as late as 90 days after contracting the infection.
There are four stages of a syphilis infection. Each stage presents with its own set of symptoms. The four stages of syphilis include primary, secondary, latent, and tertiary, or late stage.
The appearance of a chancre sore is usually the first sign of a syphilis infection. How quickly after infection the syphilis sore appears will vary from person to person. It will form at the site of infection, so around the genitals, anus, or mouth, depending on how the infection was contracted, and usually looks like a raised, painless sore. During the primary stage, chancre sores may also appear inside the vagina, anus, or lips of the mouth, making them difficult to see and sometimes causing the first signs of a syphilis infection to go undetected. A chancre sore appears as a single sore, not as a cluster of sores as in other sexually transmitted infections such as herpes blisters or HPV warts. The chancre sore will usually last around three to six weeks and goes away without treatment. Even though the chancre sore goes away, the syphilis infection is still present and can be spread to others.
Common signs of the second stage of syphilis can appear as early as 17 days after infection or as late as 6 months. The secondary stage of syphilis is marked by specific symptoms that may include:
- A reddish-brown rash on the palms of the hands or the soles of the feet
- Rashes on other parts of the body including the head, torso, and neck
- Moist and raised warts in the genital area and around the anus
- Flat, round, grayish-white sores on the mouth, throat, or cervix
- Patchy hair loss on the head or other parts of the body
- A general feeling of malaise, fatigue, swollen lymph nodes, and sore throat
In latent stage syphilis, no symptoms of the infection are present. Latent stage usually occurs 2 to 30 or more years after the infection is contracted. During the first 2 years of the latent stage, a recurrence of secondary stage syphilis symptoms is common.
Tertiary stage syphilis may occur anywhere from 2 years to 30 plus years after the infection has occurred. Symptoms of late stage syphilis may include:
- The development of small tumors called gummas on the skin, bones, liver, or other organs
- Complications with the heart and blood vessels
- Nervous system disorders, including blindness, insanity, and paralysis
Your health care provider will administer a series of blood tests to screen for syphilis. The rapid plasma reagin (RPR) and venereal disease research laboratory (VDRL) tests are two types of blood tests that check for syphilis antibodies. If antibodies are shown, your doctor will order more tests to confirm a syphilis diagnosis. These follow-up tests will look for antibodies or for actual syphilis bacteria.
Since syphilis is a bacterial infection, it responds to antibiotics. It is typically treated with penicillin; however, in the case of a penicillin allergy, a different antibiotic may be prescribed. In most cases, the antibiotic treatment clears the infection from the body. The American Sexual Health Association recommends taking the following steps to ensure the full effects of the treatment are reached:
- Take medication as directed, including completing the entire course of medication.
- Tell any sexual partners about your infection so they may be tested as well.
- Refrain from sexual contact until you and any partners have been treated and cured.
- If being treated for primary or secondary syphilis, get re-tested 6 months after treatment is completed and then again in 1 year.
- If being treated for latent syphilis, get re-tested at 6 months, 12 months, and 24 months post-treatment.
- If you have HIV, you should get re-tested for syphilis every 3 months for 2 years.
Syphilis and Pregnancy
Congenital syphilis can be transmitted through the placenta from mother to child. According to the CDC, syphilis can create complications during pregnancy, though the severity depends on how long the mother has had the infection. An active, untreated syphilis infection during pregnancy increases the chances of a stillbirth or the baby dying shortly after birth. Syphilis can also be transmitted from a woman to her baby during pregnancy. If this occurs, the baby will need immediate treatment to avoid serious complications including seizures, developmental delays, and death.
The good news is that pregnant women who test positive for syphilis can usually be treated with penicillin to prevent spreading the infection to the unborn baby. If you are pregnant or planning to become pregnant and there is any chance you may have contracted a sexually transmitted disease such as syphilis, talk with your doctor about the proper tests and possible treatments to ensure a safe and healthy pregnancy.