Introduction

Syphilis is caused by bacteria known as treponema pallidum. This is easily passed from one person to another through sexual contact. Anyone who is sexually active can get it. Both men and women can have syphilis, and pass it on. Syphilis is not as common as some sexually contagious infections but if left untreated it can cause very serious health problems in both men and women.

Symptoms

The incubation period for syphilis is normally from 10-90 days (on average 21 days). The signs and symptoms are the same in both men and women. They can be difficult to identify and you might not notice them.

Syphilis can develop into three stages:

• The first stage: primary syphilis
• The second stage: secondary syphilis
• The third or latent stage: tertiary syphilis

First stage syphilis

• One or more sores – usually painless – will appear where the bacteria entered the body. On average, this will be 2-3 weeks after coming into contact with syphilis but it can be sooner or later.
• These sores can appear anywhere on the body. In men, they appear mainly around the opening of the urethra, on the penis and foreskin, and around the anus.
• Less commonly, in men and women, sores may appear in the mouth, and on the lips, tonsils, fingers or buttocks.
• The sores of first stage syphilis are very infectious and may take 2-6 weeks to heal. By this time, the bacteria will have spread to other parts of the body and it will then be known as second stage syphilis.

Second stage syphilis

If the infection remains untreated the second stage usually occurs some weeks after any sores have appeared and healed. Syphilis is still infectious at this stage and can be passed on to someone else.

The symptoms include:

• A painless rash that is not normally itchy. It can spread all over the body, or appear in patches, but it is often seen on the palms of the hands and soles of the feet.
• Flat, warty-looking growths on the vulva in women and around the anus in both men and women (often mistaken for genital warts).
• A flu-like illness, tiredness and loss of appetite, with swollen glands (this can last for weeks or months).
• White patches on the tongue or roof of the mouth.
• Patchy hair loss.
• These symptoms will gradually go away and tertiary syphilis will be developed.

Third (latent) and advanced stage syphilis

When syphilis remains untreated it goes into another phase known as third stage or latent syphilis. At this stage, the patient’s ability to spread the virus will be gradually weakened, but the virus can remain in patient’s body for many years without showing any signs or symptoms. If treatment is continuously absent, advanced stage syphilis will be developed after 3 to 7 years (or after decades). The virus may cause very serious and permanent damage to the heart, brain, eyes, other internal organs, bones and nervous system. At this stage, syphilis can lead to death. The most common lesion at this stage is gummatous syphilis, which are developed on the skin, bones, brain or inflammatory nodules in other parts of the body2. If developed in the eyes, visual loss is normally resulted in3. At this stage, syphilis could only be diagnosed through blood test.

Reference:

http://www.chp.gov.hk/tc/content/9/24/1607.html#31
http://hospital.kingnet.com.tw/library/diagnose.html?lid=3398
http://www.fpa.org.uk/helpandadvice/

How is Syphilis passed on

You can pass syphilis on without knowing you have the infection because symptoms can be mild and you may not notice or recognize them.

• Syphilis can be passed from one person to another during sex and by direct skin contact with someone who has syphilis sores or a syphilis rash. It can be passed on before symptoms are noticeable, or after they’ve disappeared.
• The infection can spread if you have vaginal, oral or anal sex, or share sex toys. Using a condom correctly will reduce your chance of getting or passing on syphilis.
• Syphilis can also be transmitted by blood transfusion.

You cannot catch syphilis from kissing, hugging, sharing baths or towels, toilet seats, swimming pools or from sharing cups, plates or cutlery.

Syphilis tests

You will be advised to give a blood sample. Our doctor will perform a genital examination of the penis, foreskin, urethral opening and may have the anus examined internally and externally. Our doctor will also check the body generally for any rashes or warty growths. They may check the mouth and throat area. A swab will be used to collect a sample of fluid from any sores if necessary.

How soon after sex can I have a check-up?

It is important not to delay getting a test if you think you might have syphilis. Syphilis may not show up on the test straightaway, so it will be repeated at a later appointment.

Do I need to have a test to check that the syphilis has gone?

Yes. You will need to go back for follow-up tests to check that the infection has gone and that you have not come into contact with the infection again.

Your blood test will probably remain positive in any future tests – even after successful treatment. So, if you need documents for emigration or any other reason, ask your clinic for a certificate explaining your treatment. This also means that you will be advised to have regular blood tests to check that there are no changes, monitor your condition and make sure that all is okay.

If you have any questions, ask our doctor and make sure you know how to protect yourself in the future.

Reference
Donkers A. Comparative evaluation of IMMULITE 2000 syphilis screen assay and bioelisa Syphilis 3.0 assay for determination of antibodies to Treponema pallidum in pregnancy samples. 2009. 19th European Congress of Clinical Microbiology and Infectious Diseases

Treatment

First and second stage syphilis is treated using a single antibiotic injection or a course of injections or by taking antibiotic tablets or capsules.

• Treatment usually lasts around 10-21 days but sometimes longer. If complications have occurred, you may also need other treatments.
• If there is a high chance of you having the infection, treatment may be started before receiving your check-up results.
• You will also be given treatment if your sexual partner has syphilis even you do not have any symptoms.
• It is not advisable to buy any medications without a prescription.

How effective is the treatment?

First and second stage syphilis

Treatment is very effective for both first and second stage syphilis. As long as the treatment is taken correctly the syphilis will be completely cured.

Third stage or latent syphilis

Syphilis at this stage can be treated, but any damage already done to your body may be permanent.

What happens if syphilis is not treated?

Without proper treatment the infection can spread to other parts of the body causing serious, long-term complications.

Left untreated, syphilis may start to cause very serious damage to the heart, brain, eyes, other internal organs, bones and nervous system. This damage could lead to death.