The STI Files: Syphilis

Stat: Syphilis (siff-uh-liss) has been increasing in the last ten years in the US, UK, Australia and Europe. People with Penises are more susceptible to infection⁠ than people with vaginas, and most cases occur in people between the ages of 15 and 39.

What is it exactly? Syphilis is an infection caused by the bacteria Treponema pallidum.

About how many people have it? The United States is actively trying to eliminate syphilis⁠ by finding and treating everyone who is infected, so the number of infected people has been dropping very fast. There are currently less that 40,000 reported cases of syphilis in the United States. Some people think syphilis rates change in ten year cycles, so they think that the number will start to go back up again. Other people think we will be able to keep the number down.

How is it spread? Syphilis is passed when someone touches a sore on a person who has syphilis. These sores are can be on the person's mouth, penis⁠ , vagina⁠ , anus⁠ or skin. Most syphilis is passed during oral, vaginal, or anal sexual⁠ contact, though it can be passed through breaks in the skin and infected pregnant people can pass it to their baby. If a baby is born with syphilis, it often has serious mental and physical problems.

What are its symptoms? Syphilis has been called "the great imitator" because many of its signs look like other diseases. It is also difficult to know if someone has syphilis because a person might not have any symptoms at all. There are considered to be four stages of syphilis:

1. Primary. The first symptom of syphilis is a chancre. A chancre is an ulcer that forms where the person was exposed. Many people don't notice chancres if they are painless and hidden in the mouth, anus, or vagina. Chancres usually appear one to six weeks after exposure and will disappear in a few weeks on their own, but the person still has the bacteria. A person can pass the disease to other people during this stage.

2. Secondary. The symptom of secondary syphilis is a skin rash, which can appear as the chancre is healing or several weeks later. This rash is usually penny-sized sores on any part of the body. There are infectious bacteria in these sores so anyone who touches them may be infected. The person might also have a mild fever, hair loss, or get headaches and sore throats. The symptoms usually go away in a few months, but might come and go for up to two years, and the person will still carry the bacteria.

3. Latent. This stage can last for a long time. The person cannot pass the disease to another person during this stage, but they still have the bacteria in their body.

4. Tertiary/Late. Some people who are infected for a long time start to have many problems. The bacteria can damage their heart, eyes, liver, brain, bones, and joints. People may become mentally ill, blind, get heart disease, or die.

How is it diagnosed? By microscopic examination of fluid from sores, blood tests, and/or examination of spinal fluid.

Is it treatable? Yes. Penicillin can usually cure a person who has had syphilis less than one year and is often administered with either an intramuscular injection, a course of oral antibiotics, or both. If a person has had syphilis for more than a year, a longer treatment is necessary. If a person is allergic to penicillin, there are other antibiotics the doctor can use to treat them.

Is it curable? Yes, but you can get syphilis again if you are re-exposed, so all sexual partners should also be treated. You should be tested after treatment to make sure the antibiotic worked.

Can it cause death? Yes, untreated syphilis can cause death if it affects too many important organs. It is also easier for HIV⁠ , the virus that causes AIDS⁠ , to infect a person who has a syphilis sore.

How can we protect against it? If you do not have sexual contact with other people, your risk of getting syphilis is almost zero. If you are having sexual contact, it is best to practice safer sex⁠ and limit your number of partners. Having safer sex can means using latex barriers like condoms, dental dams, and gloves correctly and consistently. It is also important get regular STI⁠ checks with your partners because early treatment of syphilis is a good way to avoid serious complications. Two people who know that they are not infected and who have sex⁠ only with each other cannot contract syphilis.

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