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Syphilis

Description

Syphilis is an infection caused by the bacterium Treponema pallidum.A person can have syphilis more than once in his or her life. 

Symptoms

People with syphilis often do not realize they have symptoms of the infection. A person may be infected without knowing it. 

If left untreated, syphilis develops in 4 stages: 

  • Primary
  • Secondary
  • Latent
  • Tertiary 

Symptoms vary depending on the stage of infection.

Primary stage

In the primary stage, the only symptom is the presence of one or more ulcers also known as sores. Sores may appear:

  • On the genitals (penis, scrotum, vulva, vagina)
  • Around the anus
  • In or around the mouth and throat 

These sores often go unnoticed. They are not painful and can appear up to 3 months after transmission of the bacterium. They go away without treatment after 3 to 6 weeks.  

However, the bacterium stays in the person’s body. The infection can continue to spread and lead to complications.

Secondary stage

Secondary stage symptoms appear up to 6 months after transmission of the bacterium. They may include: 

  • Symptoms similar to those of the flu:
    • Fever
    • Headache 
    • Fatigue
    • Muscle pain
    • Swollen glands in different parts of the body 
  • Rashes
    • On the palms
    • On the soles of the feet
    • Elsewhere on the body 

These symptoms also go away without treatment after several weeks. 

However, the bacterium stays in the person’s body. The infection can continue to spread and lead to complications.

Latent stage 

The infected person shows no symptoms at this stage. However, the bacterium is still in the body. This stage can last several years. 

Tertiary stage

During this stage, the infection is no longer contagious but the infected person can develop serious health problems, such as damage:

  • To the heart 
  • To the brain 
  • To the bones 
  • To the liver 

These problems may occur 5 to 30 years after the infection.  

When to consult

If you have symptoms, or if you have had unprotected sex, see a health-care professional or contact Info-Santé 811.

Treatment

Syphilis is treated with medication. When an infection is in the primary or secondary stage, treatment heals it completely. However, damage caused by syphilis in the tertiary stage can be permanent. Infected people must be treated as soon as possible to avoid complications.

Medication to treat syphilis is free for those infected and for their sexual partners. To receive medication, infected people and their partners must first get a prescription. They can then obtain medicine at a pharmacy upon presentation of their health insurance card.

Precautions to take during treatment

Treatment requires a certain amount of time to heal the infection. During this period, the person is still contagious.

In order not to spread syphilis or catch it again, the infected personand his or her partners must avoid having sex until they are healed. 

Before having sex, the infected person and his or her partners must wait:

  • Until the end of the treatment, if it involves taking pills for several days
  • 7 days after treatment, if it involves a single dose by injection

Also, they must wait until any symptoms are completely gone.

If they cannot wait, the infected person and his or her partners can use a condom. They may also use a sheet of latex to cover the vulva or anus during oral sex. This way, the mouth does not come into direct contact with the genitals. A sheet of latex can be made by unrolling a condom, cutting off both ends and then cutting it lengthwise.

Inform partners

People with syphilis should inform their sexual partners immediately. This way:

  • They can avoid getting syphilis again from untreated partners
  • Their partners can quickly get tested, receive appropriate treatment and avoid complications
  • Their partners can avoid spreading the infection to other people

Complications

If left untreated, syphilis can last many years. Even in someone with no symptoms, it can lead to significant damage: 

  • To the heart 
  • To the brain 
  • To the bones 
  • To the liver

A pregnant woman with syphilis is at risk of delivering prematurely or giving birth to a stillborn baby.

Infected new-borns can develop serious complications, such as:

  • Anemia
  • Liver, spleen and bone abnormalities
  • Delayed development

Syphilis also increases the risk of getting or spreading HIV.

Transmission

An infected person can spread syphilis even if he or she has no symptoms. The risk of spreading syphilis is much higher in the year following the onset of the infection.  

Sexual transmission can occur during:

  • Oral sex (contact of the mouth with the penis, vulva, vagina or anus)
  • Vaginal sex (penetration of the vagina with the penis)
  • Anal sex (penetration of the anus with the penis)
  • Genital contact between partners
  • Direct contact of the skin or mucous membrane with sores or rashes
  • Sharing of sex toys

Sexual transmission can occur in the absence of penetration, orgasm or ejaculation.

Syphilis can also be spread through blood-to-blood contact when sharing equipment used to prepare, inject or inhale drugs. However, this form of transmission is rarer than sexual transmission. 

An infected mother can also pass on syphilis to her baby during pregnancy or childbirth. For further information, read the Sexually Transmitted and Blood-borne Infections (STBBIs) and Pregnancy page.

Protection and prevention

Vaccination

There is no vaccine to protect against syphilis.

Sexual protection

For the best protection against syphilis, use a condom:

  • During all contact between genital organs
  • During the entire course of oral, vaginal or anal sex
  • With each sexual encounter

The use of a sheet of latex to cover the vulva or anus during oral sex lowers the risk of spreading syphilis. It helps prevent direct contact between the mouth and the genitals. A sheet of latex can be made by unrolling a condom, cutting off both ends and then cutting it lengthwise.

Sex toys should not be shared. People who share sex toys can lower the risk of spreading syphilis by covering them with a condom. They must change condoms after each partner.

Testing

A person who has had unprotected sex should consult a health-care professional to see if he or she needs to be tested. This way, a person with syphilis can avoid passing it on to other people and prevent complications. 

A blood test can detect if you have syphilis. 

To be tested, consult a health-care professional or call Info-Santé 811.

Last update: March 9, 2017

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