Syphilis Update January 2022

Syphilis numbers remain high in Ireland

7 Things you need to Know

  1. Syphilis is an STI that can be cured.
  2. You get syphilis from condomless anal sex, oral sex (including rimming) and vaginal sex or sharing sex toys
  3. Symptoms include a genital ulcer, which is often painless, swollen glands and a rash which is non-itchy and can involve the palms of the hands and soles of the feet.
  4. Many people with syphilis don’t notice anything when they have picked up the infection and will only be diagnosed when they have a syphilis blood test.
  5. If you’ve had syphilis before, you can get it again.
  6. If you have or have had symptoms, it is important to get tested and treated.
  7. Once treated, protect yourself and new partners by using a condom for all anal, oral and vaginal sex.

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What is Syphilis?

Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria. Syphilis can be hard to spot and is one of the most easily caught sexually transmitted infections. If untreated it can cause serious health problems in both men and women.

How does someone get Syphilis?

You can catch syphilis by coming into direct contact with a syphilis sore; by having unprotected anal, oral or vaginal sex; rimming, fingering or sharing sex toys and through close genital contact. Find out how to prevent it.

Syphilis spreads best by contact between moist skin areas anywhere on or in the body. People remain infectious to others for about two years from initial infection if they are not treated.

Syphilis makes it easier for HIV to be transmitted, and sometimes having HIV can make syphilis harder to treat.

What are the symptoms?

Early syphilis is easy to miss. Many people show no sign that they’re infected. Syphilis can make some people feel very ill, especially the ‘secondary stage’ with a rash and fever. The third stage can develop many years after picking up the infection and can have very serious health consequences. It is best avoided by getting tested and treated. The best way to know if you have syphilis is to get tested.

There are three stages to syphilis infection:

1. Primary Syphilis (Early Infectious Syphilis)

10 days to three months after you have been exposed a small, sore or ulcer (called a chancre) appears. The sore will appear on the part of your body where the infection was transmitted, typically the penis, anus, rectum, vagina, tongue or lips. Most people only have one sore, but some people have more. For many people, the sore is painless but not always. You may also experience swelling in your lymph glands (such as in the neck, groin or armpit). The sore will then disappear within two to six weeks and, if the condition is not treated, syphilis will move into its second stage.

2. Secondary Syphilis

The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore.

At this stage common symptoms include:

  • a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet
  • tiredness
  • headaches
  • swollen lymph glands
  • eye problems like pain or blurring of vision

These symptoms may disappear within a few weeks, or come and go over a period of months.

Syphilis will then move into a stage where you will experience no symptoms, even though you remain infected. This is called ‘latent syphilis’. You can still pass it on during the first year of this stage. However, after a couple of years, you cannot pass the infection to others, even though you remain infected.

The latent stage can continue for many years (even decades) after you first become infected. Without treatment, there is a risk that latent syphilis will move on to the most serious stage – tertiary syphilis.

3. Teritary Syphilis

The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing a whole host of life limiting diseases.At this stage, untreated syphilis can be serious enough to cause death. This stage is best avoided by getting tested if you are at risk and getting treated early to avoid developing tertiary syphilis at a later stage, even many years later.

What does a Syphilis test involve?

Syphilis testing involves giving a sample of blood and sometimes it can involve taking a swab from a sore, if present.

Getting tested is the only reliable way of knowing if you have syphilis or not. If you develop any of the symptoms of syphilis then go to your sexual health clinic as soon as possible, especially if you notice a sore on your genitals. The earlier syphilis is treated the better. If you are generally unwell and think you are at higher risk of syphilis, then get tested.

What does treatment involve?

Syphilis is treated with antibiotics (usually Penicillin). Treatment is usually given by injection and may involve one or more doses, depending on what kind of syphilis and the stage of the infection.

Once the treatment has finished, further blood tests are carried out to make sure the infection has gone. These tests may be required at intervals for up to a year. These blood tests are important to monitor how well you have responded to treatment.

Your partner(s) should also get tested for syphilis. It can be hard to spot in its early stages and they might not realise they have it. They may be offered treatment regardless.

While you are being treated and until you get a clear test result:

  • Do not have any kind of sex
  • Avoid intimate contact with your partner and others
  • This will stop you from infecting your partner if they are clear, and stop you being re-infected if they also have syphilis.