Introduction

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. Transmission can occur through contact with a chancre or syphilitic sore, blood transfusions, or from mother to child during pregnancy or birth.

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum.

You may contract the disease from an infected person. The person may not exhibit any symptoms of syphilis, yet they can be contagious. The best way to prevent the infection is to practice safe sex such as using condoms and/or dental dams.

Sores, called chancres, caused by syphilis are typically painless and may go unnoticed. However, they can easily contribute to the spread of infection.

Transmission can occur through:

Contact with a chancre or syphilitic sore: This ulcer can occur on or around genital areas, buttocks or oral cavity. Syphilis can be transmitted through this sore during vaginal, anal or oral sex. Additionally, deep kissing can cause the spread of the infection if someone has a sore in their mouth.

Blood transfusions: There have been incidences of transmission of syphilis through infected blood. This is thought to be very rare.

From mother to child: The infection can pass from the mother to their unborn child during pregnancy or childbirth.

Symptoms may take anywhere between 10 and 90 days to develop after the infection.

You cannot get syphilis through casual contact with objects such as toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing or eating utensils.

What are the signs of syphilis in an adult?

In an adult, syphilis presents in three stages. The person may be asymptomatic in all these stages but still capable of transmitting the infection to another person. If the person does not receive treatment in stage I, they will progress to the next stage.

The primary stage: A single, firm, painless sore or chancre marks the primary (first) stage of syphilis. Sometimes, there are multiple sores. The chancre lasts for about three to six weeks and heals with or without treatment. It is seen in the genital areas, rectum, anus and oral cavity (mouth).

The secondary stage: A rash develops on the skin and/or mucous membranes (inside mouth, vagina or anus). The rash usually does not itch and may be on more than one part of the body. Sometimes, it is not noticed. There may be fever, swollen lymph nodes, sore throat, weight loss, nonspecific aches and fatigue. Symptoms of secondary syphilis go away with or without treatment.

The latent (hidden) stage of syphilis: There are no visible signs or symptoms of syphilis. Without treatment, the infection will continue in the body and transmission is possible. If left untreated, the infection will progress to the tertiary stage of syphilis.

Tertiary syphilis: Tertiary syphilis is rare and develops in untreated infection. It may appear decades after the person first contracted the infection. It can affect multiple organ systems including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Symptoms vary depending on the affected organs. Tertiary syphilis is fatal. It is the only stage of the disease that is probably not contagious.

How does syphilis affect a pregnant woman and her baby?

When a pregnant woman has syphilis, the infection can be transmitted from her to her unborn baby. Therefore, doctors recommend all pregnant women to get tested for syphilis at the first prenatal visit.

If you are a high-risk group, live in areas of high syphilis morbidity or had a positive screening test in the first trimester, the syphilis screening test should be repeated during the third trimester (28 to 32 weeks gestation) and again at delivery. If you have delivered a stillborn infant after 20 weeks of gestation, you should be tested for syphilis.

In pregnant women, untreated syphilis results in infant death in up to 40 percent of cases. It also increases the risk of developmental defects in a baby.

Sometimes, a baby infected in-utero (inside the uterus) is apparently healthy at birth but may develop serious problems within a few weeks. Untreated babies may have complications such as seizures, delayed milestones or heart defects. These babies often develop blurred vision due to corneal infection, abnormal tearing and eye pain.

Sometimes, the affected child may present late in the course of the disease with additional symptoms such as abnormal facial features such as a saddle nose, bony prominence of the forehead, high arched palate, nerve deafness and fissuring around the mouth and anus. They may develop aseptic meningitis, which is a serious inflammation of the membranes or coverings around the brain.