Syphilis FAQ

Following are common questions about Syphilis:
  1. What is Syphilis?
  2. What are the different stages of Syphilis?
  3. Who are the people at risk of infection?
  4. What are the common signs and symptoms for this disease?
  5. What are the different tests suggested to diagnose syphilis?
  6. What are the different Treatment Methods for Syphilis?
  7. What can you do to prevent syphilis?
  8. What are the complications associated with syphilis?

  1. What is Syphilis?
    • Syphilis is a sexually transmitted disease (STD), caused by a virus named Treponema pallidum which is highly contagious
    • It is spread through sexual contact, that is, vaginal, anal or oral sex
    • It can lead to complications if left untreated for a long time and cause damage to vital organs like the heart and the brain
    • Diagnosis of this disease is also very challenging
    • However, if detected in its early stages, it is very simple to cure with correct treatment
    • Infected people are often unaware of their disease and pass it on to their partner
    • Syphilis is NOT spread by
      1. Toilet Seats
      2. Door Knobs
      3. Swimming Pools
      4. Sharing clothes
      5. Eating utensils

  2. What are the different stages of Syphilis?

     There are four stages in Syphilis. In the first two stages, syphilis is very infectious. In the latent stage, it is still active but has no visible symptoms. It is not contagious at this stage. The tertiary stage is the most destructive health-wise. These are explained below:
    1. Primary Stage
      • The primary stage starts three or four weeks after the patient has been infected with bacteria
      • The infection starts with a small, round sore called as chancre
      • The patient might notice a single sore, but in fact there will be multiple sores
      • The chancre is the location where the syphilis enters the body. It is painless but highly infectious and the sore may be in the mouth, genitals or rectum
      • Syphilis is transmitted by direct contact with a sore. This usually happens during sexual activity, including oral sex.
      • The sore lasts for three to six weeks and then heals; irrespective of whether the infected person has received treatment
      • Even after the sore has healed, the person must receive treatment so that the disease does not move to the second stage
    2. Secondary Stage
      • The infected person may suffer from skin rashes and sore throat
      • The rash does not itch and is usually found on palms of the hand and soles of the feet. However, it is not always restricted to these two areas on the body.
      • The rash looks like rough, reddish-brown spots
      • The rash will be accompanied by other symptoms.
      • The symptoms recede even if treatment is not received. Still the person must receive medication, otherwise he'll still be infected.
    3. Latent Stage
      • This is a hidden or dormant stage
      • The symptoms from the first two stages disappear and there will be no noticeable indications for syphilis. But the infection will still be present.
      • The secondary symptoms may reappear or this stage might continue like this for ten to thirty years
      • Then, finally the disease enters its last stage
    4. Tertiary Stage
      • Approximately 15 to 30% of people who have not received treatment will progress to this final stage
      • The Tertiary Stage may occur decades after the initial infection
      • At this stage, the disease affects the major organs and can be potentially fatal
      • The outcomes of this stage can be:
        1. Blindness
        2. Deafness
        3. Dementia
        4. Memory loss
        5. Destruction of soft tissue and bone
        6. Paralysis
        7. Neurological disorders like meningitis or stroke
        8. Heart disease
        9. Neurosyphilis, an infection of the brain and the spinal cord

  3. Who are the people at risk of infection?

     The symptoms of the primary and secondary stages can often go undetected and also can often be confused with some other ailment. Therefore it is best for people at risk to undergo tests to diagnose syphilis. The people at risk are:
    • Those who have had unprotected sex with a person who might have been infected
    • Pregnant women
    • Sex workers
    • People in prison
    • People who have had unprotected sex with multiple partners
    • Those who have partners, who have had unprotected sex with multiple people
    • Men who have sex with men

  4. What are the common signs and symptoms for this disease?

     The symptoms are different for various stages.
    Symptoms for Primary stage
    • One or more painless ulcers in and around the genitals and mouth, within three weeks of exposure to the bacteria
    • In men, the chancre (Check question 2) occurs frequently in the genital area, usually (but not always) on the penis
    • In women, the chancre develops on the outer genitals or in the inner part of the vagina. If it is present inside the vagina or at its opening(called as cervix) then it can barely be noticed
    • Lymph nodes might swell around the region of the chancre
    • The sores might develop in other parts of the body

    Symptoms for Secondary stage
    • A noticeable rash appears 2 to 12 weeks after the appearance of sores
    • They are reddish-brown in colour, solid, flat or raised and 2 cm across. In darker skinned people, the rash is lighter in colour than the surrounding skin. But these rashes can be mistaken for some other common skin disease.
    • Small, pus-filled sores might occur on the mucous membrane. Otherwise, moist sores called condyloma lata might be present.

  5. What are the different tests suggested to diagnose syphilis?

    Tests used for screening are:
    • Venereal disease research laboratory (VDRL) Test: Checks blood and spinal fluid for presence of antibodies created in response to the cells damaged by bacteria. This antibody produced is not unique for only syphilis. So the test is not always accurate.
    • Rapid Plasma Reagin Test (RPR Test): This test also checks the blood for antibodies.
    Tests used for confirming syphilis are:
    • Enzyme Immunoassay (EIA) Test: It is a blood test which checks for syphilis antibodies. A positive test must be further confirmed with a VDRL or RPR test.
    • Fluorescent Treponemal Antibody Absorption (FTA-ABS) Test: This too checks for antibodies. The test is performed on a sample of blood or spinal fluid. Syphilis can be easily detected; except for the first three or four weeks after infection.
    • Treponema Pallidum Particle Agglutination Assay (TPPA): Tests for antibodies of syphilis in the blood. It is not performed on spinal fluid. This test is performed only after another test is found to be positive.
    • Darkfield Microscopy: The test is mainly used for detection in early stages. A sample fluid or tissue from a sore is taken and observed under a special microscope.
    • Microhemagglutination assay (MHA-TP): This is another test used to confirm the infection, after other tests have tested positive.

  6. What are the different Treatment Methods for Syphilis?
    • Primary and Secondary Syphilis is easily treated with a penicillin injection
    • Penicillin is a widely used antibiotic and is successful in curing this disease
    • Some people who are allergic to penicillin, are given oral antibiotic like ceftriaxone and doxycycline
    • Patients suffering from Neurosyphilis get a daily dose of intravenous penicillin. They are often required to be hospitalized for a short period of time.
    • Unfortunately, the damage caused by this disease is irreversible
    • The bacteria can be killed, but the treatment mainly focuses on alleviating pain and easing discomfort
    • During treatment, all sexual contact is to be avoided until all the sores have healed and the doctor has confirmed that sexual activity can be resumed
    • If the infected person is sexually active, then the partner should be treated too. Sexual activity should be suspended until the treatment of both partners is complete.

  7. What can you do to prevent syphilis?
    • Using condoms for sexual intercourse
    • Using dental dams (a piece of latex) or condoms during oral sex
    • Avoiding sex with multiple partners
    • Sharing of sex toys should be avoided
    • Getting screened for sexually transmitted infections and talking with partners about the results
    • Syphilis can also be blood-borne and so sharing needles while taking drugs, should be avoided

  8. What are the complications associated with syphilis?
    • Pregnant women with syphilis can suffer from miscarriages, still birth or premature birth
    • There is also a risk of congenital syphilis, i.e, the disease being passed from the mother to the foetus
    • Congenital syphilis may be fatal. Babies born with this can suffer from:
      1. Deformities
      2. Development delays
      3. Seizures
      4. Rashes
      5. Fever
      6. Swollen liver or spleen
      7. Anaemia
      8. Jaundice
      9. Infectious sores
    • If babies suffering from syphilis do not get proper treatment, they might suffer from later stage syphilis. This can lead to damage to their:
      1. Teeth
      2. Bones
      3. Eyes
      4. Ears
      5. Brain
    • People suffering from this disease have a higher risk of getting HIV as the sores make it easier for the infection to enter
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