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Canberra Health Services
Health Information Sheet | Canberra Health Services

Genital skin care

Syphilis is a sexually transmissible infection (STI) caused by the bacteria Treponema pallidum.

How do you get infected with syphilis?

Syphilis is usually passed on through oral, vaginal or anal sex with someone who has the infection. It can also be passed to your baby during pregnancy. Syphilis testing is an important part of routine pregnancy care.

What are the symptoms of syphilis?

Not all people with syphilis will have symptoms. This is why getting tested is very important. Syphilis has several stages of infection - primary, secondary, latent and tertiary. Each stage can cause different symptoms.

Primary syphilis

Primary syphilis is the first stage of the infection. It can present as a sore (“chancre”) or sores, usually on your genitals, mouth, vagina or anus. Chancres can look like shallow ulcers, but as they are often painless, you may not notice them. Chancres heal by themselves. However, without treatment the syphilis infection will still be in your body. It can cause problems, and you can still spread the infection to others.

Secondary syphilis

Secondary syphilis is the second stage of the infection. Symptoms may include:

  • a rash, often on your back, chest, limbs, hands and feet
  • white patches or lumps on moist parts of your body (such as your mouth, groin, and underarms)
  • fever (temperature above 38°C)
  • ‘flu-like’ symptoms (fever, chills, aches and pains)
  • swollen lymph nodes
  • headache or other neurological symptoms like changes in vision or hearing loss

If you don’t have treatment, these symptoms may come and go for up to 2 years. You can spread syphilis to others during this stage.

Latent syphilis

Latent syphilis happens when the infection is left untreated and stays in your body:

  • There are no symptoms.
  • It is not infectious through sex after the first two years but can still be transferred from a mother to her baby for years after she is infected.
  • Infection can only be found by having a blood test.
  • If treated correctly, syphilis is cured.

Tertiary syphilis

Tertiary syphilis may develop after many years if not treated. Tertiary syphilis can cause serious damage to your heart, brain, eyes and other organs.

How is syphilis diagnosed?

A blood test will show if you have a current and/or past syphilis infection. If you have a chancre or rash, a swab can also be taken and tested to diagnose syphilis.

Syphilis in pregnancy

Syphilis in pregnancy is harmful to the baby. Syphilis can cause miscarriage, premature birth, stillbirth or lifelong health problems. Treatment in pregnancy can greatly reduce these risks. For this reason, syphilis testing is now offered up to three times in pregnancy.

What is the treatment for syphilis?

Penicillin injections (usually given in the upper or side buttock muscles) are the treatment for syphilis. If you are allergic to penicillin, your health care worker will discuss other treatments.

Some people may have sudden flu-like symptoms (fevers, chills, aches and pains) for up to 24 hours after treatment. This is because the bacteria and your immune system is responding to the treatment. This is a normal reaction called a JHR (“Jarisch-Herxheimer Reaction”) and is different from side effects or an allergic reaction to penicillin. Symptoms will settle quickly and do not need any treatment other than rest and paracetamol.

Do I have to tell my partner(s)?

Yes. It is very important to tell your sexual partner(s) that you have been diagnosed with syphilis. This will help protect you from being infected with syphilis again, and other people and babies from being exposed to syphilis. Your partner(s) can be tested and possibly treated as well. Your health care provider can help you work out who you need to tell and how to tell them. Websites like “Let Them Know”, “The Drama Down Under” and “Better to Know” can help too.

Do I need more tests after I have been treated?

Yes. You will need follow up blood tests to make sure the treatment has worked at 3, 6 and 12 months after treatment. You should also have a check for other STI’s and blood borne viruses at these times.

How do I avoid getting infected again?

  • Make sure that your current sexual partner(s) are tested and treated if infected.
  • Always use a condom, this is the best way to prevent becoming infected again. This may not be necessary if you and your partner have both been tested and neither of you have other partners.
  • Have regular STI check-ups and discuss with your health care provider whether HIV PREP (Pre-Exposure Prophylaxis) may be helpful for you.

If you need more information or have any questions, please contact the Canberra Sexual Health Centre on (02) 5124 2184 or talk to your GP.

Contact tracing websites:

Other resources:

References:

canberrahealthservices.act.gov.au