Syphilis, known as the Great Pretender, is a sexually transmitted disease (STD) caused by a bacterium called Treponema pallidum.1 The STD earned its dubious nickname because its signs and symptoms can mimic so many other illnesses. Because of this, people often overlook their signs and symptoms or misdiagnose them for something else.
A person can contract syphilis by having vaginal, anal, or oral sex with someone who has syphilitic skin sores known as chancres. Direct contact with these sores or mucous membranes can allow the bacteria to spread.2 Mothers can also transmit syphilis to their unborn babies during pregnancy (congenital syphilis).
Syphilis is a relatively common STD, which comes as a surprise to many people. As an example, over 101,000 new cases of syphilis were reported to the Centers of Disease Control and Prevention (CDC) in 2017.1,3 That's more than the number of new human immunodeficiency virus (HIV) infections which occurred in 2016.
Preventing the spread of syphilis and other STDs requires education and awareness. In addition to learning the main signs and symptoms, understanding the risk factors and potential health complications of syphilis can help you and your partners take steps avoid it.
Risk Factors for Syphilis
Anyone who is sexually active has at least some risk for contracting syphilis, however some people have a greater risk than others.2 These include:
- Men who have sex with men and men who have sex with both men and women. The CDC estimated that fully 60% of all new syphilis diagnoses in 2015 affected this demographic.2
- Infants born to black or Hispanic mothers who have untreated syphilis. 918 cases of congenital syphilis occurred in 2017. Compared to babies born to white mothers, babies born to black and Hispanic mothers were affected at a 6.1 and 3.5 times higher rate, respectively.1
- People who have numerous sexual partners.
- People who have HIV.
- People who have unprotected sex.
Because chancres can occur on areas of the skin that aren't covered by condoms (including the anus, rectum, mouth, lips, and vagina), it's possible to contract this STD even when practicing safer sex.
Complications Associated with Syphilis
Having syphilis can increase the chance of contracting other STDs, including HIV. According to the CDC, people with syphilis are up to 5 times more likely to acquire HIV when exposed to the virus compared to someone without syphilis.1
Additional complications exist, however, and without proper treatment, syphilis can progress and worsen significantly over the course of months, years, and decades. In advanced untreated cases, syphilis can be fatal. The specific complications a person may face with untreated syphilis can depend on the stage of the illness: primary, secondary, and tertiary.
The main complication or issue with the primary stage of syphilis, which occurs within three weeks after initial exposure, is that a person will develop chancres. As mentioned, a chancre is the hallmark syphilitic sore and is generally firm, round, and painless. Because they don't cause discomfort, chancres are easily overlooked. This can increase the likelihood that a person will unknowingly transmit the STD to their sexual partner(s).
The secondary stage of syphilis can occur anywhere from three weeks to three months after initial exposure to the bacteria. During this stage, a person remains contagious. They will also begin to experience uncomfortable signs and symptoms, including a non-itchy rash on the trunk and elsewhere on the body, muscle aches, fever, sore throat, headaches, weight loss, swollen lymph nodes, genital sores, unusual hair loss, and fatigue. These issues generally resolve after a few weeks but may return over a period of several weeks or months.
A complication called ocular syphilis may occur at this or later stages. This condition occurs when syphilis infects the eye, potentially leading to vision loss and blindness.
Even though a person is no longer contagious during the tertiary stage, their health is still at serious risk once they enter this advanced phase of the disease.
At this stage—which occurs around one to three decades after initial exposure (and generally preceded by a latency phase where a person has no symptoms, despite remaining contagious)—a person can begin to experience multi-organ failure. This is because syphilis can attack tissues including the nerves, brain, eyes, liver, bones, , and heart. A person in this stage may also develop gummas, which are soft non-cancerous growths on the skin.
As a specific example, neurosyphilis is a complication that occurs when the STD affects the brain and nervous system. This usually happens during the tertiary stage but can also occur earlier in the disease process. Symptoms may include a change in mental status, confusion, difficulty concentrating, weakness, walking and balance difficulties, numbness in the arms and legs, headaches, seizures, vision loss, and dementia.
Complications of Congenital Syphilis (Mother-to-Infant Transmission)
For infants who contract syphilis from their mothers during pregnancy, consequences can be dire. While they may not exhibit any signs or symptoms initially, babies with congenital syphilis may eventually exhibit things such as developmental delays, problems gaining weight, fever, rash, bone pain, blisters, watery nasal fluid, and seizures (which can be life-threatening). Congenital syphilis can also cause disfigurement, such as an abnormally shaped nose, shin bone, or teeth.
Sadly, many babies of mothers with untreated syphilis do not survive the pregnancy—the CDC estimates that the risk for stillbirth or infant death is as high as 40% for pregnant mothers with this STD.1 Because of the severity of congenital syphilis, all women who are pregnant are advised to get screened for syphilis during their first prenatal appointment.1
The good news is that syphilis is treatable with antibiotics such as penicillin. Earlier diagnoses minimizes the risk of complications and can improve outcomes, as well as reduces the risk of transmission.
Are you sexually active? Regular screening is an essential part of a healthy sex life and can protect you and your partners from syphilis. For affordable and accurate STD screening in the privacy of your own home, request your STD test kit today.