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About syphilis

Syphilis is an infection caused by the bacterium treponema pallidum. It can occur more than once in a lifetime.


Syphilis is a serious disease caused by bacteria. It is spread through genital, anal or oral sexual contact with an infected person. The first symptom is a painless lesion that appears where the bacteria have entered the body. The second stage of the disease appears several weeks later as a rash. Syphilis attacks the whole body.


When to seek help for syphilis?

If you have had unsafe, unprotected sex, you should see your health care professional for testing.

A person who has had unprotected sex should see a health care provider who will assess the need for testing. This will help a person who has syphilis avoid passing it on to others and prevent complications.

Signs and symptoms

Some people with syphilis have no initial symptoms. When symptoms are present, they often begin between 0 and 3 months after transmission. The disease then progresses through stages, where various symptoms may occur:

  1. Primary stage

    • Appearance of a painless chancre (ulcer-like lesion) at the site of entry of the germ (mouth, penis, vagina or anus) within the first 3 months of transmission. The disease is transmitted from this lesion. It can sometimes be accompanied by small bumps in the groin area (lymph nodes). The chancre disappears by itself after 3 to 8 weeks. 

    • However, the individual is still contagious at this point, although the screening blood test performed at this time may indicate a negative result.

  2. Secondary stage

    • Between 4 weeks and 6 months after the appearance of the chancre, redness appears on the skin and mucous membranes. Fever, fatigue, headaches and muscle pain also occur. These symptoms resolve themselves after 3 to 12 weeks, without the need for treatment. However, the disease is not cured and enters a latency period. 

    • Syphilis remains symptomless after this period and is only detectable by blood samples. However, the infected person remains contagious.

  3. Tertiary stage

    • Occurs on average 5 to 30 years after transmission of the disease, if untreated 

    • This can lead to various problems in the skin, bones and vital organs (cardiovascular and neurological systems)

Transmission

An infected person can transmit syphilis even if he or she has no symptoms. The risk of transmitting syphilis is highest during the first year after infection begins.

Sexual transmission can occur through:

  • Oral sex (mouth contact with the penis, vulva, vagina, or anus);

  • Vaginal sex (penetration of the penis into the vagina);

  • Anal intercourse (penile penetration of the anus);

  • Contact between partners' genitals;

  • Direct skin or mucous membrane contact with chancres or rashes of an infected person

  • Sharing sex toys.

  • Sexual transmission can occur even without penetration, orgasm or ejaculation.

Syphilis can also be transmitted through blood contact by sharing drug preparation, injection or inhalation equipment. However, this mode of transmission is much less common than sexual transmission.

An infected mother can also pass syphilis to her baby during pregnancy or at the time of delivery. 


Window or incubation period (time interval before the disease is detectable) 

  • 10 days to 12 weeks

Prevention

The main protection against syphilis is the use of condoms. Condoms must be used during all genital contact and all oral, vaginal and anal sex. 

Using a latex square to cover the vulva or anus during oral sex is also a reliable means of protection. To make a latex square, simply unroll a condom, cut off the ends and cut lengthwise. 

It is also recommended that sex toys not be shared or be covered with a condom whenever possible, changing the condom between partners.

Complications

If left untreated, syphilis can last for years. Even in a person who has no symptoms, it can cause significant damage to :

  • The heart;

  • The brain;

  • The bones;

  • The liver.

A pregnant woman who has syphilis is at risk of giving birth prematurely or having a stillborn baby.

Infected newborns can have serious complications, such as:

  • Anemia

  • Liver, spleen or bone abnormalities;

  • Developmental delay.

Syphilis also increases the risk of acquiring or transmitting HIV.

Treatment

  • Because syphilis is a bacterial infection, it is treated with antibiotics. The duration and route of administration of antibiotics vary depending on the stage of the disease. Treatment can range from a single dose to 28 days of treatment. 

    It is important to avoid sex during treatment, for 7 days after treatment and for the duration of symptoms. If sex cannot be avoided during this period, it is important to use a condom. 

    Following diagnosis, it is also recommended that sexual partners within the last 3 to 12 months be contacted (depending on the stage of infection), in order to break the chain of transmission and so that they too can be tested and treated if necessary. 

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