The Lambda Clinic - Sexual Health Advice - Patient Information Leaflet
http://www.lambdaclinic.co.uk/syphilis.html
Syphilis
What is syphilis?
Syphilis is a sexually transmitted infection caused by a bacterium called Treponema pallidum. You can pass on syphilis without knowing you have the infection because symptoms can be very mild or you may not recognise them.
How do you get syphilis?
Syphilis infection is passed from person to person through contact with a syphilis ulcer (described below). Depending on where the ulcer is, the syphilis infection can be passed on during anal, vaginal or oral sex or if you share sex toys. Using a condom will reduce your chance of getting and passing on syphilis infection. It is, however, not spread by hugging, toilet seats, bath tubs, door knobs, sharing clothes, baths or towels or from swimming pools.
Syphilis can also be transmitted by blood transfusion. All blood donors in the UK are screened to prevent this type of infection.
If you are pregnant, you can pass on syphilis to your unborn baby (congenital syphilis). All pregnant women are therefore tested for syphilis in the UK.
What are the symptoms of syphilis?
The signs and symptoms are the same in both men and women. If left untreated, the infection typically follows a pattern of four stages. These stages are called primary syphilis, secondary syphilis, the latent (hidden) period, and tertiary syphilis.
Primary syphilis
Usually one small ulcer (sore or chancre) develops where the syphilis bacteria enters the body. This is commonly on the penis in men, on the vulva or vagina in women, or on the anus. The ulcer usually appears about 2 – 3 weeks after having sex with an infected person, but it may appear anytime up to three months later. The ulcer is classically a painless ulcer about a size of a small coin and has a clear fluid draining. The ulcer is very infectious and may take up to 6 weeks to heal. During this healing time the syphilis bacteria usually spreads to other parts of the body.
Sometimes the primary stage is non-typical. For example:
· The ulcer may be painful
· You may have more than one ulcer
· The ulcer may be in the mouth or in the rectum
· Pus may come from an ulcer
· The ulcer may be on the cervix in women which means that it is not seen or felt
· You may have no symptoms or very mild symptoms
Secondary syphilis
If the primary ulcer is not noticed, or not treated, secondary syphilis usually occurs within weeks of the ulcer appearing. The symptoms include:
· A non itchy or painless rash - dark skin patches each about the size of a penny. The patches may sometimes spread all over the body particularly on the palms of the hands and soles of the feet.
· Wart-like growths may develop around the penis, vagina or the anus in both men and women (condylomata lata).
· A flu like tiredness, illness, swollen glands (can last weeks to months).
· Patchy hair loss.
· White patches on tongue or roof of mouth.
· Less commonly, inflammation may develop around the liver and in other parts of the body.
· Without treatment, the rash and other symptoms from secondary syphilis usually disappear after several weeks. However, the symptoms may ‘come and go' for up to two years.
· Secondary syphilis is still very infectious.
Latent (hidden) syphilis
After the symptoms of secondary syphilis have cleared, you may not have any symptoms for several years. In this ‘latent' period where you may think that the disease has gone forever. This is true in some cases but not in all cases.
Tertiary syphilis
After many years untreated syphilis may cause very serious damage to the nervous system, brain, bones, heart, blood vessels, eyes, liver and skin. At this stage this stage of syphilis can be fatal.
How is syphilis diagnosed?
· A swab can be used to collect a sample of fluid from any sores or if there are no sores, a blood test can detect syphilis.
· A test can be done as soon as you think you have been in contact with syphilis. The results of the blood test will usually be known within 5 days. For some people syphilis will not show up on the test straight away so it needs to be repeated at a later appointment.
· The Lambda Clinic can arrange these tests for you.
How will I know how long I have had syphilis infection for?
It can be impossible to know, particularly if you have not had any symptoms. You might never know whether you got syphilis from your current or a previous sexual partner. This can often be difficult to handle. Do not be afraid to talk to the Lambda Clinic staff about how you feel.
What is the treatment for syphilis?
A course of penicillin injections over 10 – 14 days is the usual treatment. Treatment during the primary or secondary stages of the disease normally treats the infection adequately and this usually prevents any permanent long-term damage.
You must avoid anal, vaginal or oral sex until you and your partner have both finished the complete treatment, otherwise you risk re-infecting each other. Using a condom will reduce the risk of re-infection but it does not guarantee it.
Can syphilis be prevented?
If you practice safe sex, and always use a condom, your risk of catching syphilis is very much reduced. However, condoms do not provide complete protection, as syphilis ulcers can sometimes be on areas not covered by a condom.
If you have had syphilis, and had it treated, you can still get re-infected if you have sex with an infected person.
Should I tell my partner about my syphilis?
Yes. If you have syphilis it is very important that your current sexual partner and any other recent and previous sexual partners are tested and treated.
The staff at the Lambda Clinic can discuss with you how you might tell your partner(s). If you find this too difficult the Lambda Clinic can notify your partner(s) for you. Your confidentiality will be protected at all times.
It is strongly advised you do tell your partner(s) but it is not compulsory.
Can syphilis go away without treatment?
No. If you delay seeking treatment you may inadvertently pass the infection on to someone else. You also risk the infection causing long term damage.
What happens if I get syphilis when I am pregnant?
All pregnant women in the UK are offered an antenatal blood test to detect syphilis. If you are found to have syphilis then treatment can be given safely during pregnancy with no risk to the unborn baby. If a woman has untreated syphilis she may pass the infection to her baby in the womb possibly causing miscarriage, stillbirth or the baby being born with the infection.
BMI The Edgbaston Hospital
22 Somerset Road
Edgbaston
B15 2QQ
Telephone: 0121 452 2815