Syphilis Risks & Complications

How do people get syphilis?

Syphilis is spread from sexual contact with an infected person. Specifically, people get syphilis by having direct contact with a syphilis sore or rash during vaginal, anal, or oral sex. The bacteria can enter the body through the penis, anus, vagina, mouth, or through broken skin. An infected pregnant woman can also pass the disease to her unborn child. You cannot get syphilis from toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.

Who is at risk for getting syphilis?

Anyone can get syphilis if they have unprotected sexual contact with an infected person. Babies born to infected women are also at risk.

How can I prevent getting syphilis?

• No sex. The only 100% certain way to keep from getting syphilis is to stop having sexual contact. This means not having vaginal, oral, or anal sex.
• Be mutually monogamous. You only have sex with one person who has tested negative for syphilis and they do the same.
• Use condoms every time. Using a condom the right way and every time you have vaginal, anal, or oral sex might lower your risk. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex use a male latex condom.
• Get tested. Testing for many STIs is simple and often can be done during your checkup. The sooner syphilis is found, the more likely it can be cured quickly and easily.

Syphilis is most infectious during the primary and secondary stages of infection.

A single sore or chancre appears in the primary stage. It's easiest to spread syphilis when an infected person is most likely to have sores, which is on average 21 days after getting infected. These sores can take the form of a chancre (pronounced SHANG-ker), a mucous patch (lesion), or wart-like patch in or on the vulva, vagina, penis, cervix, anus, rectum, mouth, lips, tongue or anywhere else the body was originally infected during sexual contact.

Syphilis can make it easier to contract HIV.

People are 2 to 5 times more likely to be infected with HIV if syphilis sores are also involved in the sexual contact of infected partners. Sores also make it easier to spread HIV to others as well. This is because syphilis sores can bleed easily and more easily come in contact with mucous openings of partners. Men who have sex with men (MSM) make up 64% of people in the two most contagious stages of syphilis (primary and secondary stages). This MSM population also has a high degree of being infected with HIV and syphilis at the same time, with 20% to 70% rates of co-infection showing up in studies of MSM in some of the largest cities in the U.S.

Left untreated, syphilis can lead to a final, deadly stage.

The fourth and final stage of syphilis is called the tertiary stage. 15% to 40% of people with untreated syphilis get to this stage within 1 to 35 years of infection. This is when small, rubbery lesions develop inside the body on bones, skin, nervous tissue, heart arteries or the brain. These lesions and other complications can lead to a heart attack, deafness, an aneurysm, paralysis, blindness, a stroke, psychiatric illness, mental problems, seizures and death. And even if it?s diagnosed in the third latent stage of the infection, lesser, but still serious complications could include muscle movement problems, numbness, losing sight, and dementia. Once many of these complications begin, while antibiotics can cure the infection, they cannot reverse any damage to the body that could prove to be permanent.

Pregnant women with syphilis can infect their babies in the womb.

Syphilis can be passed from mother to baby during the latent stage of infection. If a mother has had untreated syphilis during the four years before pregnancy there is a 70% chance that the fetus will be infected with what is called congenital syphilis. And 40% of the time congenital syphilis leads to fetal death through miscarriage, stillbirth (baby dead at birth) or infant death. Each year there are less than 1,000 pregnant women with syphilis leading to just under 350 babies born with congenital syphilis. While babies born with congenital syphilis may not show any symptoms, if they are not treated immediately they can develop serious issues within weeks such as becoming developmentally delayed, have seizures, or even death. This is why all pregnant women should be tested for syphilis.