Syphilis Prevention & Risks

Reviewed by Ruthann Cunningham, MD, July 6, 2017

How do people get syphilis?

Syphilis is spread during anal, genital or oral sex with an infected person. 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.

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Who is at risk for getting syphilis?

Anyone can get syphilis if they have sexual contact with an infected person. There is a much greater risk with unprotected sex. 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. The sooner syphilis is found, the quicker and more easily it can be cured and lessen the chance of spreading it to your partners.

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. It often goes unnoticed because it is not painful. These chancres are a mucosal lesion, or wart-like patch, in or on the vulva, vagina, penis, cervix, anus, rectum, mouth, lips, or tongue.

Syphilis can make it easier to contract HIV.

People are 2 to 5 times more likely to be infected with HIV if the infected partner also has a syphilis sore. 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.

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

The last stage of syphilis is called the tertiary stage. If untreated, 15% to 40% of people 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. Once complications develop, antibiotics can cure the infection, but they cannot reverse any damage that has already been done.

Pregnant women with syphilis can infect their unborn babies

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. Congenital syphilis leads to death through miscarriage, stillbirth (baby dead at birth) or infant death 40% of the time.

Each year there about 350 babies born with congenital syphilis. Initially babies born with congenital syphilis may not show any symptoms. If they are not treated immediately they can become developmentally delayed, have seizures, or even die. This is why all pregnant women should be tested for syphilis.

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