What is syphilis?

Caused by bacteria called Treponema pallidum, syphilis is a dangerous STI that's passed on through unprotected sex, and from mother to child before or during birth. Also known as the pox, bad blood, old joe and syfy (Polish for zits), it moves through the body in stages damaging your organs.

Exactly when and how syphilis came about is the subject of much debate. For years the finger of blame was pointed at Columbus bringing it back from the 'New World' in 1492, but other historians claim it spread after French king Charles VIII invaded Naples in 1495. However, regardless of who introduced it, once it took a foothold, it quickly ripped though Europe during the 1500s to become one of the most deadly and horrific epidemics in European history. No one was immune; it caused immense pain and suffering in every class of society. Some of its more famous sufferers include Henry VIII, Ivan the Terrible, William Shakespeare, Al Capone and supposedly Adolf Hitler.

Infection rates have fluctuated greatly since, but the last notable rise in reported cases was during the sexual revolution of the '60s. However, new cases are on the increase once more - mostly among young adults and gay men.

What are the symptoms of syphilis?

Syphilis goes through four different stages: primary, secondary, latent and tertiary. Following the initial infection, it takes up to four weeks before a highly contagious sore, a 'chancre' (pronounced shanker), appears on the genitals, rectum or mouth. This is usually painless and if left untreated will disappear, but that doesn't mean the disease has gone away.

Within eight weeks the disease moves into its secondary stage. Symptoms include a rash, warty-looking growths on the genitals, tiredness, headaches with a fever, swollen lymph nodes, a sore throat, and hair and weight loss. These symptoms can come and go at random over roughly three months, but unless treated will begin to affect the entire body as it progresses to the latent period. 

Lasting anything from a month to a patients' entire lifetime, the latent period sees the spirochete (the type of bacteria) affecting the bone marrow, lymph glands, vital organs and the central nervous system of its host. However, there are no obvious symptoms, and around 50-70% of patients live out the rest of their lives without the disease ever progressing to the tertiary stage.

Here's the rare, but scary stuff. Once syphilis has reached the tertiary stage you can expect a smorgasbord of nasties: lesions appear on the skin, bone and vital organs, gummas (ugly and painful tumours) can form on any part of the body; bone tissue can be eaten away and valves in the aorta can degenerate and the brain can be affected, causing you to lose your mind.

Within eight weeks the disease moves into its secondary stage. Symptoms include a rash, warty-looking growths on the genitals, tiredness, headaches with a fever, swollen lymph nodes, a sore throat, and hair and weight loss. These symptoms can come and go at random over roughly three months, but unless treated will begin to affect the entire body as it progresses to the latent period. 

Lasting anything from a month to a patients' entire lifetime, the latent period sees the spirochete (the type of bacteria) affecting the bone marrow, lymph glands, vital organs and the central nervous system of its host. However, there are no obvious symptoms, and around 50-70% of patients live out the rest of their lives without the disease ever progressing to the tertiary stage.

Here's the rare, but scary stuff. Once syphilis has reached the tertiary stage you can expect a smorgasbord of nasties: lesions appear on the skin, bone and vital organs, gummas (ugly and painful tumours) can form on any part of the body; bone tissue can be eaten away and valves in the aorta can degenerate and the brain can be affected, causing you to lose your mind.

What does it look like?

The chancres can be red, firm and sometimes wet. They don't hurt and there's usually only one, but there can be more. During the second stage a reddish/brown rash can develop anywhere on the body, white patches can appear on the tongue and wart-like growths can materialise where the infection started. Once in the tertiary stage, multiple weeping sores can spread all over the genitals, anus or around the mouth.

How do I treat syphilis?

If you find a chancre or you've had unprotected sex with someone with a dubious past, go to your nearest genitourinary medicine (GUM) clinic or make an appointment to see your doctor (GP). Caught in the primary or secondary stage, a scraping will be taken from the sores and a blood test may be needed for diagnosis. Treatment is simple: primary and secondary syphilis can be blasted with a high dose injection of penicillin, which will kill the bacteria within 24 hours. Left until the latent stage, however, and treatment will require three injections given at weekly intervals. Antibiotics will be prescribed if you're allergic to penicillin.

Treatment of tertiary syphilis requires longer courses of antibiotics and may need to be administered intravenously. However, while it may stop the spread of infection it cannot repair any damage that has already been caused.

As there's a high risk of passing it on it's essential to inform partners so they can get themselves checked out.

What if I ignore it?

Syphilis is a dangerous STI that doesn't just go away. The symptoms may come and go and even disappear for years, but unless treated the bacteria can easily become active again.

An untreated pregnant woman is likely to pass the infection on to her unborn child, which can lead to miscarriage or stillbirth, or the baby being born with syphilis. Syphilis also increases the risk of HIV infection because HIV can enter the body more easily when there's a sore present.

How do I protect myself from contracting syphilis?

Using a condom in penetrative, oral and anal sex reduces the risk but won't eliminate it. Also, as it's possible to contract syphilis from open sores, it's essential to avoid skin-to-skin contact with anyone who has visible chancres or a rash.

How soon can I have sex again?

Dubbed "the great imitator", the early symptoms of syphilis can easily pass off as something else, so don't be duped into thinking you're rid of it. It's crucial to finish any treatment and get the all clear from your GP before you have sex again.

An untreated pregnant woman is likely to pass the infection on to her unborn child, which can lead to miscarriage or stillbirth, or the baby being born with syphilis. Syphilis also increases the risk of HIV infection because HIV can enter the body more easily when there's a sore present.

How soon can I have sex again?

Dubbed "the great imitator", the early symptoms of syphilis can easily pass off as something else, so don't be duped into thinking you're rid of it. It's crucial to finish any treatment and get the all clear from your GP before you have sex again.

Updated: 15/08/2011