Syphilis is a bacterial STI that infects about 35,000 people in the U.S. each year.

Transmission
Syphilis is transmitted through vaginal, anal, and oral sex (even without penetration). It can also be transmitted from mother to child during pregnancy or childbirth.

Symptoms
Most of the time, syphilis has no symptoms. Without treatment, the infection progresses through four phases, which may overlap, and differ by person. The possible symptoms during each phase are described below.

Primary stage: Within two weeks to three months after infection, a painless sore called a chancre may appear on the infected area (genitals, anus, mouth, etc.). This sore will usually go away by itself after three to six weeks.

Secondary stage: Within two weeks to six months after infection, symptoms may include rashes on the body including the palms of hands and bottoms of feet, warts, “mucus patches”, and loss of hair. These symptoms may last from two to six weeks, and will clear up on their own.

Latent stage: During this stage, which can last for many years, there are no symptoms of syphilis but the infection continues to progress.

Late/Tertiary stage: This stage can occur years after infection. Symptoms include “gummas” (small tumors), cardiovascular problems, and nervous system problems such as blindness, paralysis, and mental illness.

Diagnosis
Syphilis can be diagnosed with blood tests, biopsy, or fluid tests. The fluid tests can only be done when there are visible lesions (during the primary or secondary stage).

Treatment
Syphilis can be cured with antibiotics (usually penicillin). It is important to get treatment even if symptoms appear and then disappear, because the infection remains in the body. All partners should be tested, and treated if appropriate. The patient should avoid sex until all treatment has been completed. Follow-up tests are recommended six months and one year after treatment.

Prevention
The following strategies can help reduce the risk of infection:
• Abstinence
• Mutual monogamy
• Condoms, dental dams, or other barrier methods