Syphilis - Everything You Need to Know
Syphilis has been around for a long time and is one of the most common and well-known sexual transmitted diseases.
It’s most historically known for causing dementia because the disease, left untreated, can deteriorate the brain (neurosyphilis).
While considered a deadly disease, it’s now curable now with a treatment which usually includes antibiotic tablets or injections . Testing for syphilis and other STD’s and learning common prevention methods will help stop the spread of the disease.
- Written by Tommy Gonzales on April 22, 2020.
- Medically reviewed by Dr. Andrea Pinto on November 5, 2021.
What is a syphilis infection?
Syphilis is a bacterial infection that is spread most often through sexual contact.
These days syphilis can be cured with penicillin, sometimes by a single shot if caught early.
Failure to treat it, however, can lead to severely damaged organs such as the brain and the heart.
The first recorded syphilis outbreak occurred in Europe in 1495 and was spread by military troops coming home from war.
Being the first disease outbreak to happen after the printing press was invented made sure that its history was well documented through the years from that point forward.
For a long time, there was no effective cure for the disease and patients suffered from deformities, dementia, and death.
Syphilis is making an unfortunate comeback in the US with cases reaching a 20-year high, as reported by the CDC.
They also reported increases transmission of other STDs as well. In the last year, there were more than 115,000 cases of syphilis diagnosed in the US. 
Cases where newborns were infected also rose by 40%. Possible causes of this rising epidemic are an increase in unsafe sexual activities, as well as drug use, which sometimes is related to poverty, and unstable housing as well.
Additionally, this might be attributed to cuts in funding for STD prevention programs in schools and clinics.
How do you get syphilis?
Syphilis is caused by a bacterium called Treponema Pallidum.
It is mostly spread through sexual contact, entering the body through minor cuts. It is rarer but still possible to catch syphilis through direct close contact with an active lesion through kissing someone who has an active mouth chancre.
The disease can also be transmitted from mother to child during pregnancy. It is a highly contagious, sexually transmitted disease.
What are the common signs and symptoms of syphilis?
Syphilis can be a tricky disease because sometimes there are no visible symptoms and a person might be unaware that they have it.
The starting syphilis symptoms are mild and can be easy to miss. In the primary stage, you might develop one or more syphilis sores called chancres. These chancres are painless, and many people don’t realize they have them.
They can show up on your sex organs, mouth or rectum. If you do see a sore, know that it is highly contagious and not something that can be ignored.
If untreated the sores will go away, but syphilis will not, it can only be cured with medication.
Please take note you can still pass syphilis on to your partner even if you aren’t showing symptoms.
Other symptoms include:
- Mild flu-like symptoms such as swollen glands, Fever
- Feeling tired
You can go months or even years without symptoms and still be a carrier.
Should you get tested for syphilis?
Anyone who is sexually active should get tested for syphilis and other sexually transmitted diseases.
People with multiple sexual partners, MSM, bisexual and other populations are more at risk.
Being infected with the AIDS virus can also raise your risk. If you are high risk or become pregnant then it is important to get tested for syphilis immediately.
You can get tested again once a year or every 6 months depending on your risk factors.
When to get tested for syphilis?
If you think you might have had sex with an infected person, then seek testing and treatment right away. Keep in mind that the average incubation period for syphilis is 21 days, but it can range between 10 to 90 days, so you could get a false negative result if you test too early.
Additionally, if you have sores, these can be tested for most accurate results.
If you don’t have active sores you can still get tested with a simple blood test. It can show the disease as early as one to two weeks after infection.
How do you collect a sample for syphilis testing?
Syphilis testing with your doctor can be done in a few different ways. A common way to screen for syphilis is with a rapid plasma reagin (RPR) test.
It is a blood test that detects nonspecific antibodies that are produced when your body fights off an infection.
This test will normally be combined with a specific antibody testing to confirm the results.
The RPR test is recognized as a quick way to screen anyone who has a high risk for sexually transmitted diseases such as syphilis.
The blood is collected from the vein in tubes at a doctor’s office or lab testing center. The blood tests are optimal because you don’t have to present with an active sore for testing.
If you do have syphilis sores (lesions) then a swab can be taken and looked at under a microscope in a test called a dark-field microscopy.
Syphilis for home testing is usually taken care of with a finger-prick blood test that is safe and easy to perfect. In a doctor’s office, you would have labs drawn with vials of blood.
An at-home test can be a cheaper and more private alternative to seeing a doctor or going to a clinic.
The at-home tests are just as accurate, and testing is generally done in the same labs that doctors use.
You can get an at home syphilis test from the following providers:
How long does a syphilis test take?
Time spent waiting for medical test results can feel like an eternity.
Luckily, you can get test results back in as little as 3 to 5 days most of the time. For at-home testing the majority of the time it takes to get results is waiting for shipping.
Some at-home testing companies will have an online portal so you can access your results privately very quickly.
How accurate are syphilis test results?
Test results are typically pretty accurate, but Syphilis is tricky because blood results can yield a false positive from time to time, especially if you’ve been treated for syphilis in the past.
A fluid or tissue sample from an active sore is the most accurate, but that limits your window of testing to when and if active sores are present.
Sometimes a secondary screening is ordered after the first positive test result.
How do I understand my STD testing results?
Syphilis test results are not as straight forward as other STD results.
A negative blood test merely lets you know there is no infection evident at the time, but the disease can still be incubating if the time window has been reached.
Repeated testing might be needed if you are at high risk. A positive test can also be false and is usually followed up by a second screening to confirm the diagnosis.
Can syphilis be cured?
Nowadays syphilis can be cured with antibiotics. Besides this fact, is important to do what is in your power to avoid getting any STD including syphilis.
Additionally, it is important to catch the disease early though because untreated damage to the brain and heart is not reversible.
The most common and effective treatment for syphilis is penicillin. Some people are allergic to penicillin and they can be treated with azithromycin or doxycycline instead.
What type of long-term damage can syphilis cause?
If the infection isn’t treated you can develop long-term serious complications with your brain, heart, and nerves.
People with advanced untreated syphilis can become paralyzed, blind, deaf, or cognitively impaired. Common nervous system symptoms of syphilis include brain damage, headaches, meningitis, paralysis, hearing loss, and vision loss.
Heart damage from syphilis can cause damaged valves or bulging blood vessels called aneurisms. Syphilis weakens your immune system making you more susceptible to HIV and other STDs.
Can you treat syphilis while pregnant?
Syphilis can be passed from mother to child while pregnant, so it is important that women get screened for syphilis early in their pregnancy.
If a woman tests positive for the STD she can be treated with penicillin which will also prevent the disease from being transmitted to the baby through the placenta.
Left untreated, the disease will spread to the baby and can cause stillbirth or deformities. The number of babies being born in the US with sexually transmitted diseases like syphilis are on the rise and is of growing concern.
Standard STD testing during pregnancy could help avoid devastating results such as stillbirth and birth defects.
Written by Tommy Gonzales on April 22, 2020. Updated and republished in June 2021.
- Neurosyphilis Information Page
- Syphilis Treatment
- New CDC Report: STDs Continue to Rise in the U.S.
- Congenital Syphilis - CDC Fact Sheet
- Syphilis Treatment and Care
- Syphilis - CDC Fact Sheet
- Brief History of Syphilis
- Syphilis & MSM (Men Who Have Sex With Men) - CDC Fact Sheet
- North Dakota Department of Health
- Rapid Plasma Reagin (RPR)
- Syphilis Treatment and Care