Syphilis

Syphilis is a bacterial sexually transmitted infection caused by Treponema pallidum. It progresses through stages over months to years. Syphilis is fully curable with a simple course of antibiotics if diagnosed early — but untreated, it can cause serious damage to the heart, brain, and nerves, and can be passed from a pregnant woman to her baby (congenital syphilis) with severe consequences.

How it spreads

• Vaginal, anal, or oral sex with an infected person
• Direct contact with a syphilis sore
• From mother to baby during pregnancy or childbirth (congenital syphilis) — preventable with antenatal screening and treatment
• Rarely, through blood transfusion
• Not spread through toilet seats, shared clothing, swimming pools

Stages and symptoms

• Primary syphilis — a painless sore (chancre) at the site of infection, usually 3 weeks after exposure. Heals on its own in 3-6 weeks even without treatment — giving false reassurance.
• Secondary syphilis — weeks to months later: a non-itchy rash (often on palms and soles), fever, swollen glands, patchy hair loss, mucous patches, wart-like growths (condylomata lata). Symptoms resolve on their own but the infection is still active.
• Latent syphilis — no symptoms, but blood tests remain positive. Can last years.
• Tertiary syphilis (years to decades later, if untreated) — severe damage: heart and great-vessel problems, soft-tissue gummas, neurosyphilis (affecting brain and nerves — personality change, memory loss, tremors, stroke, paralysis, blindness)

Congenital syphilis — infection passed from mother to baby in pregnancy. Can cause miscarriage, stillbirth, premature birth, bone deformities, deafness, blindness, developmental problems. Universal antenatal syphilis screening is done in India specifically to prevent this.

Diagnosis

• Blood tests — VDRL, RPR, TPHA, FTA-ABS
• Dark-field microscopy of a sore, in early disease
• Spinal fluid examination for suspected neurosyphilis

Treatment

Syphilis is highly treatable:

• Penicillin injections — usually single-dose intramuscular for early syphilis; longer courses for late or neurosyphilis
• Alternative antibiotics for people allergic to penicillin
• Follow-up blood tests at 3, 6, and 12 months to confirm cure
• Sexual partners need testing and often preventive treatment

Prevention

• Condoms — consistent use reduces risk; don't fully prevent it if a sore is on skin not covered
• Mutual monogamy with a known-negative partner
• Regular STI testing if you have multiple partners
• Antenatal syphilis screening — routine in India; prevents congenital syphilis
• Partner testing and treatment

Free or low-cost STI testing and treatment are available at government health centres and sexual-health clinics. Getting tested is not shameful — it's responsible.