Syphilis is a sexually transmitted bacterial infection that is on the rise in Canada. Syphilis is transmitted through oral, genital, or anal sex with an infected person. A pregnant woman with syphilis can pass it on to her unborn child, sometimes causing birth defects or death. Although less common, it can also be transmitted through sharing needles or through broken skin.

Syphilis cases were rare in Canada, but rates have been on the rise since 2001, when outbreaks began occurring in urban centres across the country. The number of cases continues to grow, suggesting that people are not consistently using safer sex methods. Syphilis disproportionately affects men in Canada, particularly those over 30.

Syphilis is diagnosed through a simple blood test and is easily treated with penicillin or other antibiotics. Left untreated, syphilis moves through four stages:

  • primary
  • secondary
  • latent
  • tertiary

Syphilis is usually infectious for less than a year, during the primary and secondary stages, and early in the latent stage. If the infection continues to go untreated, syphilis may progress to the tertiary stage. Not everyone infected with syphilis will develop symptoms. That is why it is important to know if you are at risk and how to take preventative action.

Health effects of syphilis

Syphilis is often referred to as "the great imitator" because of the wide range of symptoms that infected people may experience. These symptoms can easily be confused with those of other conditions. Healthcare professionals may overlook syphilis as a possible diagnosis because the rate of infection in Canada has been low until recently.

In primary syphilis, a painless open sore or ulcer appears at the site where the bacteria first entered the body, usually the genital area, throat, or anus, and swollen glands may be present in the groin. Symptoms can occur within a few days or a couple of months after infection. Because the ulcer is usually painless and hidden, you may not be aware you are infected. While the sore may go away on its own without treatment, the infection will remain and progress to secondary syphilis.

In secondary syphilis, the symptoms can sometimes overlap with those of the primary stage and vary considerably. They can include:

  • patchy hair loss
  • a rash on the soles of the feet, the palms of the hands, or elsewhere on the body
  • fever
  • malaise
  • swollen glands
  • flat grayish-white sores in mouth and on genitals

It is at the tertiary stage that syphilis can do the most damage to the body, affecting the brain, blood vessels, heart, and bones.  If untreated, syphilis can eventually lead to death.

Of particular concern is the interaction between syphilis and HIV/AIDS. Syphilis increases the risk of contracting or spreading human immunodeficiency virus (HIV). It can also be difficult to successfully treat HIV patients who have syphilis.

Minimizing your risk

Following these suggestions can help you avoid contracting and transmitting syphilis:

  • Learn about safer sex and needle-sharing practices.
  • Make informed decisions. Talk to your partner(s) about their STI status and the use of protection.
  • Correctly and consistently using a condom during sex reduces the risk of STIs.
  • Get tested for syphilis if you are sexually active. If you are diagnosed and treated for syphilis, follow up with your doctor after treatment to make sure the infection is gone. It is also important that you or someone from your public health department notify sexual or needle-sharing partners who may have been put at risk of infection. They will also need to be tested and possibly treated.
  • Avoid unprotected sexual activities that may put you at risk for reinfection until both you and your partner(s) have completed your antibiotic treatment and have been told the infection is gone.

Consult the national case definition for additional information.

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