Syphilis explained

Syphilis is on the rise in Canada and can be difficult to diagnose because its symptoms are mistaken for those of other conditions.


Sexually transmitted and blood-borne infections (STBBIs) threaten health and well-being. These include syphilis, which is caused by the bacterium treponema pallidum.


The means of transmission

Syphilis is transmitted primarily through sexual contact or, more rarely, through the sharing of injection drug equipment. An infected mother can pass syphilis to her baby during pregnancy or delivery.

Sexual transmission can occur through:

  • oral contact with the penis, vulva, vagina or anus
  • penal penetration of the vagina or anus
  • genital contact between partners
  • direct skin contact with lesions of an infected person
  • sharing of sex toys.


The progression of symptoms

Some people may exhibit symptoms of the disease without knowing it. In the event of unprotected sex, be very vigilant and consult a healthcare professional if there is any doubt.

There are four stages of the disease:

  • primary
  • secondary
  • latency
  • tertiary

In the primary stage, the appearance of one or several ulcers, called chancres, occur. Chancres appear in the area where bacteria have entered the body, usually in the genitals, mouth, throat or anus. Glands in the groin can become swollen. Chancres are painless and may go unnoticed. They may appear up to three months after infection with the bacteria and may disappear on their own after three to eight weeks. However, the bacteria remain present in the body and can be transmitted.

In the secondary stage (up to six months after infection with the bacteria), other symptoms may appear, including:

  • fever
  • headache
  • fatigue
  • muscle aches
  • swollen glands
  • patchy hair loss
  • greyish-white lesions on the genitals or in the mouth, and
  • redness on the palms of the hands or soles of the feet or elsewhere on the body

These symptoms also disappear spontaneously after several weeks.

In the latency stage, the infected person has no symptoms, although the bacteria are still present in the body and can be transmitted. This stage can last for several years. Finally, in the tertiary stage, the infection is no longer contagious. However, it is at this stage that complications are observed affecting the:

  • heart
  • brain
  • bones, and
  • liver

These complications can appear from 5 to 30 years after the chancres have disappeared. Without treatment, syphilis can cause death.


Screening and treatment

Anyone who has unprotected sex should consider getting a blood test. You may feel uncomfortable talking about it. Rest assured that your healthcare provider will address it in a professional, confidential and non-judgmental manner.

If you test positive, it is essential that you notify all of your sexual partners or anyone with whom you have exchanged needles. Treatment must be started quickly. Antibiotics will provide complete recovery if the infection is treated in the primary or secondary stages. However, complications in the tertiary stage can be permanent.

Medications to treat syphilis are available by prescription. They are free of charge for people who have a valid health insurance card.



The antibiotic treatment's full effect is not immediate. The infected person remains contagious for some time. To prevent reinfection or the spread of syphilis, it is advisable to abstain from all sexual activity:

  • until the end of treatment, if the medication administered is in tablet form
  • up to seven days after the end of treatment by injection
  • until symptoms have completely disappeared

If abstinence is not possible, people under treatment can protect themselves with a condom (male or female) for the duration of each sexual encounter. They can also use a dental dam or a latex square, obtained from a nonlubricated condom, to cover the vulva or anus during oral contact with these parts of the body. Your pharmacist can provide information on the products that are available and how to use them.

It is important to follow up with your doctor to confirm that the infection has healed. It goes without saying that the use of a condom is recommended as long as any doubt remains.

Syphilis can remain undetected for many years. To prevent the spread and complications associated with it, practise safe sex. When it comes to STBBIs, it's not just about your health, it’s also about your partner’s health.


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Syphilis explained

Syphilis can cause a number of symptoms common to other diseases. Therefore, it is better to be informed than to contribute to the spread of the infection!
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