Syphilis on the rise

Syphilis rates are increasing in every part of the U.S. Health experts are particularly concerned about:

• Continued high rates among gay and bisexual men

• The increase in babies born with the disease (congenital syphilis)

Syphilis stages and symptoms

Syphilis gets worse in stages. The symptoms in each stage may be very mild. You may not even notice them.

Stage 1: A painless sore on the genitals, anal skin, or mouth. The sore goes away in 3 to 6 weeks.

Stage 2: A rash, fever, sore throat, muscle aches, extreme tiredness (fatigue), and other flu-like symptoms. These symptoms often are severe enough that the person gets medical care. If they are mild, or not brought to attention, they will also go away over time. But the infection is still there. You may have no other symptoms until serious problems occur.

Stage 3: Severe diseases. These often occur years or even decades later. They can include nerve or walking problems, paralysis, a change for the worse in your mental state, damage to internal organs, seizures, blindness, or death.

Treatment

Syphilis is treated with antibiotics. It's often treated with shots of penicillin. The shots may be given once. Or you may get them weekly for 3 weeks. It also may be treated with doxycycline or other antibiotics taken by mouth for up to 1 month. More severe infection may need IV (intravenous) penicillin.

During treatment, it's important not to have sex, or you may infect someone else. See your healthcare provider for follow-up visits. This lets your provider check to make sure the syphilis is cured. Your partner should also be checked for the infection. Syphilis can be cured with the right antibiotics. But treatment won't fix any damage that the infection has caused.

Prevention

As with all STIs, knowing your partner’s sexual history is a big step toward preventing syphilis. You should also know the signs and symptoms of the infection. And use latex condoms to reduce your risk.

If you are a gay or bisexual man who is sexually active:

• See your healthcare provider. Tell your provider about your sexual history. Ask to be tested for syphilis and other STIs.

• Get tested. Get a syphilis test at least once a year. Get tested more often if you are at risk. Often there are no symptoms. So testing is the only way to know for sure that you don't have syphilis.

• Have 1 partner. It's safest to be in a long-term relationship with only 1 sex partner. Your partner should be tested and have negative STI test results.

• Use latex condoms. It's important to use latex condoms the correct way each time you have sex.

• If you have multiple sex partners, get tested again. Even after you’ve been successfully treated for syphilis, you can still be reinfected.

If you are pregnant:

• See your healthcare provider. Tell your provider about your sexual history and STI testing.

• Get tested. Get a syphilis test at your first prenatal visit. You may also need to be retested during your third trimester and at delivery, if you are at risk.

• Know your test results. If you test positive for syphilis while you are pregnant, get treatment right away.

• Have 1 partner. It's safest to be in a long-term relationship with only 1 sex partner. Your partner should be tested and have negative STI test results.

• Use latex condoms. Whenever you have sex, use latex condoms the correct way.

• Go to follow-up visits. Keep seeing your provider during your pregnancy. If you learn that a sex partner has or may have syphilis, tell your provider. Your partner should be treated too.

Resources

American Sexual Health Association STD Hotline,  www.ashasexualhealth.org , 919-361-8488

CDC, www.cdc.gov/std, 800-232-4636