Syphilis

Syphilis is a sexually transmissible infection (STI) caused by bacteria. It can go undetected, so regular testing is important. It’s easy to cure if found early, but can be serious if untreated. We monitor and report on syphilis case numbers and trends and provide guidelines to minimise the risk.

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What syphilis is

Syphilis is an STI caused by bacteria called Treponema pallidum.

It’s easy to treat if found early. But it can cause serious health problems if you don’t get treatment.

If untreated, syphilis can progress through different stages:

If you have syphilis while pregnant, it can spread to the baby. This is called congenital syphilis, and can cause severe health problems for the baby or even death.

Symptoms depend on the stage of your infection. But not everyone gets symptoms, and sometimes syphilis can mimic other conditions. 

Syphilis screening tests are very effective at detecting infections. It is important to get tested regularly if you are at risk of exposure. 

If you’ve previously had syphilis and recovered, you’re not immune – you can get it again. 

You can take steps to protect yourself from syphilis infection.

Why it matters to public health

Syphilis can cause serious health problems if untreated, and congenital syphilis has severe consequences for babies. Adults and babies in Australia are still dying from untreated syphilis and congenital syphilis. 

Some groups are at much higher risk, especially those who may have limited access to health care, such as Aboriginal and Torres Strait Islander people living in remote and very remote areas. 

Syphilis is preventable and easily treated in the early stages. Yet, over the past 20 years, the number of cases in Australia has significantly increased. 

Congenital syphilis is also on the rise.

The factors that contribute to the rise in syphilis cases include:

  • limited access to healthcare services, including early testing and treatment
  • limited access to culturally appropriate care
  • stigma
  • lack of awareness.

Because of this, we:

Symptoms

Some people with syphilis have no symptoms, so you may not know you have it unless you get tested.

healthdirect’s symptom checker can help you decide whether to see a health professional.

Check your symptoms

Primary syphilis

Common signs and symptoms of primary syphilis include:

  • firm, painless sores in or on the mouth, anus, penis, vagina or cervix
  • swollen and usually painless lymph nodes in the groin area.

The sores usually go away without treatment after 2 to 6 weeks, so you might not notice those signs and symptoms. But you can still infect others, even after the sores have disappeared.

Signs and symptoms usually show between 10 and 90 days after infection.

Secondary syphilis

Common signs and symptoms of secondary syphilis include:

  • a rash, usually in the
    • palms of the hands
    • soles of the feet
    • chest area
    • back area
  • white or grey lesions (snail trail) in the mouth or genital area
  • fever
  • fatigue
  • headache
  • enlarged glands in the armpits and groin
  • hair loss.

Signs and symptoms can show between 4 and 10 weeks after infection.

Latent syphilis

Latent syphilis is when someone is untreated for syphilis but has no symptoms. Only a blood test can identify infection.

If you have previously recovered from syphilis, and get it again, you are more likely to have latent syphilis.

Latent syphilis can progress to tertiary syphilis.

Tertiary syphilis

Signs and symptoms of tertiary syphilis depend on which body system is affected, and might include:

  • heart disease
  • neurological problems, including
    • headaches
    • difficulty coordinating muscle movements
    • paralysis
    • numbness
    • dementia
  • visual impairment and blindness
  • soft, tumour-like growths (called gummas) that can appear on the skin, bones or internal organs.

Signs and symptoms usually start years after an untreated infection. 

If not treated, tertiary syphilis can result in death. 

Congenital syphilis

Congenital syphilis is serious and can result in miscarriage or stillbirth.

Once a baby is born, common signs and symptoms include:

Signs and symptoms usually appear in the first 2 to 8 weeks of life, but can also appear later in childhood.

Read more about symptoms, diagnosis and treatment of syphilis.

Onset of symptoms

The first symptoms of syphilis usually show between 10 and 90 days after infection.

How it spreads

Syphilis most often spreads through unprotected skin-to-skin contact during vaginal, anal or oral sex. 

Congenital syphilis gets passed on to the baby during pregnancy through the placenta or during delivery.

Syphilis can less commonly spread by:

  • non-penetrative sex
  • blood contamination
  • needle-stick injury
  • sharing injecting equipment.

Infectious period

Syphilis is most contagious during the primary, secondary and early latent stages (within 2 years of infection). 

Generally, people are not considered infectious during tertiary and late latent stages (after 2 years of infection).

Transmission to a baby during pregnancy can occur at any stage of syphilis infection.

Prevention

Protecting yourself

There is no vaccine for syphilis.

The best way to protect yourself against syphilis is to:

  • get regular sexual health checks
  • avoid sexual activity with anyone with syphilis symptoms until they have sought medical advice and testing
  • practise safe sex
  • get tested if you are pregnant – your healthcare professional will tell you when to get this done
  • know the symptoms and what to do if you develop them
  • speak to your healthcare professional to discuss other prevention and treatment options for syphilis.

Congenital syphilis is preventable. The best way to protect your baby is to get tested at least 3 times if you are pregnant. Your healthcare professional will tell you when to get this done.

Protecting others

If you’ve been diagnosed with syphilis, you should:

  • not have any sexual contact for 7 days after you complete your treatment or until symptoms have resolved (whichever is longer)
  • get regular sexual health check-ups, even after you have been treated because you can still get it again
  • tell anyone you have had sex with during the past 12 months, so that they can get tested and treated – you can do this anonymously through:
  • not have sex with current or previous partners until they all:
    • have been tested
    • have been treated, if necessary
    • are no longer infectious. 

High-risk groups and settings

Some people are at greater risk of getting syphilis or of getting very sick from it.

Syphilis can also spread within sexual networks and in settings with frequent sexual activity between different partners, such as:

  • venues that offer sex on premises
  • parties or other social events where intimate contact occurs.

If you are at greater risk, it is especially important to take steps to protect yourself and see a healthcare professional if you are exposed to syphilis or develop symptoms.

If you are pregnant, it is important to get tested and follow your health professional’s advice. This is because untreated syphilis during pregnancy can put your baby at risk of getting congenital syphilis. 

People at greater risk of severe disease

Those at greater risk of severe illness include:

  • people with syphilis who do not receive appropriate antibiotic treatment, particularly in the early stages
  • people who have both syphilis and HIV
  • babies born to someone with untreated syphilis during their pregnancy.

People at greater risk of exposure

Those at greater risk of infection include:

  • people who have unprotected vaginal, anal or oral sex with someone infected with syphilis
  • babies born to a person who has not been tested for syphilis, or has untreated syphilis during their pregnancy.

Diagnosis and treatment

Your healthcare professional can diagnose syphilis by:

  • assessing your symptoms and medical history
  • referring you for a blood test
  • taking a swab from your sore (if you have any) and sending it for testing. 

Your healthcare professional may consider other diagnosis methods if you have complications.

You can use healthdirect’s directory to find a health service near you.

Find a health service

Your healthcare professional will:

  • prescribe and administer antibiotics called penicillin to treat syphilis, if appropriate
  • ask you to come back for another test to make sure the treatment is working.

Depending on the stage of infection, treatment can take up to 3 weeks.

If you are pregnant, it is important to seek early advice from your healthcare professional, and get tested and treated (if necessary) to protect you and your baby.

You should tell anyone you have had sex with during the past 12 months, so that they can get tested and treated. You can do this anonymously.

If you’ve previously been treated for syphilis, you’re not immune – you can get it again.

Read more about how to manage or treat syphilis.

Surveillance and reporting

Syphilis is a nationally notifiable disease – these are diseases that present a risk to public health.

Health authorities in each state and territory report new confirmed and probable cases to us daily through the National Notifiable Diseases Surveillance System.

This is part of our surveillance activities, which help us monitor case numbers around the country and understand disease patterns.

We analyse the data and report on case numbers and other data through our:

Outbreaks

The states and territories are responsible for responding to syphilis outbreaks in their jurisdictions.

Public health units might respond to a syphilis outbreak by:

  • providing information about syphilis and its symptoms
  • providing access to testing and treatment services
  • engaging early with local communities.

Read more about how we define and plan for outbreaks and pandemics.

Support

For information about syphilis in your state or territory see:

If you need mental health support, see a list of organisations, websites and services that offer support, counselling and information.

We regularly add new content to this website. This will include more topics and diseases. In the meantime, information about other diseases in Australia is on the Department of Health, Disability and Ageing’s website. 

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