Syphilis

Syphilis is an STI caused by bacteria. It is passed through contact with a syphilis lesion (sore or rash). There are four stages of syphilis: primary, secondary, latent, and tertiary. Syphilis is most infectious during the primary and secondary stages and causes the most harm during the latent and tertiary stages.

Rates of syphilis have significantly increased in Saskatchewan in the past few years, with several areas of the province issuing syphilis alerts and outbreak notices. Women of reproductive age are of particular concern because of the risk for congenital syphilis (syphilis passed from mother to baby during pregnancy or delivery). For more information on congenital syphilis, click here.

Get Tested

Symptoms

Syphilis can cause a variety of symptoms, but an infected person may not experience any symptoms. Even if a person experiences no symptoms, the infection can still be passed to others. Each stage of syphilis has different possible symptoms.

	Stage 1	Stage 2	Stage 3	Stage 4
Time since infection:	3 – 90 days*	2 weeks – 6 months	2 – 30 years	10 – 30 years
Symptoms might include:	Sores (often painless or hidden) Swollen lymph nodes *Usually occurs three weeks after infection	Rash, fever, lack of energy and appetite, sore throat, hair loss, painless sores, headache, hard to see or hear	No symptoms, but damage to nervous system, bones and organs continues	Serious organ damage, numbness, vision loss, dementia, problems controlling muscles

Primary syphilis (the first stage) may have the following symptoms:

One or more painless sores in the genital area, rectum, or mouth
Swollen lymph nodes in the groin area (usually within a week of the sore appearing)

While sores usually heal and disappear within 3 to 6 weeks, treatment is still necessary. Without treatment, syphilis can progress to the next stage.

Secondary syphilis (the second stage) may have the following symptoms:

Rash on the palms of hands and/or bottom of feet
Fever
Lack of energy and appetite
Sore throat
Hair loss
Painless sores on moist areas (genitals, inside the mouth, throat, anus)
Headache
Weight loss
Swollen lymph nodes
Muscle aches
Hearing and vision loss

The third stage, known as the latent stage, begins when the secondary stage ends. There are no symptoms, but the infection can still be passed between partners and damage the nervous system, bones, and organ systems.

The fourth stage of syphilis, known as the tertiary stage, occurs a year or more after the initial infection. Resulting problems may appear 10 to 30 years after initial infection. These problems may include the following:

Organ damage, including to the heart, blood vessels, brain, and nervous system
Numbness
Problems controlling muscles
Vision loss
Dementia

Transmission

Syphilis is passed between partners through contact with a syphilis lesion (sore or rash) in the genitals or mouth, or through vertical transmission (mother to child transmission) during pregnancy.

Syphilis is most commonly passed through unprotected oral, vaginal, or anal sexual contact. Although rare, syphilis can also be passed through sharing of sex toys, wet kissing, sharing substance use equipment, and breastfeeding.

If a pregnant person is infected with syphilis (either before or during pregnancy) and is untreated, the infection can be passed to the baby during pregnancy or delivery. This is called congenital syphilis.

Having syphilis increases the risk of becoming infected with and passing on HIV. For more information about HIV, click here.

Testing

Testing for syphilis requires a blood sample or swab of the infected area. Testing is free and confidential. Syphilis is a reportable infection, meaning that it must be reported to public health whenever an infection is confirmed.

All pregnant people should be tested for syphilis (along with other STBBIs such as chlamydia, gonorrhea, and HIV) during their first prenatal visit. Repeat testing may be important for some pregnant people. Pregnant people should discuss their need for repeat testing with their healthcare providers.

For more information about syphilis and community resources in Saskatchewan, visit www.talksyphilis.ca.
To find a testing site near you, download the Keep It Safe Saskatchewan (KIS-SK) smart phone app: www.skprevention.ca/kis-sk.

Treatment

Syphilis is curable with an injection of antibiotics (a special form of penicillin).

If a pregnant person is diagnosed with syphilis, they can be treated to lower the risk of passing syphilis to the baby. If the infected pregnant person is over 20 weeks pregnant, an ultrasound may be performed to detect if there are any fetal abnormalities in the baby and to evaluate how the baby has responded to treatment.

Even with treatment, a baby may still be born with congenital syphilis. Treatment can greatly reduce this risk.

Congenital Syphilis

A baby exposed to syphilis during pregnancy can develop congenital syphilis. Most of the time this happens during pregnancy, but it can also happen during vaginal birth if the baby has direct contact with a syphilis lesion (sore or rash).

Congenital syphilis poses the following risks:

Miscarriage
Stillbirth
Prematurity
Low birth weight
Death shortly after birth

These risks can depend on the length of infection and if/when treatment was received. Treatment greatly reduces the harms associated with congenital syphilis.

A baby born with congenital syphilis may have the following problems:

Fever
Enlarged liver and spleen
Anemia (not enough healthy red blood cells to carry oxygen to body)
Rash on face, mouth, genitals, anus, hands, or bottoms of feet
Runny nose
Meningitis (an infection that causes swelling of brain and spinal cord)
Neonatal death (when a baby dies in first 28 days of life)

If congenital syphilis is not treated, the baby may develop problems later in life with the following:

Bones and joints
Vision
Hearing
Nervous system
Developmental delays

If a baby is born with congenital syphilis, antibiotics need to be given as they are important for the prevention of further harm. For some babies, congenital syphilis can be cured. For others, treatment for health conditions caused by the infection may be needed.

Resources

Posters

Let’s Talk About Syphilis

January 16, 2024

Syphilis Poster – Healthcare Provider

March 25, 2021

Syphilis

November 12, 2019

Are You Positive You’re Negative? Protect Yourself and Others. Get Tested.

November 4, 2015

Protect Your Fertility

April 30, 2014

Fact Sheets

CATIE Syphilis Fact Sheet

Information Cards

Let’s Talk About Syphilis

January 16, 2024

Syphilis Information Card – Mother

March 25, 2021

Syphilis Information Card – Healthcare Provider

March 25, 2021

Links

Government of Saskatchewan
Information is provided on syphilis.
Public Health Agency of Canada
This fact sheet provides information on congenital syphilis.
Let’s Talk About Syphilis
Information on syphilis, testing, treatment, and community resources in Saskatchewan.
Keep It Safe Saskatchewan (KIS-SK)
Smart phone app with information on sexually transmitted infections, contraceptives, and testing sites in Saskatchewan.

Information for Healthcare Providers

Clinical Resources

Syphilis - Public Health
Saskatchewan Health Authority
Decision Making Algorithm for Syphilis for Primary Care Providers
Northern Inter-Tribal Health Authority
Canadian STBBI Guidelines (Apple App Store or Google Play)
Public Health Agency of Canada

Additional Resources

Syphilis
Saskatchewan Ministry of Health
Diagnosis and Management of Congenital Syphilis - Avoiding Missed Opportunities
The Canadian Paediatric Society
Congenital Syphilis
National Collaborating Centre for Infectious Diseases
Let’s Talk About Syphilis
Public Health Agency of Canada
Responding to Syphilis in Canada
Public Health Agency of Canada
Syphilis
CATIE

Webinars

Syphilis in Saskatchewan
Saskatchewan Prevention Institute
Syphilis in Saskatchewan: Impacts and Opportunities in Indigenous Communities
Saskatchewan Prevention Institute
Syphilis in Canada: Where We Are, How We Got Here, and What We Can Do About It
CATIE
HIV and Syphilis in the Prairies: Intersecting Epidemics
CATIE

Syphilis

Syphilis is an STI caused by bacteria. It is passed through contact with a syphilis lesion (sore or rash). There are four stages of syphilis: primary, secondary, latent, and tertiary. Syphilis is most infectious during the primary and secondary stages and causes the most harm during the latent and tertiary stages.

Rates of syphilis have significantly increased in Saskatchewan in the past few years, with several areas of the province issuing syphilis alerts and outbreak notices. Women of reproductive age are of particular concern because of the risk for congenital syphilis (syphilis passed from mother to baby during pregnancy or delivery). For more information on congenital syphilis, click here.

Get Tested

Symptoms

Syphilis can cause a variety of symptoms, but an infected person may not experience any symptoms. Even if a person experiences no symptoms, the infection can still be passed to others. Each stage of syphilis has different possible symptoms.

	Stage 1	Stage 2	Stage 3	Stage 4
Time since infection:	3 – 90 days*	2 weeks – 6 months	2 – 30 years	10 – 30 years
Symptoms might include:	Sores (often painless or hidden) Swollen lymph nodes *Usually occurs three weeks after infection	Rash, fever, lack of energy and appetite, sore throat, hair loss, painless sores, headache, hard to see or hear	No symptoms, but damage to nervous system, bones and organs continues	Serious organ damage, numbness, vision loss, dementia, problems controlling muscles

Primary syphilis (the first stage) may have the following symptoms:

One or more painless sores in the genital area, rectum, or mouth
Swollen lymph nodes in the groin area (usually within a week of the sore appearing)

While sores usually heal and disappear within 3 to 6 weeks, treatment is still necessary. Without treatment, syphilis can progress to the next stage.

Secondary syphilis (the second stage) may have the following symptoms:

Rash on the palms of hands and/or bottom of feet
Fever
Lack of energy and appetite
Sore throat
Hair loss
Painless sores on moist areas (genitals, inside the mouth, throat, anus)
Headache
Weight loss
Swollen lymph nodes
Muscle aches
Hearing and vision loss

The third stage, known as the latent stage, begins when the secondary stage ends. There are no symptoms, but the infection can still be passed between partners and damage the nervous system, bones, and organ systems.

The fourth stage of syphilis, known as the tertiary stage, occurs a year or more after the initial infection. Resulting problems may appear 10 to 30 years after initial infection. These problems may include the following:

Organ damage, including to the heart, blood vessels, brain, and nervous system
Numbness
Problems controlling muscles
Vision loss
Dementia

Transmission

Syphilis is passed between partners through contact with a syphilis lesion (sore or rash) in the genitals or mouth, or through vertical transmission (mother to child transmission) during pregnancy.

Syphilis is most commonly passed through unprotected oral, vaginal, or anal sexual contact. Although rare, syphilis can also be passed through sharing of sex toys, wet kissing, sharing substance use equipment, and breastfeeding.

If a pregnant person is infected with syphilis (either before or during pregnancy) and is untreated, the infection can be passed to the baby during pregnancy or delivery. This is called congenital syphilis.

Having syphilis increases the risk of becoming infected with and passing on HIV. For more information about HIV, click here.

Testing

Testing for syphilis requires a blood sample or swab of the infected area. Testing is free and confidential. Syphilis is a reportable infection, meaning that it must be reported to public health whenever an infection is confirmed.

All pregnant people should be tested for syphilis (along with other STBBIs such as chlamydia, gonorrhea, and HIV) during their first prenatal visit. Repeat testing may be important for some pregnant people. Pregnant people should discuss their need for repeat testing with their healthcare providers.

For more information about syphilis and community resources in Saskatchewan, visit www.talksyphilis.ca.
To find a testing site near you, download the Keep It Safe Saskatchewan (KIS-SK) smart phone app: www.skprevention.ca/kis-sk.

Treatment

Syphilis is curable with an injection of antibiotics (a special form of penicillin).

If a pregnant person is diagnosed with syphilis, they can be treated to lower the risk of passing syphilis to the baby. If the infected pregnant person is over 20 weeks pregnant, an ultrasound may be performed to detect if there are any fetal abnormalities in the baby and to evaluate how the baby has responded to treatment.

Even with treatment, a baby may still be born with congenital syphilis. Treatment can greatly reduce this risk.

Congenital Syphilis

A baby exposed to syphilis during pregnancy can develop congenital syphilis. Most of the time this happens during pregnancy, but it can also happen during vaginal birth if the baby has direct contact with a syphilis lesion (sore or rash).

Congenital syphilis poses the following risks:

Miscarriage
Stillbirth
Prematurity
Low birth weight
Death shortly after birth

These risks can depend on the length of infection and if/when treatment was received. Treatment greatly reduces the harms associated with congenital syphilis.

A baby born with congenital syphilis may have the following problems:

Fever
Enlarged liver and spleen
Anemia (not enough healthy red blood cells to carry oxygen to body)
Rash on face, mouth, genitals, anus, hands, or bottoms of feet
Runny nose
Meningitis (an infection that causes swelling of brain and spinal cord)
Neonatal death (when a baby dies in first 28 days of life)

If congenital syphilis is not treated, the baby may develop problems later in life with the following:

Bones and joints
Vision
Hearing
Nervous system
Developmental delays

If a baby is born with congenital syphilis, antibiotics need to be given as they are important for the prevention of further harm. For some babies, congenital syphilis can be cured. For others, treatment for health conditions caused by the infection may be needed.

Resources

Posters

CATIE Syphilis Fact Sheet

Information Cards

Government of Saskatchewan
Information is provided on syphilis.
Public Health Agency of Canada
This fact sheet provides information on congenital syphilis.
Let’s Talk About Syphilis
Information on syphilis, testing, treatment, and community resources in Saskatchewan.
Keep It Safe Saskatchewan (KIS-SK)
Smart phone app with information on sexually transmitted infections, contraceptives, and testing sites in Saskatchewan.

Information for Healthcare Providers

Clinical Resources

Syphilis - Public Health
Saskatchewan Health Authority
Decision Making Algorithm for Syphilis for Primary Care Providers
Northern Inter-Tribal Health Authority
Canadian STBBI Guidelines (Apple App Store or Google Play)
Public Health Agency of Canada

Additional Resources

Syphilis
Saskatchewan Ministry of Health
Diagnosis and Management of Congenital Syphilis - Avoiding Missed Opportunities
The Canadian Paediatric Society
Congenital Syphilis
National Collaborating Centre for Infectious Diseases
Let’s Talk About Syphilis
Public Health Agency of Canada
Responding to Syphilis in Canada
Public Health Agency of Canada
Syphilis
CATIE

Webinars

Syphilis in Saskatchewan
Saskatchewan Prevention Institute
Syphilis in Saskatchewan: Impacts and Opportunities in Indigenous Communities
Saskatchewan Prevention Institute
Syphilis in Canada: Where We Are, How We Got Here, and What We Can Do About It
CATIE
HIV and Syphilis in the Prairies: Intersecting Epidemics
CATIE

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Syphilis

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Resources

Information for Healthcare Providers