The syphilis epidemic

The syphilis epidemic: what you should know (Part II)


In the first half of our two-part series on the epidemic of syphilis, we discussed how the disease is spread, and the earlier stages of the disease. Here is how syphilis—if not treated—will progress beyond the earlier stages

Later stages of syphilis


This period starts when the symptoms of secondary syphilis go away. During this time, he person thinks he is fine, because there are no symptoms at all. But the bacteria is still in his body, waiting to reactivate and cause widespread damage. This stage can last from a year to 30 or even more years. About 1/3 of people who reach this stage, if not treated, progress to the final stage.


The disease becomes symptomatic again, and drastically so. It may damage the heart, liver, bones, and other internal organs, and spread to the brain and spinal cord. This stage may begin many years after the initial infection, but typically it occurs within 10 years.


In primary syphilis, a sample of the secretion from the nodule may be studied to see if there are bacterium present. This test though requires special equipment and microscopes, and many facilities cannot do this test. But a simple blood test will be diagnostic. Some health centers can give the result within an hour.

Sometimes this test at first might be normal, because the test measures antibodies against the bacteria, which take time to develop.  So a repeat blood test in a month or more after the first blood test might be needed.

Congenital syphilis

If a mother has syphilis she is likely to pass it onto her baby via the placenta or during birth. Every mother should have a blood test for syphilis early in the pregnancy. If positive, she needs treatment. If untreated, the baby has a high chance of being stillborn, pre-term, or low-birth weight. If the baby survives, he will be left with serious problems affecting multiple systems.


The earlier treated, the easier it is to cure, but syphilis is curable at any stage. However any organ damage already done is not reversible. So all sexually active people need to be tested whenever there is a question, and treated if positive.

The treatment is intramuscular (not oral) penicillin, but other alternative antibiotics are used in case of penicillin allergy. If diagnosed in the earlier stages, one dose of penicillin should cure it, but later stages require longer courses of penicillin.

Get tested

If you have been sexually active and have never been tested, you should have a syphilis blood test. If you have relations with a new person, or multiple partners, or at times do not use condoms, you should be tested yearly or even more frequently.


Besides being tested if you are sexually active, the best thing is prevention. If you are not in a mutually monogamous relationship with another person known to be free of disease, you should use condoms for each sexual intercourse. Note that even if you or your sexual partner is taking PrEP to prevent HIV infection, the PrEP pills do not protect against syphilis. So also in this situation, condoms are needed to prevent infection with the syphilis bacteria.

To find a doctor, of any specialty, anywhere in Brazil, check out our website:

See also in ProcuraMed:

Be careful with cat bites

Where the germs hide in your kitchen

Esta postagem também está disponível em: Portuguese (Brazil)

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This post is related to specialty Infectious Disease. Below is a list of some physicians related to this specialty.