Pathogen and transmission
Syphilis is a sexually transmitted infection that is triggered by the bacterium Treponema pallidum and can progress chronically. The infection can be transmitted during the primary, secondary and early latent stages (less than one year after infection) by direct contact with lesions of the skin or mucosa which can appear primarily in the genital and anal region but also in the mouth. The infection can also be transmitted from the mother to the child during pregnancy or childbirth (congenital syphilis).
Clinical picture
After If untreated, syphilis manifests in four different stages.
Primary syphilis: The first symptoms can appear as early as 5 to 21 days and as late as 3 months after infection as hardened, painless sores, called chancres, at the entry point of the pathogen (penis, anus, vagina, throat or other parts of the body) and as swollen lymph nodes. The first-stage symptoms can remain undiscovered and generally disappear, even without treatment, after four to six weeks. However, the disease and its transmissibility remain.
Secondary syphilis: Appears 3 to 10 weeks after the first stage and is characterised by widely varying types of a mainly non-itching skin rash (soles of the feet, palms of the hands or elsewhere). Hair loss, swollen lymph nodes or fever are also possible. These symptoms likewise disappear without treatment.
Latent syphilis: An asymptomatic period that can last several months or even several years and is often detected in the course of a routine serological test. The disease continues to progress and leads in particular to damage of the nervous system. This latent stage is subdivided into an early (< 1 year) and a late latent stage (> 1 year). Persons in the early latent stage may exhibit sporadic lesions of the skin and mucous membranes and consequently are potentially still infectious.
Tertiary syphilis: This stage appears years after the beginning of the infection (3 to 20 years) and can lead to permanent damage to the heart, brain, bones, skin and other organs. Neurosyphilis leads to a progressive destruction of nerve tissue in the brain or the spinal cord, the main consequence of which are personality disorders or even dementia. Treatments with antibiotics have made this stage increasingly rare, however.
A new classification of the disease distinguishes between early syphilis (less than one year after infection: primary, secondary and early latent stage) and late syphilis (more than one year after infection: late latent and tertiary
stage).
Congenital syphilis: Congenital syphilis can bring about malformations and other severe problems in the child, such as inflammations, blindness or even death.
Frequency and distribution
The number of syphilis cases is increasing again worldwide, principally in highly developed countries, including Switzerland. An increased risk of infection exists mainly for men who have sex with men, for persons with numerous different sexual partners and in the context of prostitution. In 2022, 1078 cases have been reported.
Prevention
Using a condom reduces the risk of syphilis infection. But you can still get infected even if a condom is used. What’s important is to identify this and get appropriate treatment as swiftly as possible.
So:
If you have changing or multiple sexual partners during the same time period, talk to your doctor or another specialist about syphilis and other sexually transmitted infections and get advice on whether you may need to be tested.
If you are found to have an infection, you’ll find useful guidance and tips on our www.lovelife.ch website on how to inform your partner(s).
And for everyone having sex:
Do your Safer Sex Check at www.lovelife.ch!
If you’re pregnant, be sure to have regular check-ups with your gynaecologist, too. Pregnant women are tested for HIV, syphilis, hepatitis B and more to help protect the unborn child.