Women’s Health


Syphilis is a sexually transmitted diseases called by a spirochete bacterium known as Treponema pallidum. The first reported outbreak of this disease was in 1494 after which it spread rapidly through Europe. In the 16th century it was known as the “great pox” to distinguish it from smallpox. At various times in history it has been called the “French Disease”, the “Italian Disease” and “English Disease”. The Russians called the “Polish Disease” and the Arabs called it the “Christian Disease.” It was not until 1913 that the etiology of this disease was discovered—a spiral-shaped bacterial called Treponema pallidum.

An estimated 32,000 cases of syphilis were reported in 2002 by the CDC. About a quarter were diagnosed in the primary and secondary stages of the disease and majority occurred in women ages 20-24 years of age.

Prior to modern antibiotics this disease often progressed from an initial ulcer called primary syphilis to a generalized rash, secondary syphilis, and eventually to a debilitating destruction of the brain, tertiary syphilis, that caused paralysis—neurosyphillis.

The tragedy of syphilis is that many of those infected with may not have symptoms for years, yet are at risk for developing the late complications of this disease if not treated.

Primary syphilis

Primary syphilis is marked by the appearance of a painless single sore called a chancre. In some cases, however, there are multiple sores. The latent period—time between the infection and the appearance of the chancre averages 21 days (10 – 90 days). The chancre is usually firm, round and small and appears at the spot on the body where the bacteria entered. Typically the chancre lasts 3-6 weeks and heals on its own without treatment. If treatment is not rendered during this phase the disease progresses.

Secondary syphilis

The stage starts with the development of a generalized rash that begins while the chancre is still present or several weeks later. The rash appears on one or more areas of the body and does not cause itching. Typical sites for the rash of secondary syphilis are the palms of the hands and bottoms of the feet. Sometimes the rash is so faint that it is barely noticed. The rash may be accompanied by fever, chills, swollen lymph nodes, a sore throat and hair loss as well as generalized muscle aches and fatigue. Without treatment the infection progresses to the latent and tertiary stages of the disease.

Tertiary syphilis

During the latent phase of the disease the bacteria is still present though there are no signs or symptoms of the disease. The disease progresses, however and causes damage to the internal organs including brain, nerves, eyes, heart, blood vessels, liver, bones and joints. The phase of the disease is very slowly progressive but eventually causes difficulty in coordination of muscle movements, paralysis, blindness and dementia.

How do people get syphilis?

Syphilis is passed from person to person through direct contact with a chancre (sore). Sores typically occur on the vulva, vagina, anus, rectum, mouth and lips. Additionally, pregnant women may pass this disease onto their babies. Syphilis may cause stillbirth or giving birth to a baby that dies shortly after birth. Untreated babies may develop severe neurological problems.

How is syphilis diagnosed?

The simplest way to diagnose this disease is with a routine blood test. You can request this test from your health care provider.

Can syphilis be treated?

Syphilis is easily treated provided it is diagnosed in its early stages. A single intramuscular injection of penicillin (for those not allergic) will cure syphilis in those who’ve had it for less than a year. For those who are penicillin-allergic there are other convenient antibiotic remedies. It is important for the disease to be diagnosed early as the treatment will not reverse damage already done by this bacterium.

What’s the link between syphilis and HIV?

The presence of sores makes it easy for the treponeme (type of bacterium) to enter the body and become infected with HIV if the woman is exposed. There is an estimated 2 to 5-fold increased risk of acquiring HIV infection when syphilis is present.

Where can I get additional information?

STD information and referrals to STD Clinics
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English, en Español

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
1-888-282-7681 Fax
1-800-243-7012 TTY
E-mail: info@cdcnpin.org

American Social Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827