Syphilis II: The Silent Infection
Syphilis can be easy to miss because symptoms may be mild, painless, or disappear on their own. During the latent stage, there may be no visible symptoms at all, while the infection is still present and can be detected through blood tests.
Whether you should be screened depends not only on symptoms, but also on your recent sexual history and possible exposure.
How syphilis spreads
Syphilis is mainly spread through sexual contact, including vaginal, anal, and oral sex. Transmission occurs through direct skin or mucosal contact with an infectious lesion, which may appear on the genitals, around the anus, or on the lips or inside the mouth.
Condoms significantly reduce the risk, but transmission can still occur from lesions outside the area they cover.
Kissing and oral contact
Transmission is possible if an infectious syphilis lesion is present on the lips or inside the mouth and there is direct contact with it, but the risk from ordinary casual kissing is generally low.
Everyday contact
Toilet seats, swimming pools, bathtubs, door handles, and shared everyday items such as utensils or clothing are not typical routes of syphilis transmission.
Transmission through casual everyday contact is very unlikely.
Syphilis screening during pregnancy
Syphilis can cross the placenta during pregnancy and infect the fetus, causing congenital syphilis. Untreated infection can increase the risk of miscarriage, stillbirth, preterm birth, and infection in the newborn.
Syphilis screening is a routine part of care during pregnancy. Repeat testing may be recommended for those at higher risk, depending on local guidelines.
Screening recommendations
The appropriate timing and frequency depend on individual risk.
| Situation | Recommendation |
|---|---|
| New partner or unprotected sex | Consider testing; repeat if too early. |
| Multiple partners or ongoing higher risk | Regular screening, often every 3–6 months. |
| Partner diagnosed with syphilis | Prompt evaluation, testing, and possible treatment. |
| Another STI diagnosed | Screen for syphilis, HIV, and other STIs. |
| Using HIV PrEP | Regular STI screening. |
| Pregnancy | Routine screening; repeat if higher risk. |
| Uncertain past exposure | Consider testing after the window period. |
Many STIs can be asymptomatic. Regular screening is important, especially with higher risk.
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When to seek medical care
See a doctor if you develop an unexplained painless sore, a rash involving the palms or soles, a widespread rash, or unusual lesions in the mouth or genital area.
Syphilis can be present without symptoms, so if there has been a possible exposure, timely testing is more reliable than waiting for symptoms to appear.
