Prevention & support for sexual health




What is Syphilis ?

Syphilis is a sexually transmitted infection. It is caused by the bacterium called Treponema pallidum, and it can affect the whole body. This infection is currently on the increase in different areas of the world, including Quebec. It mainly affects MWHSWM (men who have sex with men).

How do you get Syphilis ?

  • From sexual relations with penetration of the penis in the vagina or anus;
  • From oral sex;
  • When sex toys are shared;
  • An infected mother can transmit the bacteria to her baby during delivery;
  • In rare cases, syphilis may be transmitted by using a needle previously used by an infected person;
  • Syphilis may be transmitted even when there are no symptoms.

What are the symptoms of Syphilis ?

Often there are no symptoms.

When symptoms are present, they are the same in men and women, and vary according to the stage of the infection.

First stage, or Primary syphilis: (from 3 to 90 days after onset of the infection):

Presence of a painless ulcer, or chancre, on the genitalia, anus, mouth or throat. Ulcers may disappear after approximately 3 weeks, but the infection is still present.

Second stage, or Secondary syphilis (from 2 weeks to 6 months after onset of the infection):

  • Fever and other flu-like symptoms;
  • Skin sores (chancres) or rash appear anywhere on the body, especially on the palms of the hand and soles of the feet.

If untreated, the person will have a period of the illness called latent (hidden) syphilis. This means that all the signs of the disease go away, but the disease is still very much there, and the infected person is still contagious. The infection can then only be detected by a blood test.

Third stage, or Tertiary syphilis (from 1 year to over 20 years after the initial infection):

  • Damage to the heart, brain, bones and liver.
  • Lesions in the bones, subcutaneous tissues, and skin; damage to the cardiovascular and nervous systems.

What are the possible complications of Syphilis ?

If left untreated, the disease spreads from one stage to the next, and becomes more and more difficult to treat. It can even cause death.

How is Syphilis diagnosed ?

Diagnosis is done by taking a blood sample. It is important to be tested often, especially when engaging in at-risk sexual behaviour.

What is the treatment for Syphilis ?

Syphilis is treated with antibiotics prescribed by a health-care professional. There may be side effects. Treatment is free in Quebec for the infected person and his or her partner(s), who must also be treated. Antibiotics cure syphilis but do not cure the damage to the skin or other parts of the body caused by the disease. With early treatment, syphilis can be easily cured.

How can Syphilis be prevented ?

  • Use a condom. (Note that a condom does not protect sexual partners if there are sores or rashes on other parts of the infected person’s body not covered by the condom);
  • If an ulcer, skin sore, chancre or rash is present, practice abstinence (avoid sexual relations), and consult a health-care professional;
  • Be tested regularly if you have multiple sex partners;
  • If symptoms appear or if syphilis has been diagnosed, advise your sex partners (from the previous 3 to 12 months, depending on the stage of the infection).

What are the risks for HIV-positive people ?

  • People living with HIV are more likely to contract syphilis.
  • Genital sores and discharge caused by syphilis make it easier to transmit an HIV infection.
  • HIV-infected people may have the following symptoms:
    • Multiple and extensive ulcers;
    • More rapid evolution to neurosyphilis (3rd stage);
    • Damage to the eyes;
    • Greater risk of treatment failure;
    • Shorter latency period between secondary and tertiary stages.

Additional information

  • A large number of people with syphilis do not remember having had the first ulcer or chancre.
  • Symptoms in the first and second stages often disappear without treatment, but the bacteria are still present and can be transmitted.
  • People with syphilis are particularly contagious within the first year of infection.
  • If left untreated, syphilis may develop into a serious chronic infection (it will never heal).

Reporting of syphilis is compulsory in Quebec.* Therefore, doctors who diagnose Syphilis must inform the Public Health Department of their region.

A public health professional will offer support in identifying and informing sexual partners up to 6 weeks prior to the appearance of the first symptoms. If the person with syphilis is asymptomatic, sexual partners from even earlier must also be informed.

*Outside Quebec, similar public health laws apply.
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