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Syphilis is a highly contagious sexually transmitted disease caused by the bacteria Treponema pallidum. You can contact this disease by direct contact with a syphilis sore during vaginal, anal, or oral sex. More than 7.1 million adults between 15 and 49 years old have acquired syphilis. This disease has 4 different stages, if left untreated it could cause serious or life-threatening health problems.

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There are 4 stages to this disease. The first stage is the primary stage. In this stage, the appearance of a single or multiple chancre(s) at the spot where the bacteria entered the body. The second stage is the secondary stage. Weeks or months after the chancre heals, skin rashes and/or sores in the mucous membranes may start to form. The third stage is the latent stage. This is known as the hidden or sleeping stage, the latent stage is where symptoms no longer occur. The final stage is the tertiary stage. This affects multiple organ systems, causing a number of health complications deepening on which organ systems are affected.

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All pregnant people should receive syphilis testing at their first prenatal visit. Some pregnant people need to receive syphilis testing again during the third trimester at 28 weeks and at delivery. If you are pregnant and have syphilis, you can give the infection to your unborn baby. Having syphilis can lead to a low-birth-weight-baby. It can make it more likely you will deliver your baby too early or stillborn. At birth, a baby with a syphilis infection may not have signs or symptoms of disease. However, if the baby does not receive treatment right away, the baby may develop serious problems within a few weeks. These babies can have health problems, such as cataracts, deafness, or seizures, and can die.

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During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. These sores usually occur in, on, or around the penis, vagina, rectum or lips. The sore usually lasts 3 to 6 weeks and heals regardless of whether you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.

During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet. The symptoms from this stage will go away whether you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.

The latent stage of syphilis is a period when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years.

Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen, it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of multiple tests.

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Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described above.

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In the first two stages a single injection of penicillin or a 10–14-day course of antibiotic in tablet form will be administered. In the early latent stage, a single injection of penicillin or a 10–14-day course of antibiotic in tablet form will be administered, but in later latent stages: three injections or a 28-day course of antibiotics in tablet form will be administered. In the tertiary stage, patients may require further and more advanced treatments with additional treatment for health complications if necessary.

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The only way to completely avoid STDs is to not have vaginal, anal, or oral sex. Use condoms the right way every time you have sex. Condoms prevent the spread of syphilis by preventing contact with a sore.

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If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for syphilis or other STDs. You should get tested regularly for syphilis if you are sexually active and are a gay or bisexual man; have HIV; or have partner(s) who have tested positive for syphilis.

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This is an example of what the chancres may look like.

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These are Syphilis reported cases by state.