syphilis

Last edited 07/2020 and last reviewed 07/2020

Syphilis is a sexually transmitted disease which is characterised by:

• minor early illness
• more serious late manifestations after a variable latent period

The infective agent is a spirochaete, treponema pallidum.

Syphilis burden in the UK

• syphilis is a sexually transmitted bacterial infection caused by Treponema pallidum subspecies pallidum which can be successfully treated with antibiotics
• the burden of syphilis in the UK has remained low since penicillin became widely available
• however, over the past two decades the number of new diagnoses has increased and the number of cases in women more than doubled between 1999 and 2007 [1,2]

Syphilis prevalence in pregnant women remains low. A study of syphilis screening in pregnancy in England found that one-in-2800 pregnant women required treatment for syphilis in the period 2010-2011 [3].

Syphilis disease stages:

There are four stages of syphilis infection: primary, secondary, latent and tertiary (late).

• the first two stages are symptomatic with sores, referred to as chancres, developing on the genital or mouth region in primary syphilis which lasts 4-12 weeks, and rash or more general symptoms such as fever and sore throat developing in the secondary stage which lasts 3-4 months. In some cases, these symptoms can be mild and overlooked or go unnoticed
• latent syphilis is typically asymptomatic, although there can be a relapse of symptoms in the early latent stage, which lasts up to 2 years
• the late latent stage, which can last a lifetime, is generally non-symptomatic
• in one-third of cases, latent syphilis develops into the tertiary stage around 10-13 years after the initial infection. This final stage can result in severe multi-organ damage, neurosyphilis and death [4]

References:

• Health Protection Agency. Syphilis and Lymphogranuloma venereum (LGV): resurgent sexually transmitted infections in the UK. GOV.UK. https://www.gov.uk/government/publications/syphilis-and-lymphogranuloma-venereum-lgv-resurgent-sexually-transmitted-infections-in-the-uk (accessed 13 Feb 2019).
• Public Health England. Annual review of infections in UK blood, tissue and organ donors: 2016. Health Protection Report Volume 11 Number 33. 2017. https://www.gov.uk/government/publications/safe-supplies-annual-review
• Townsend CL, Francis K, Peckham CS, et al. Syphilis screening in pregnancy in the United Kingdom, 2010-2011: a national surveillance study. BJOG Int J Obstet Gynaecol 2017;124:79–86. doi:10.1111/1471-0528.14053
• Garnett GP, Aral SO, Hoyle DV, et al. The natural history of syphilis: its implications for the transmission dynamics and control of infection. Sex Transm Dis 1997;24:185–200.