Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It can also be passed from mother to baby during pregnancy or birth causing a disease called congenital syphilis.
Syphilis (other than congenital syphilis) occurs in four stages; primary, secondary, latent and late (also called tertiary), that sometimes overlap. If left undetected syphilis will eventually cause symptoms in about 40% of infected people.
Syphilis has many possible symptoms which are similar to those of many other diseases. Many people with syphilis do not have symptoms for years and sores that develop in the initial stages of the illness can be overlooked. More information about syphilis is available from NHS Direct Wales On-line.
Who gets it and how serious is it?
People most at risk of getting syphilis are those having unprotected sex (i.e. not using a condom), those with more than one sexual partner and those who change partners frequently. It is caught through unprotected vaginal, oral or anal sex or genital contact with an infected partner. An infected person may have no symptoms but can still transmit the infection without knowing.
Unlike other bacterial STIs, the majority of cases are not among teenagers; the highest rates are seen in older age groups. In Wales, the highest rates of infectious syphilis were recorded in men aged 21-43 years. Men who have sex with men (MSM) account for over three-quarters of the cases confirmed in Wales.
Tertiary syphilis can cause very serious damage to body systems and organs, and cause death.
All stages of syphilis are treatable with antibiotics although it is easier to cure in the early stages. However, damage to organs that may occur in late syphilis cannot be reversed.
How common is it?
The incidence of infectious syphilis relative to other sexually transmitted infections remained low in Wales until the late 1990s. The number of cases of infectious syphilis reported had been increasing in recent years from 27 in 2002 to 119 in 2008. This however was followed by a significant drop to 56 cases in 2009, 58 cases in 2010 and 39 provisional cases in 2011.
More information about the rates and surveillance of infectious syphilis can be obtained from the Public Health Wales Health Protection Division microsite by following the link: rates and surveillance of syphilis in Wales
Sexually active people can reduce their risk of contracting syphilis by reducing their numbers of sexual partners and by using condoms correctly and consistently during sex.
Individuals can request confidential screening for syphilis and other sexually transmitted infections, either from their GP or from a genitourinary medicine (GUM) clinic, lists of which are available from the FPA website. GUM clinics are completely confidential and will not inform GPs of results unless requested to do so by the patient. Clinics can be attended at any age.
Minimising impact in Wales
Public Health Wales has established the Sexual Health Programme which collects and collates data on the levels of sexually transmitted infections, including syphilis, in the Welsh population. Since January 2002, an enhanced infectious syphilis surveillance programme has also been undertaken in Wales. These data allows significant trends and any particular groups of the population affected to be identified, and enables effective delivery of high quality, accessible and appropriate specialist public health services, both in partnership and support of other national and local bodies.