Syphilis

Bacterial STD on the rise among men who have sex with men since the 2000s. It is transmitted by contact with lesions (usually during sexual relations). Fortunately, access to antibiotic treatment is free for everyone in Quebec.

Causes

Syphilis is a bacterial infection caused by the Treponema pallidum bacterium. The bacterium is transmitted by contact with lesions caused by syphilis. Syphilis is usually transmitted during sexual relations, but also through contact with a lesion (skin-to-skin contact, for example). Syphilis can also be transmitted from a pregnant mother to her child, with the risk of serious complications for the baby.

Who is at risk of infection?

Syphilis is less widespread than chlamydia or gonorrhea. Currently, a resurgence of syphilis is being observed in Quebec, affecting mainly men who have sex with men (MSM), a group that is particularly at risk.

The following activities are associated with a higher risk of infection:

  • Vaginal, anal or oro-genital sexual contact, with or without penetration
  • Having sex with several partners
  • Sharing sex toys
  • Sharing injection equipment

Symptoms and complications

Syphilis has been nicknamed "the great imitator" because its clinical presentation is often confused with that of other diseases. Classically, untreated syphilis progresses through three clinical stages: primary, secondary and tertiary.

The most frequently observed symptoms, by stage :

  • The primary stage (appearing approximately 3 to 90 days after infection):
    • Non-painful ulcer, commonly known as chancre (may disappear after several weeks)
  • The secondary stage (appears about 2 to 12 weeks, sometimes several months, after the chancre has healed):
    • Skin rash (most often on chest, stomach, hands, feet and genitals)
    • Flu-like symptoms (such as fever, headache, fatigue)
  • The tertiary stage (occurs on average 5 to 30 years after the chancre has healed):
    • Cardiovascular complications, such as aortic aneurysm
    • Injuries that can damage various parts of the body, including skin and bones
    • Neurological complications, such as dizziness and dementia

In the long term, the consequences of syphilis are serious and can cause death.

It's important to note that syphilis infection can increase the risk of becoming infected and transmitting HIV.

Screening and treatment

How to screen? Screening is performed by a blood test.

When to screen? The minimum delay before detection is about ten days. The window period ends 12 weeks after exposure.

Treatment consists of administering antibiotics, mostly in injectable form. A single course of treatment is often sufficient, but a longer course may be necessary. Treatment is free of charge for the sufferer and his or her partners, under the Free Drug Program for the Treatment of Sexually Transmitted Infections. Response to treatment is assessed by medical follow-up and blood sampling.

We recommendnotify and treat all sexual partners in the 90 days prior to diagnosis. In addition, screening is recommended for recent sexual partners up to one year before diagnosis.

Protection

There is no vaccine to protect against syphilis. The best way to protect against syphilis is to use a condom at all times. Since it is possible to be infected and still have no symptoms, routine screening is recommended for all sexually active single people, especially in the presence of new partners or during unprotected sex.