Caused by the bacteria known as Treponema Pallidum, Syphilis is a sexually transmitted infection (STI) once thought to have been almost eradicated in the 1940’s and 50’s after the discovery of penicillin. In the past few decades, there has been a steady rise in rates of infection, especially in men who have sex with men, sex with commercial sex workers, and as a co-infection with HIV. The disease is mostly spread through penetrative sex (vaginal or anal) and oral sex. However, syphilis can potentially transmit through any other direct contact with an infected sore.
The Different Stages
Syphilis can be considered to have three main ‘active’ stages: Primary, Secondary, and Tertiary syphilis. During these active stages, symptoms such as an ulcer or chancre at the site of infection, body rashes, swollen glands, etc. may be present. In between these stages, the infection can be completely asymptomatic and be ‘latent’. The latent stage can last for months to years, or even decades. This is especially true after the secondary stage has passed. This is why syphilis should always be considered when doing a routine sexual health screen, even if someone feels perfectly well.
Syphilis is also known as The Great Imitator, as there are many symptoms which can mimic other more common conditions, possibly causing the diagnosis to be initially missed. For example, while the classical chancre in primary syphilis is usually solitary and painless, there are also cases of multiple painful sores which turn out to be syphilis. Rashes in secondary syphilis are typically spread evenly around the body and typically include lesions over the palms and soles. However, we sometimes see localized rashes over the scalp, trunk or limbs alone without any lesions on the hands or feet.
Screening can dependably detect syphilis, even if it is asymptomatic. A simple blood test is usually run for either treponemal antibodies (TPAb/TPPA) or non-treponemal antibody tests (RPR/VDRL). Even if someone is asymptomatic, there is still a risk that the infection can be spread.
Rapid point-of-care testing is also now available and will check for TPAb/TPPA antibodies. Testing only requires a finger prick blood sample, with results ready in 15-20 minutes. This test can be performed anonymously, along with other rapid STI tests for chlamydia and gonorrhea. Anonymous testing means no personal identifiers are required from the patient, and positive results do not need to be notified by name. Anonymous screening can reduce stigmatization of STI testing and improve accessibility to those who may not otherwise test. This means that infections may be picked up and treated at an earlier stage, helping to reduce the risk of ongoing transmission in the community.
If you think you need an anonymous syphilis test, please reach out to our DTAP clinics for a confidential, and professional diagnosis.