What is syphilis and why are cases on the rise?

Condom use can help to prevent syphilis [Photo: Getty]
Condom use can help to prevent syphilis [Photo: Getty]

You’d think with the rise in sex education that we’d be pretty clued up about sexual health, but according to a new report the number of cases of syphilis in Europe has hit an all-time high, with the UK seeing one of the steepest rises.

A report by the European Centre for Disease Prevention and Control revealed that the number of cases of the sexually transmitted infection (STI) in the UK more than doubled between 2007 and 2017.

There were 3,561 cases of syphilis in the UK in 2007 but by 2017 this number had soared to just over 7,798.

The UK was one of five countries – alongside Iceland, Ireland, Malta and Germany – which saw the number of cases of the infection more than double over the time period.

According to the research the rise in the number of cases of syphilis is mainly driven by men who have sex with men.

The report also attributed the increase in the number of cases to men not using condoms, multiple sexual partners and substance abuse.

More risky sexual behaviour was also cited as a contributing factor for the rise.

Andrew Amato-Gauci, head of the ECDC programme on HIV, STI and viral hepatitis told Telegraph that people no longer fearing the contraction of HIV had lead to people taking more risks with their contraception.

"The increases in syphilis infections that we see across Europe, as well as other countries around the world, are a result of several factors such as people having sex without condoms and multiple sexual partners, combined with a reduced fear of acquiring HIV.”

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What is syphilis and how is it spread?

“Syphilis is a bacterial infection that's usually spread through unprotected vaginal, oral or anal sex, or sharing sex toys,” explains Dr Laura Joigneau Prieto online doctor at Zava UK.

According to Dr Lizzie Kershaw-Yates, GP and medical team member at The STI Clinic , the infection is passed from person to person through contact with a syphilis sore (ulcer).

“Depending where the ulcer is, the infection can be passed on during vaginal, anal or oral sex and by sharing toys with somebody who is infected.

“Anybody who is sexually active is potentially at risk,” she adds.

Dr Kershaw-Yates says it may also be possible to catch syphilis if you inject yourself with drugs and you share needles with somebody who is infected or through blood transfusions.

But it is worth noting that syphilis cannot be spread by using the same toilet, clothing, cutlery or bathroom as an infected person.

Experts attribute increasingly risky sexual behaviour as contributing to the rise [Photo: Getty]
Experts attribute increasingly risky sexual behaviour as contributing to the rise [Photo: Getty]

What are the symptoms of syphilis?

The symptoms at the first stage of the infection include a small painless sore called a 'chancre' found at the site of infection.

“It is more frequently found on the penis or the vagina or around the anus,” Dr Joigneau Prieto says. “It may appear on the fingers, mouth, lips or buttocks. Your glands in your neck, groin or armpits may also swell.”

These symptoms disappear within eight weeks even without treatment, and worryingly some people may not experience any symptoms at all or may not notice them.

“But this doesn't mean the infection has gone,” warns Dr Joigneau Prieto. “Without treatment it will develop into the secondary stage, known as secondary syphilis.”

According to Dr Kershaw-Yates syphilis is divided into stages (primary, secondary, latent, and tertiary) and there are different signs and symptoms associated with each stage.

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What happens if syphilis is left untreated?

While syphilis is fairly easy to treat with antibiotics, if left untreated the infection can cause severe symptoms including fever, fatigue, joint pain, headaches, a blotchy red rash, growths around the anus or vulva, or even hair loss.

“Eventually the infection can damage your heart, brain, nervous system and bones, leading to heart problems, blindness, stroke or even dementia,” Dr Joigneau Prieto explains.

How is syphilis diagnosed?

If you suspect you may have been put at risk of contracting syphilis you can be tested at a sexual health or genitourinary medicine (GUM) clinic, or you can also take a test at home, using a home STI test kit.

“To diagnose syphilis, you'll usually have a blood test, and you may also have a physical exam and a swab test of any visible sores,” Dr Joigneau Prieto says.

She points out that it can take several weeks for syphilis to show up on a test after you catch it, so if your test comes up negative for syphilis, your doctor will recommend to repeat it.

“It's important to remember that if you don't get tested you can be putting yourself and other people you infect at risk of further complications.

“If you think you've been exposed to syphilis, it's important to check for other STIs too, as it's possible to be infected with multiple STIs at once,” she adds.

How is it treated?

If you have syphilis, you will be treated with a short course of antibiotics. Treatment is essential because the infection doesn't go away on its own.

“Antibiotics are usually enough to treat the infection, but the type of antibiotic you will be prescribed will depend on how long you have had syphilis for,” Dr Joigneau Prieto explains.

“If you have had syphilis for less than two years, you will either be injected with penicillin or prescribed up to 14 days of antibiotic tablets if you are unable to take penicillin.

“For syphilis which has lasted for over two years, you will usually need three penicillin injections or a 28-day course of antibiotic tablets.”

According to Dr Kershaw-Yates it is important to avoid sex until the syphilis sores are completely healed, and a test confirms that the syphilis infection has gone.

“It is also important to tell your current sexual partner(s) so that they can also be tested and treated if necessary,” she adds.

Cases of syphilis are on the rise [Photo: Getty]
Cases of syphilis are on the rise [Photo: Getty]

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How can syphilis be prevented?

Though syphilis cannot always be prevented, Dr Kershaw-Yates suggests you can reduce your risk by practising safer sex.

“If you practice safe sex and always use a condom, your risk of catching syphilis is very much reduced (condoms do not provide complete protection as syphilis ulcers can sometimes be on areas not covered by a condom),” she says.

She also suggests using a dental dam (a square of plastic) during oral sex.

“Also, avoid sharing sex toys but if you do share them, wash them and cover them with a condom before each use,” she adds.

These measures can also reduce your risk of catching other sexually transmitted infections (STIs).