Syphilis is a difficult disease to diagnose because it often imitates other diseases and infections. Often called, "The Great Imitator," syphilis is a great example of why getting tested for STDs frequently is essential. The symptoms can mimic other diseases, which may lead to a lack of testing until it's too late and permanent damage is done. So, what is syphilis? How does it spread? 

Transmission

Like many other STDs, syphilis can be transmitted via oral, anal, and vaginal sex during unprotected sex, including sex without condoms. It cannot be passed along by sharing clothing, eating utensils, swimming pools, toilet seats, or other non-sexual contact. The only exception to this is the fact that an infected mother can pass it along to her child during birth, which is called congenital syphilis.

Symptoms

There are four stages to a syphilis infection. The first one is not very extreme. Because of that, it may be difficult for many people to realize that they are infected.

• Primary Stage

The main way you can distinguish syphilis from other diseases is a chancre that appears during the primary stage. A chancre is a small, painless sore that can appear on the affected genitals, or anywhere else on the body. For women, sometimes the chancre will show up on the inside of the vaginal canal, even on the cervix, so it can be very difficult to diagnose. While the chancre will go away on its own within a few weeks, that doesn’t mean that the disease is gone. Swollen lymph nodes are also common at this stage.

• Secondary Stage

The second stage is characterized by the appearance of a rash. True to the impostor quality of syphilis, this rash can often seem like a host of other diseases or skin problems. The most unusual thing though is that this rash tends to come out most prominently on the palms of the hands or the bottoms of the feet. Your mucous membranes, such as those in the nose or in the vagina, may also become irritated with sores. This rash can be accompanied by flu-like symptoms: a fever, sore throat, headache, sore body or weakness, etc. If you develop a rash while dealing with what you think is the flu, it may be time to get tested.

• Latent (Hidden) Stage

The latent stage is the most complicated, and frankly, the scariest. This stage happens about a year after the first infection, if the syphilis has not been cured. It can last between five and twenty years. But what makes it even scarier is that the only way to diagnose it is through a blood test. That’s right-- there’s no symptoms, but a person can still be contagious throughout the entire latent stage (although most specialists agree they are more contagious at the beginning of the stage). The latent stage can become symptomatic again if the infected person relapses. This generally happens in about a third of people in the latent stage. Either way, it is extremely dangerous to become pregnant during a syphilis infection because it can not only be passed along to the baby as cogenital syphilis, but it can also cause miscarriages or stillbirths.

• Tertiary (Late) Stage

The most dangerous stage of syphilis is the tertiary stage. This is when the syphilis has progressed so far that it begins to affect the rest of the body in life-threatening ways. In can manifest by attacking the skin, respiratory system, bones, eyes, and gastrointestinal system, through a disease called Gummata. This disease causes small sores which can cause very serious problems with the above symptoms. It can also cause cardiovascular syphilis, which narrows the blood vessels leading to the heart, eventually resulting in an aortic aneurysm or heart failure. Finally, it can cause neurosyphilis. This attacks the nervous system causing changes in mental state and personality and vastly limiting a person’s abilities to function within society. It can cause intense headaches, tremors, loss of mental acuity, memory loss, vision loss, and hearing loss. The most famous victim of neurosyphilis?  Al Capone.

Syphilis and HIV

If those symptoms aren’t scary enough for you, syphilis can also increase your risk of contracting HIV. If exposed to HIV while infected with syphilis, the risk very nearly doubles due to a weakened immune system and the open sores that syphilis causes.

Treatment

All of these things may seem completely terrifying. But syphilis is one of the easiest diseases for us to treat. At any stage in a syphilis infection, including the tertiary stage, a doctor can prescribe penicillin or an alternative antibiotic to cure the disease. Really, that’s it. The damage the disease did (including scarring or any of the other more frightening effects) may not be reversed, but the disease will stop progressing. Additional blood tests may be required to be sure that the entire infection was killed, and your doctor may want to monitor your health in the future to make sure you don’t suffer from any belated health effects due to your exposure.

You can prevent further infections by using barrier methods of protection, like condoms and dental dams. Additionally, the VivaGel (also called the HIV-killing condom) is said to prevent syphilis infection, although it is not on the market yet.