Causes and Risk Factors of Syphilis

Syphilis is a sexually transmitted infection (STI) caused by a bacterium called a spiral Treponema pallidum. It is usually spread by touching a sore while having sex with an infected person. The mother can also pass it on to her child during pregnancy.

Certain risk factors can increase your chances of getting syphilis. Read on to learn more about them and how germs can spread from one person to another so you can take precautions to protect yourself.

Common causes

Sexual contact is the main way people get syphilis. A pregnant mother can also pass it on to her baby.

sexual contact

Sexual transmission of syphilis infection occurs when skin or mucosal tissue comes into contact with an open ulcerated sore (called mandibleThe corkscrew shape of the bacteria allows it to burrow into the mucous membranes of the mouth, vagina or rectum or into tiny crevices in the skin.

In adults and sexually active youth, syphilis is transmitted almost exclusively through oral, vaginal, or anal sex. The infection can also be passed from one person to another through kissing if a partner has sores in their mouths, although this mode of transmission is less common.

If left untreated, syphilis goes through four stages of infection: primary, secondary, latent, and tertiary.

Risk and mode of transmission may vary by stage:

  • During primary syphilis, the disease is spread by touching sores that may be hard round or painless.
  • During secondary syphilis, the disease can be spread through contact with a secondary rash.
  • During latent syphilis, there are no signs of symptoms and the infection generally does not spread.
  • During tertiary syphilis, the disease has spread to other organs and can be highly contagious.

Syphilis is not spread through toilet seats, casual touching, or sharing utensils or personal care items.This is because Pallidococcus Has a flimsy shell that lacks the components needed to last long outside the body.

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mother to child

Perinatal transmission of syphilis, also known as congenital syphilis, occurs when the syphilis bacteria in the pregnant mother penetrates the placenta around the developing fetus.

While this can happen at any stage of pregnancy, it is most likely in the second half of the pregnancy. The risk of transmission varies depending on the stage of infection in the mother.

According to the Centers for Disease Control and Prevention (CDC), about 40 percent of babies born to women with untreated syphilis are stillborn or die from complications of the infection soon after birth.

Lifestyle Risk Factors

While syphilis can affect anyone, there are many risk factors that increase your likelihood of infection.

The most common risk factors include:

  • Inconsistent condom use: This is the main cause of transmission in all populations. According to a CDC study, only about 24 percent of women and 33 percent of men between the ages of 15 and 44 use condoms consistently.
  • Multiple sexual partners: This puts you at risk due to increased exposure. This is especially true among anonymous partners who meet on online platforms.
  • Gay, bisexual, and other men who have sex with men (MSM): These individuals account for about half of primary and secondary syphilis infections in the United States. Physiological vulnerability (eg, rectal tissue vulnerability) and high HIV infection rates place MSM at inherently increased risk compared with heterosexual peers.
  • Injecting drug use has caused a series of outbreaks of sexually transmitted infections. While syphilis is rarely spread through blood contact, injecting drug use can impair judgment and increase the risk of sexual violence or sexual intercourse.
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avoid screening

Perhaps one of the biggest barriers to detecting and treating syphilis infection is avoiding STI screening. There could be multiple reasons for this.

Some people may not be tested due to lack of access to health care, while others may not be aware of screening guidelines.

Others may actively ignore them. Reasons for avoiding testing may include stigma or fear of receiving an HIV diagnosis at the same time. This means an increased risk of infection and reinfection.

​​A 2015 UCLA study reported that 6% to 8% of MSM who had been previously infected with syphilis would be reinfected within two years. Many people who put off testing until they are reinfected admit that they either don’t want to know or are afraid to know the results.

Young African-American men were 62 percent less likely to be tested if they linked STIs to immorality, shame, uncleanness or character weakness. Today, the incidence of syphilis in African Americans is almost five times higher than in whites.

Syphilis infections on the rise

In the United States, syphilis infections are steadily increasing across many races and age groups. In 2000, fewer than 6,000 cases of primary or secondary syphilis were reported (or 2.2 per 100,000 people). By 2019, that number had increased to nearly 39,000 cases (or 12 per 100,000).

Test Guide

The CDC now recommends testing for syphilis, chlamydia and gonorrhea at least annually for all sexually active gay, bisexual men and other men who have sex with men.

All sexually active HIV-infected individuals should also be screened for these STIs at their initial HIV care visit and at least annually throughout their care.

In addition, pregnant women should be tested for syphilis at their first antenatal visit.

All sexually active gay and bisexual men with multiple or anonymous sexual partners should be screened more frequently (eg, every three to six months).

Failure to follow these guidelines can increase the chances of an undetected case of syphilis, which can then be passed on to a partner.

VigorTip words

When it comes to your health, be honest about your risks and do everything you can to protect yourself and anyone who may be exposed to infection.

If the cost makes you hesitant to get tested, research some free or reduced-cost ways to get tested for STIs.

Frequently Asked Questions

  • How is syphilis spread?

    Syphilis is primarily a sexually transmitted infection that causes painless ulcerative sores called chancres. Syphilis is spread when mucous membranes or incomplete skin come into contact with a chancre or sore. Syphilis can also be passed from mother to child during pregnancy.

  • How does syphilis not spread?

    Syphilis cannot be spread through daily contact, toilet seats, sharing utensils, or touching objects because the bacteria quickly dies once it leaves the body.

  • What causes neurosyphilis?

    Neurosyphilis is a complication of untreated syphilis that can occur up to 10 to 20 years after the initial (primary) infection. About 10% of untreated individuals will go on to develop neurosyphilis. People living with HIV account for the majority of cases.

  • Congenital syphilis is caused by what?

    Congenital syphilis is caused when a mother who has syphilis passes the infection on to her unborn baby. It can happen at any stage of pregnancy. In most U.S. states, pregnant women undergo routine screening to ensure early treatment and reduce the risk of transmission or complications.

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