Syphilis is a sexually transmitted disease (STD) caused by the bacteria Treponema pallidum. New syphilis infections are at record highs in King County. Gay, bi, and other men who have sex with men make up the majority of cases. Syphilis has also dramatically increased among straight men and women causing syphilis infections to rise among newborns. Currently, reported syphilis cases are low (less than 1%) among transgender and non-binary people.

Through sex. Sex is the most common way people get syphilis. You can get syphilis by having contact with a syphilis sore during oral, vaginal, or anal sex. Syphilis is easy to miss because sores might be hidden, especially in the vagina, anus, or mouth. Syphilis sores are also easy to miss because they don’t hurt, so it’s not always clear when you might have them.

During pregnancy. Pregnant individuals can transmit syphilis to their unborn baby during pregnancy. This is called Congenital Syphilis. And, syphilis infections are quickly rising among pregnant women. If you are pregnant, visit a prenatal care provider to get tested and treated. Syphilis is curable and congenital syphilis is preventable.

Get tested regularly. Regular testing can detect STDs even if you have no symptoms.

DoxyPEP. Doxycycline Post-exposure Prophylaxis (DoxyPEP) is an antibiotic commonly used to treat bacterial infections. DoxyPEP can prevent bacterial STDs like syphilis, chlamydia, and gonorrhea when taken after condomless sex. Talk to your medical provider if you’re interested in taking DoxyPEP. For more information, click here.

Know the symptoms.If you notice an unusual sore or rash on your body or on a partner, or experience vision or hearing problems, hold off on sex until you or your partner can get tested and treated.

Make a safer sex plan. Talk with your partner(s) about syphilis and other STDs. Make a safer sex plan that meets your needs to reduce your risk.

Use condoms. Condoms help protect you and your partner(s) from HIV, syphilis, and other STDs. When it comes to syphilis, the condom must cover the actual sores to prevent transmission. Condoms can protect areas of the penis, vagina, and anus. But condoms may not prevent you from getting syphilis from sores on other areas of your partner’s body.

More partners = more risk. Having sex with more people increases the risk of getting an STD. A monogamous relationship can reduce your risk for syphilis or STDs. If you are not having sex, you cannot get syphilis.

More Facts – Public Health-Seattle & King County



Symptoms of syphilis can be easy to miss or mistake for something else. Even if you don’t notice symptoms, or if the symptoms go away on their own, you can still have syphilis. Regular STD testing can help catch syphilis before it gets too serious.

Different stages, different symptoms. Syphilis goes through four stages if left untreated, each with its own set of symptoms. These symptoms are easy to miss and go away on their own even without treatment. Regular testing for STDs can help catch syphilis early. However, it’s important to be aware of what each stage looks like so you can seek treatment.

Primary Syphilis

The first stage is called primary syphilis. It occurs 10-90 days after infection. In this stage people develop a painless sore (called a chancre) where the bacteria that causes syphilis enters the skin. This could be on the mouth, lips, tongue, penis, anus, rectum, and vulva or vagina. The sore goes away on its own without treatment. As a result, many people don’t notice this stage. But don’t ignore the sore! Even if it goes away, syphilis is still in your body. Be sure to get treated as soon as you notice it!

Secondary Syphilis

The second stage is called secondary syphilis. It occurs several weeks after infection, while the primary syphilis sore is still healing. In this stage people can get a reddish-brown, spotted rash on the palms of the hands or bottoms of the feet. Additionally, the rash can appear on the chest, stomach, back, arms, and legs. People with secondary syphilis may also develop white spots in their mouths, patchy bald spots, and/or fleshy bumps that occur in the skin folds. Some people have flu-like symptoms like fever, fatigue, aches, and swollen glands. Even without treatment, secondary syphilis will also resolve on its own.

Latent Syphilis

No symptoms: After secondary syphilis, the infection enters the latent stage where there are no symptoms. Although there are no symptoms, you will remain infected if you don’t get cured.

Tertiary (Late) Syphilis

Finally, after two to three decades, syphilis enters the tertiary stage. Most people do not experience tertiary syphilis. If it does occur, it will severely affect organ function. It is important to know that syphilis can also affect the eyes, ears, and brain at any stage, especially early syphilis.


If you’re sexually active, make syphilis testing part of your routine just like testing for HIV and other STDs.

It’s a simple blood test used to detect syphilis antibodies.

If you’re a sexually active gay, bi, or other man who has sex with men, get tested for syphilis, gonorrhea, chlamydia and HIV at least once a year, but every three months if you:

  • Have had gonorrhea, chlamydia, or syphilis in the last 2 years 
  • use injection drugs  
  • use methamphetamine or nonprescription opioids  
  • have condomless anal sex with a partner living with HIV who is virally unsuppressed or a partner with unknown HIV/STD status 
  • trade sex for money, drugs, or other items 
  • have had 10 or more sex partners in the last year 
  • are taking HIV pre-exposure prophylaxis (PrEP 

If you are a sexually active heterosexual man or woman, get tested for syphilis and other STDs at least once a year, but every three months if you:  

  • use injection drugs 
  • use methamphetamine or nonprescription opioids 
  • are unhoused or without shelter 
  • trade sex for money, drugs, or other items 
  • have ever been to jail or prison  
  • have had syphilis in the last 2 years 

If you’re pregnant, get tested during the 1st and 3rd trimester and at the time of delivery to protect your health and your newborn’s health.  


Where can I get tested?

Get tested if you think you might have syphilis. Visit your doctor or one of the HIV/STD community-testing locations listed below. Cost varies.


There is a cure for syphilis! The sooner you get tested, the easier it is to cure. Delaying treatment can result in serious health conditions. So, get tested and treated right away if you think you might have syphilis.

If you have syphilis, avoid having sex until you are cured. Tell your sex partners so they can also get tested and cured. Do not have sex with a partner who has syphilis until they are cured.

Can I get syphilis again after I’ve been cured?

Yes. Having syphilis once does not protect you from getting it again. If your partners have not been cured, they can re-infect you.

If you are sexually active and you notice a sore, a rash, changes in your vision, or any other syphilis symptoms, GET TESTED RIGHT AWAY! Syphilis is curable. And, it’s easier to treat the earlier it’s caught!