Syphilis is a sexually transmitted disease (STD) caused by the bacteria Treponema pallidum. New syphilis infections are at record highs. Cases are continuing to rise in King, Pierce, and Snohomish Counties. This trend is primarily among gay and bi men who account for 72% of new infections in the area. There are also increases in syphilis infections among women and 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.

From an infected parent. A pregnant parent can transmit syphilis to their unborn child. This is called Congenital Syphilis. If you have symptoms and you’re pregnant, get tested and treated.

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

Get tested regularly. Regular testing can detect STDs even when the symptoms are difficult to spot.

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, like their mouth.

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. Symptoms may start mild but can progress to vision problems, brain damage, and even death. It’s important to be aware of what each stage looks like so you can get treated early!

Primary Syphilis

Painless sore: The first symptom of syphilis is a raised, open sore called a chancre. It usually shows up on the penis, vagina, anus, or mouth 1-3 weeks after exposure, but can take up to 90 days (3 months) to appear. The sore is painless and goes away by itself after several weeks. But don’t ignore it! Even if the sore goes away, syphilis is still in your body. Be sure to get treated as soon as you notice it!

Vision problems: Problems like blurry vision, spots that float through your vision, flashing lights, and eye pain can also start at this stage. 

Without treatment, your infection will progress to Secondary Syphilis. 

Secondary Syphilis

Spotted rash: This stage usually starts with a reddish-brown, spotted rash. The rash most commonly appears on the palms of the hands or bottoms of the feet. But it can also appear on other parts of your body like the chest or back. The rash can be very subtle, and it usually does not itch. The rash can appear as the chancre is healing, or many weeks after the chancre has gone away. It may come and go for up to two years. 

Additional symptoms: Large, raised, gray or white skin growths, known as condyloma lata, may develop in warm, moist areas such as the underarm, groin, penis, vagina, anus, or mouth. Other symptoms at this stage may include swollen lymph nodes, fever, fatigue, patchy hair loss, weight loss, and headache. These symptoms usually last 2-6 weeks and will clear up on their own. 

Vision problems: Eye and vision problems can also happen at this stage. 

Just like with the sores, when the rash goes away, it does not mean that the syphilis has gone away. Without treatment, it will remain in your body and progress to Latent Syphilis. 

Latent Syphilis

No symptoms: This stage begins when symptoms of secondary syphilis go away. During latent syphilis, there are no signs or symptoms, and the infection can only be detected through a blood test. A relapse to secondary syphilis can occur during the first few years of latency. Latent syphilis is not associated with physical symptoms. But neurological issues such as vision problems can happen at this stage. Untreated latent syphilis can affect your body and health for life. It may also progress to Tertiary (or Late) Syphilis.

Tertiary (Late) Syphilis

Organ damage: About 33% of people who don’t get treated for their syphilis infection suffer serious damage to the brain, nervous system, heart, or other organs. Late syphilis can also cause paralysis, dementia, vision loss, deafness, and heart failure.  

Death: Yes, syphilis can lead to death if left untreated. 

Late Syphilis can still be cured, which can prevent further damage to your body or death. However, treatment cannot repair or reverse damage that has already occurred. So, it’s important to get tested and treated for syphilis as soon as possible. 


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. If you already have HIV and are sexually active, get tested regularly for syphilis and other STDs.

If you’re a sexually active gay or bi man, get tested for syphilis, gonorrhea, chlamydia and HIV at least once a year.

If you’re a gay or bi man, get tested every three months if you:

  • Had gonorrhea, chlamydia, or syphilis in the last year
  • Used methamphetamine in the last year
  • Had condomless anal sex with a partner living with HIV who is virally unsuppressed or a partner with unknown HIV/STD status
  • Had 10 or more sex partners
  • Are taking HIV pre-exposure prophylaxis (PrEP)

All women aged 45 and older who have not had a syphilis test since January 2021 are urged to get tested for syphilis the next time they see a medical provider.

Pregnant persons should all be tested for syphilis when they first receive prenatal care, in the 3rd trimester, and more frequently based on the advice of their medical provider.

People with any of the following risk factors, and/or sex partners with the following risk factors, should test for syphilis every 3 months:

  • Injection drug use or use of meth or nonprescription opioids
  • Homelessness or unstably housing
  • Transactional sex 
  • Incarceration in the prior 2 years  
  • A history of syphilis in the prior 2 years 
  • Women who have male partners who also have sex with men should test annually
  • Sexually active HIV positive persons outside of mutually monogamous relationships

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 seek treatment the easier it is to cure. Delaying treatment can result in serious health conditions. Those conditions are heart failure, dementia, deafness, vision loss, and even death. 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 give you immunity 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!