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What should I do if I’ve been exposed to syphilis?

What should I do if I’ve been exposed to syphilis?

Updated on:
June 27, 2021

So you recently had a sexual/non-sexual encounter where you suspect or know your partner(s) had syphilis at the time.

Don’t panic. Thousands of Canadians are diagnosed with syphilis every year and it’s easily curable. With the proper steps taken, you can determine whether you have the infection and obtain treatment that will remove it from your body if needed.

What are the risks of getting syphilis?

Many factors can determine how high your chances of contracting syphilis are. Some of these factors include:

  • Having unprotected sex (not using condoms or not using them correctly)
  • Having multiple sex partners
  • Having sex with a partner who has multiple sex partners
  • Exchanging sex for drugs or money

Regardless, you can participate in none of these activities and still catch syphilis. It can happen to any of us. Generally, the risk of infection from syphilis from a single sexual encounter with an infected partner falls somewhere between 3% to 10% (source).

Potential symptoms for syphilis

Around 50% of those infected with syphilis are asymptomatic, meaning there’s a high chance that you may not present any symptoms even if you have caught it.
For those that do present symptoms, it can take anywhere from two weeks to even three months for them to show up. Common signs that may appear during the earlier stages of syphilis include:

  • Sores/ulcers (called chancres)
  • Swollen glands
  • Rashes
  • Skin growths similar to genital warts
  • Flue-like symptoms (fatigue, headaches, joint pain, fever)

For an in-depth view of all the potential symptoms associated with syphilis, please take a look at our article about syphilis symptoms.

Symptoms are not a reliable indicator for ruling out a syphilis infection. If you have any worry you have been exposed to the infection, the only sure way to know your status is to get tested.

How do I get tested for syphilis?

For diagnosing syphilis, your experience can feature around three steps in the testing process:

Physical examination
After communicating your sexual history and whether you’re aware of any sores on your body, your attending physician will ask to examine your genitals. During this process, they are looking for any growths that appear to be caused by the syphilis bacteria.

Blood test
This test allows your doctor to tell whether you currently have syphilis or have had it in the past.

Blood tests during your first visit for syphilis typically check for any antibodies present within your body. These include:

  • Rapid plasma reagin test (RPR)
  • Treponema pallidum particle agglutination (TP-PA)
  • Enzyme immunoassay (EIA)

While they all test for syphilis antibodies, the rapid immunochromatographic test can usually produce results within the time of your doctor’s visit if they have a ‘point of care’ test. Antibodies are tested for rather than looking for actual syphilis bacteria because bacteria-based tests are not reliable and need to be sent to more specialized labs, slowing down the turnaround time for results.

These antibody blood tests are usually positive 2-4 weeks after infection. Sometimes the tests do not become positive until after a chancre appears - typically within three weeks of exposure. Therefore, the total testing window is around four weeks. The testing window means that it’s typical for an accurate reading of a syphilis infection one month after the initial exposure.

Suppose the period since your last suspected exposure is too close to the time of testing. In that case, your doctor may recommend that you test again in the next few weeks to confirm a negative result as your body needs time to realize the disease is present and produce antibodies to fight it off.

Swab test
If you do have any growths or rashes that appear potentially related to a syphilis infection, your physician may use a swab to take a sample for testing as well. This swab test is looking for the genetic material of syphilis, otherwise known as a PCR test.

While you’re at the testing site for syphilis, it is recommended that you also be tested for other STIs like chlamydia and gonorrhea. It is possible to have more than one STI, and the physician can usually perform tests for additional STIs in the same visit.

Where can I get tested for syphilis?

You can find free testing for syphilis and other STIs in walk-in clinics, family doctors’ offices, sexual health clinics, and other community centers in Canada.

Testing timeline for syphilis

Apart from point of care rapid immunochromatographic tests that provide results in the same visit, typical testing can take about 7-10 days to complete.

If your first round of tests ends with a negative result, it is recommended that you be retested one to three months after the initial time of exposure to confirm.

How urgent is post-exposure treatment for syphilis?

As with all STIs, the sooner you’re treated for syphilis, the better.

If you prolong obtaining treatment, the infection can develop more severe side effects and take longer to cure through medication.

At any stage of the infection, antibiotic treatment can cure it. Though the longer you wait, the longer the treatment period may become.

What happens if I don’t get treated?

While the symptoms of syphilis can go away without treatment, the infection itself will not go away if you do not treat it with medicine.

By not getting treated, it is likely that your body will eventually enter the later stages of the disease, which can result in severe and irreversible side effects like:

  • strokes
  • dementia
  • aneurysms
  • visual problems or blindness
  • loss of coordination
  • meningitis
  • heart problems
  • death

Can I have sex if I’ve been exposed to the syphilis infection?

Until your syphilis test results come back, you should refrain from partaking in sexual contact with anyone. Otherwise, you risk spreading the infection to your partners.

How long do I have to wait after being treated for syphilis to have sex?

The syphilis bacteria (T. pallidum) is highly vulnerable to the antibiotic penicillin. Experts recommend that you abstain from sexual contact for seven (7) days after your last dose of treatment.

What alternatives can I take if I still want to be sexually active?

While spreading syphilis through kissing is uncommon, it is still possible if there are sores in your mouth - cases of this have been documented (source).

Until it’s been seven (7) days after completing your treatment, it’s recommended that you keep all flirtatious activity above the clothes. Consider this period of celibacy as foreplay until your treatment runs its course.

Do I need to tell my partner(s)?

If you are diagnosed with syphilis, the clinic that processed your test will notify your provincial Public Health Unit. Your provincial Public Health department is required to notify any partners that may have been exposed to syphilis. This notification process is meant to mitigate the spread and get them tested and on treatment as soon as possible. Public Health will contact you shortly after your positive result and ask for your recent partners’ names and contact info. When they reach out to them, they will not include your name to try and maintain as much confidentiality as possible.

Depending on what stage you’re currently in for your syphilis infection, the time to trace back sexual contacts can range from three months to one year before the test.

You also have the option to contact your previous partners yourself. Just inform the agent that gets into contact with you and feel free to ask for advice and resources on how to best communicate this test result with your partner(s).

How do I tell my partner(s)?

It’s in the best interest of anyone you’ve had sexual contact within the allotted trace-back period to find out as soon as possible so that they can get tested and treated.

How you tell them is entirely up to you. You can do it face-to-face, over a phone call, or even through a text message. As long as you’re making sure your partners are made aware in a timely manner.

The method you choose depends on how safe you feel with the person. If you’re closer with them, an in-person meet or video call may feel more appropriate. Otherwise, a phone call or text will do the job just fine.

If you fear their response being aggressive or even violent, please defer the communication to the Public Health professional. Remember to keep your own health in mind as well.

Sources:

  • https://www.healthline.com/health/vdrl-test#results
  • https://www.nhs.uk/conditions/syphilis/diagnosis/
  • https://medlineplus.gov/lab-tests/syphilis-tests/
  • https://www.uofmhealth.org/health-library/hw5839
  • https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3138
  • https://www.medicalnewstoday.com/articles/how-long-does-it-take-an-std-to-show-up#dormant-st-is
  • https://www.healthline.com/health/how-long-does-it-take-for-std-to-show-up#std-incubation-periods
  • https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/syphilis/treatment-follow-up.html
  • https://globalnews.ca/news/3793409/everything-canadians-need-to-know-about-sti-testing-and-sexual-health/
  • https://www.actioncanadashr.org/resources/sexual-health-info/sexually-transmitted-infections/sti-testing-faqs

Reviewed by:
Dr. Caley Shukalek

Caley is passionate about evidence-based, patient-centred care, including telemedicine that can provide high quality care from wherever a patient may choose.

He helped create Alberta's PrEP guidelines and works as a specialist in General Internal Medicine with additional training in sexual health, including HIV and sexually transmitted infections.

He holds an Masters of Public Health from Johns Hopkins University, an MD from the University of Calgary and an MSc from the University of Alberta.