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What is the incubation period for syphilis. How long before symptoms appear. On average, how long does each stage last?


Syphilis is a disease caused by the bacterium Treponema pallidum. It is typically classified as a sexually transmitted disease. If a person contracts syphilis after exposure to another infected person, the average time to appearance of a painless ulcer (known as a chancre) is about three weeks (but can be as short as 1½ weeks or as long as 3+ months). The appearance of the chancre signals the stage of disease known as primary syphilis. The ulcer can last from 1-5 weeks before it disappears. Between 1 and 3 months after the chancre resolves, the stage of disease known as secondary syphilis can occur (in fact, a few cases can even occur while the chancre is still present). There can be many different types of symptoms with this stage of syphilis; in fact, the symptoms are so varied that syphilis is sometimes call "the great imitator" because it can mimic many other diseases. Commonly, however, during secondary syphilis, a skin rash may occur on any area of the body. There can be patchy balding, low grade fevers, sore throat, weight loss, aching joints, swelling of lymph nodes ("glands"), headache, kidney problems, irritation of the liver, stomach upset and even blurry vision to name a few symptoms. This stage can last for a few days to a couple of months. Even if this stage ends, it can occasionally come back (relapse) in a small percentage of people. When the secondary stage finishes, some people will never have symptoms again, even though they are not "cured." Many of these people are diagnosed with syphilis because of a blood test that is done. If these people have been infected for more than 1 year this is called latent syphilis. Even though they do not have symptoms, we still may be able to determine approximately when they had either primary or secondary syphilis; this may be done by reviewing if they have had symptoms or a chancre in the past, or by knowing if and when they have had a previous negative blood test. However, some persons will progress on to the last stage of syphilis known as late syphilis. This stage can occur from months to years (or even decades) after the secondary stage finishes. As with the secondary stage, there can be many different symptoms. However, some of the more serious effects here can include damage to major blood vessels (including the aorta), blindness, severe damage to nerve tissue in the brain which can lead to insanity, and difficulty with balance and stability. As one can see, syphilis is a very complex disease. During pregnancy, it can even be transmitted to the baby and cause a disease call congenital syphilis, which has serious health consequences for the baby; it may even cause the pregnancy to end with a miscarriage or stillbirth. Anyone who suspects that he/she has syphilis should contact his/her doctor. There is effective treatment for syphilis. Further, there are ways to prevent from getting syphilis. For more detailed information about syphilis, the reader is directed to the Centers for Disease Control and Prevention web page (Health topics A-Z).

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Response by:

Stephen   Kralovic, MD Stephen Kralovic, MD
Associate Professor
College of Medicine
University of Cincinnati