Syphilis is an uncommon disease in New Zealand that can be very serious if left untreated. The bacteria enter the body through tiny breaks in the skin or through the linings of the body cavities i.e. vagina, anus, mouth. Syphilis is almost always acquired by sexual contact. This disease is detected by a blood test.


First Stage The first sign of syphilis is an ulcer (chancre). The ulcer is not painful or itchy. It appears at the place where the germ enters the body, usually on the sex organs but sometimes elsewhere. Sometimes the ulcer is hidden in the rectum or anus (back passage) or vagina or mouth at sites of sexual contact. The ulcer usually appears about three weeks after contact but may occur at any time from 9 days to 90 days. It can vary in size from very small to that of a five cent piece or larger. There is usually only one ulcer. The glands in the groin may also become swollen, although this is normally painless. The ulcer will probably disappear of its own accord within a few weeks but the infection is still active in the body. This early stage is very infectious. Any genital ulcer must be examined by a doctor even if it starts to heal by itself and/or is small and painless. Second Stage A rash will appear, sometimes quite suddenly, about six weeks after infection. It may appear on the body, face, arms and often the palms of the hand and soles of the feet. The type and extent of the rash will vary from person to person and even vary on different parts of the body of the same person. It may be very obvious but it may be so mild as to pass unnoticed, and often disappears as suddenly as it appeared. The rash lasts about 4 to 6 weeks. There may also be one or more of the following symptoms present: mouth ulcers, headache, swollen glands, fever and flat, warty growths in the genital or anal region. A person in the first or second stage of syphilis is very infectious because the ulcer and the rash are teeming with syphilis germs and there is a risk of infecting a sexual partner. Late Stage The symptoms of the second stage will disappear even without treatment. After this there are usually no signs of the disease for at least five years and in many people there will be no harmful effects or further signs of the disease at all. In some people the syphilis germs will eventually cause damage to internal organs which may include the heart, brain and the nerves in the spinal cord. In late syphilis the doctor may advise a chest X-ray, and a lumbar puncture (spinal tap) to help assess if any of these parts of the body are affected. After two years the person is no longer infectious to others. Diagnosis is made by blood tests at any time during this stage. Treatment is still effective and can prevent further damage, but will not repair any damage that has already taken place.


The length of treatment varies according to the stage of the infection and the type of antibiotic used. In most cases penicillin injections are used but under certain circumstances the medication may be taken orally (by mouth). After treatment, follow-up blood tests are essential for two years to make sure the cure is complete. Your sexual partners must be advised to visit their doctor or STI clinic. This is the only way to control the disease and protect the health of sexual partners.


A pregnant woman who has syphilis can pass the germs through her bloodstream to her unborn baby if she does not get treatment. This may cause damage to the baby and cause the baby to be born with syphilis. Effective treatment of the mother during the pregnancy will prevent the baby being born with syphilis.

This page was last updated at 12:00PM on February 18, 2019.