Cause: Spirochete bacterium Treponema pallidum.

Illness and treatment: The disease occurs in four stages:

Primary Infection: The primary stage of syphilis infection is usually marked by the appearance of one or more sores (chancres) at the spot where syphilis entered the body. One is highly infectious during this primary stage, and infection will progress to the second stage if appropriate treatment is not administered.

Secondary Infection: Skin rash and mucous membrane lesions characterize the secondary stage. Other symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. Mucous patches on mucous membranes may also appear, as may wart-like lesions called condyloma lata. Without treatment, the infection will progress to the latent and late stages of disease.

 Latent Stage: Syphilis infection is referred to as latent when symptoms are not present. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms.

Latent syphilis is divided into two stages:

  • Early Non-Primary Non-Secondary (formerly “Early Latent”): This stage applies when an individual is asymptomatic and the earliest date of infection or exposure can be determined to have occurred within a year of diagnosis.
  • Unknown Duration or Late: This stage applies when an individual is asymptomatic and either the time of infection cannot be determined with certainty or the infection occurred more than 12 months prior to diagnosis. If the case remains untreated, late syphilis can persist for the remainder of the person’s life.

Congenital syphilis: This occurs when a mother infected with syphilis passes it on to their baby during pregnancy. Babies born to mothers with untreated syphilis can experience a variety of serious health complications, and the infection may cause a baby to be born stillborn or die as a newborn.  

Sources: Syphilis is sexually transmitted or acquired before birth.

Additional risks: Risk for syphilis is higher among men who have sex with men.

Prevention: Use safe sexual practices to reduce transmission.

Recent Washington trends: Rates have increased greatly since 1996, when 9 cases were reported. Recently over 1,000 primary and secondary cases have been reported annually. Rates are higher among males.

2021: 1,488 cases of primary and secondary syphilis were reported (19.2 cases/100,000 population).

View the most recent morbidity report on reported syphilis cases

Purpose of Reporting and Surveillance

  • To assess trends in epidemic patterns, understand the impact of the burden of infection on populations, the health care infrastructure, and to better target population-level infection prevention efforts
  • To assure the adequate treatment of infected individuals in order to reduce the duration of infectiousness and prevent sequelae of infection. (e.g., neurosyphilis, gumma)
  • To identify cases in a timely fashion in order to interrupt the chain of infection through patient-level interventions such as management of sexual contacts and behavioral risk reduction counseling

Legal Reporting Requirements

  • Health care providers: notifiable to local health jurisdiction within 3 business days
  • Health care facilities: notifiable to local health jurisdiction within 3 business days
  • Laboratories: notifiable to local health jurisdiction within 2 business days, specimen submission required to State Public Health Laboratory or Public Health, Seattle & King County laboratory
  • Local health jurisdictions: notify the Washington State Department of Health STD Services Section within 7 days of case investigation completion; summary information required within 21 days for all reported cases
  • Laboratories, health care providers, and health care facilities shall report the patient’s race, ethnicity, and preferred language as outlined in WAC Chapter 246-101