Caused by the bacterium Treponema pallidum, syphilis is a sexually transmitted infection (STI) that is curable, but if not diagnosed and treated, it can cause complications. The alert to care, attention and prevention are reinforced every third Saturday of October, on the National Day to Combat Syphilis and Congenital Syphilis. In this context, the Ministry of Health runs an information campaign through social networks.
The disease presents in primary, secondary, latent and tertiary stages. In the primary and secondary stages, the possibility of transmission is greater, via sexual intercourse with an infected person. The most serious cases of acquired syphilis are observed in the tertiary phase, because if there is no adequate treatment, serious complications can arise, such as skin, bone, cardiovascular and neurological lesions, which can lead to death. At all stages, syphilis can be transmitted to a child during pregnancy or childbirth.
In 2021, more than 167 thousand new cases of acquired syphilis were registered in Brazil, with a detection rate of 78.5 cases for each group of 100 thousand inhabitants; 74 thousand cases in pregnant women, with a rate of 27.1 for every 1 thousand live births; 27,000 occurrences of congenital syphilis, with a rate of 9.9 in children under one year of age per 1,000 live births; and 192 deaths from congenital syphilis, with a rate of 7.0 per 100,000 live births.
Until June 2022, 79,587 cases of acquired syphilis, 31,090 cases of syphilis in pregnant women and 12,014 cases of congenital syphilis were registered in the country.
“The testing rate has increased, which makes it possible to expand the diagnosis of the disease, especially among pregnant women, and also to offer treatment in a timely manner”, observes the general coordinator of Surveillance of Sexually Transmitted Infections at the Ministry of Health, Angelica Espinosa Miranda. .
The rapid syphilis test is available at SUS health services, being practical and easy to perform, with reading the result in a maximum of 30 minutes, without the need for a laboratory structure. In 2022, until September, 9.5 million rapid tests were distributed to all states and the Federal District. The number exceeds the number of deliveries made in the whole of 2021, which was 9.03 million.
prevention and treatment
To prevent syphilis, it is essential to use male or female condoms. It is the only way to avoid the disease. In 2022 alone, Brazil distributed 293.9 million male and 4.5 million female condoms to the 26 states and the Federal District.
Syphilis is treated with antibiotics, which can be found in Basic Health Units. In the case of pregnant women, due to the risk of transmission to the fetus, treatment should be started only with a positive test, without having to wait for the result of the second test.
Syphilis infection can put both the adult and the baby at risk during pregnancy. Therefore, monitoring and testing of pregnant women and sexual partners during prenatal care is recommended in order to prevent congenital syphilis.
Congenital syphilis can have serious consequences for the baby, such as deafness, blindness, bone changes and mental deficiency, which can lead to death. Therefore, every pregnant woman should be tested in the first prenatal consultation (ideally, in the 1st trimester of pregnancy); at the beginning of the 3rd trimester (28th week); at the time of delivery, or in case of abortion/stillbirth, regardless of previous examinations.
To reinforce actions to combat congenital syphilis in Brazil, the Ministry of Health instituted the Seal of Good Practices towards the Elimination of Vertical Transmission of Syphilis and/or HIV. In 2022, 45 municipalities with more than 100 thousand inhabitants applied to receive certification. For syphilis, 21 proposals were submitted and are being analyzed by the national certification commission, being two for the gold category, 14 silver and five bronze. The delivery of certificates will be held at an event on December 7th.
Signals and symptons
Symptoms vary with each stage of the disease. In the primary phase, the appearance of a wound on the penis, vulva, vagina, cervix, anus, mouth or other skin sites occurs between 10 and 90 days after infection. This sore does not cause pain, itching, burning or the appearance of pus, and may be accompanied by bumps (lumps) in the groin. The wound goes away on its own, regardless of treatment.
In secondary syphilis, signs appear between six weeks and six months after the appearance and healing of the initial wound. Spots may appear on the body, which usually do not itch, including the palms and soles of the feet. Fever, malaise, headache, and body swelling may also occur. The spots disappear in a few weeks, regardless of treatment, giving the false impression of healing.
Tertiary syphilis can appear between one and 40 years after the onset of infection and usually presents with cutaneous, bone, cardiovascular and neurological lesions.
A person can have syphilis and not know it, because the disease can appear and disappear, but remain latent in the body. The asymptomatic phase is called latent syphilis, without symptoms or signs, divided into recent (up to one year of infection) and late (more than one year of infection).
The Special Epidemiological Bulletin on Syphilis – 2022 is available by clicking here.
Learn more about the disease on the Health A to Z page.
Ministry of Health
Official content – Fact Check – Verified