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Once you understand how people pass syphilis to one another, you can figure out whether you're at risk. The disease is transferred from one person to another through contact with a syphilis sore. These sores may appear externally on the penis and outer vaginal area, or internally in the vaginal canal, anus, and rectum. They may also be present on the lips and inside the mouth.  If you've had vaginal, anal, or oral sex with someone infected with the disease, you are at risk of contracting syphilis. However, you need to come into direct contact with an infected lesion. Syphilis cannot be spread by shared eating utensils, toilet seats, doorknobs, hot tubs or swimming pools. Men who have sex with men (MSM) are significantly more likely to contract syphilis, with 75% of reported new syphilis cases in 2013. It's especially important to use safer sex practices if you are a man who has sex with men. The early stages of the disease do not have significant noticeable symptoms, and many people don't even know that they have syphilis. Even if carriers do notice sores and symptoms, they may not recognize them as an STD, and may leave them untreated for long periods of time. Because the minor sores can progress gradually from 1-20 years after the initial infection, carriers may unknowingly pass the disease on to others. Syphilis has 3 stages: primary, secondary, and tertiary/late stage. The primary stage usually begins about 3 weeks after the first exposure to a syphilis sore. However, symptoms might begin to appear anywhere between 10 and 90 days after exposure.  The primary stage of syphilis most often begins with the appearance of a painless sore called a “chancre,” which is small, hard, circular, and painless. Although there is usually just one sore, there may be more. The sore appears where the disease entered the body. Common infection sites include the mouth, genitals, and anus.  The sore will heal on its own in 4 to 8 weeks, and won't leave a scar. However, this does not mean that the syphilis is gone. Without proper treatment, the infection simply moves on to the second stage. The secondary stage of syphilis usually begins 4 to 8 weeks after the initial infection, and lasts between 1 and 3 months. This stage begins with a "maculopapular rash" on the palms of the hands and the soles of the feet. This type of rash doesn't usually itch, but causes rough, reddish brown spots on the skin. Other rashes with a slightly different appearance may show up on other parts of the body at this time. People usually either don't notice these rashes or assume they have other causes. This usually results in delayed treatment of their actual cause.  Other symptoms eventually appear in this stage as well. They too are sometimes mistaken for other problems, such as the flu or stress. These symptoms include: fatigue, muscle aches, fever, sore throat, headaches, swollen lymph glands, patchy hair loss, and weight loss.  About a third of those who don't get treatment during the secondary syphilis stage will develop latent or tertiary syphilis. The latent stage is the symptom-less period that precedes the appearance of tertiary stage symptoms. The latent stage begins when the symptoms of stages 1 and 2 disappear. The syphilis bacteria is still in the body, but there are no longer any signs or symptoms of the disease. This stage can last for years. However, about a third of those who go untreated during the latent stage will develop the tertiary stage of syphilis, which has severe symptoms. Tertiary stage syphilis may not show itself until 10 to 40 years after the initial infection.  Tertiary stage syphilis can see damage to the brain, heart, eyes, liver, bones, and joints. This damage may be serious enough to cause death. Other symptoms of the tertiary stage include difficulty with muscle movement, numbness, paralysis, progressive blindness, and dementia. If a pregnant woman has syphilis, she can transfer disease-causing bacteria to the unborn child through the placenta.  Proper prenatal care should help prepare your doctor for any complications. The most common symptoms seen in babies born with syphilis include:  Intermittent fevers Enlarged spleen and liver (Hepatosplenomegaly) Swollen lymph nodes Chronic sneezing or runny nose with no apparent allergic cause (persistent rhinitis) Maculopapular rashes on the palms and soles

Summary:
Understand how people get syphilis. Be aware that syphilis carriers can go years without knowing they have it. Recognize the symptoms of primary stage syphilis. Tell the difference between primary and secondary stage syphilis. Learn to identify the symptoms of latent and tertiary stage syphilis. Be vigilant for syphilis symptoms in babies.