Dear Dr Laura,
I live in the East of England and I’ve heard there’s been a bit of an outbreak of syphilis around these parts. Is that true and what’s your advice? Cheers.
Yes indeed, there’s been a surge in syphilis cases in the East of England, as in many parts of the UK. Syphilis is mainly found in men who have sex with men and particularly amongst those also living with HIV. Public Health England, who monitor sexually transmitted infections (STIs) and develop health information campaigns, have joined up with the Terrence Higgins Trust charity to create a campaign targeting the East of England:
You can read about it here: THT.org.uk/banana (the web page includes links to clinics in the East of England so you can find somewhere to get tested and, if necessary, treated)
Or follow #syphilisbanana on social media
Also check the link to sexual health services in the East of England: icash.nhs.uk
The campaign has been triggered by the reporting of over 300 cases of syphilis in the East of England in 2017 – an 11% increase on the previous year and an 82% increase over the last 5 years!
However, this doesn’t mean you need to be more concerned than if you lived in another part of England. The East of England has the lowest rate of STIs in the country, and although syphilis went up by 11% from 2016 to 2017, the rise was 20% across the whole of England.
In 2017, people in London were almost 2.5 times more likely to be diagnosed with an STI than people in the East of England. What is concerning is that fewer people in the East of England have STI testing than in other parts of the country and if STIs, including syphilis, are going up, this suggests that there may be people with undiagnosed infections passing them on to their sexual partners. The rates of positive chlamydia tests in young people are lower than they should be for the East, which also suggests that not enough of the people at risk are getting tested.
Although most UK syphilis cases are in gay men, anyone who is sexually active can get the infection. Condoms reduce the risk but don’t eliminate it altogether as syphilis can be passed on through contact with the skin or mouth of someone with the infection.
Symptoms include a small, painless ulcer (anything from a week to 3 months after exposure and usually on the genitals, bum or in the mouth) which may go unnoticed; this may be followed by a rash (classically affecting the palms of the hands or soles of the feet, sometimes the whole body) and lumps around the genitals and/or bum – all of which are infectious.
Without treatment, even without symptoms, someone with syphilis can pass it on for up to 2 years after being infected. Untreated syphilis can lead to serious complications – you can read more about these in my January 2019 Boyz article (boyz.co.uk/dr-laura-waters-boyz-docs-complete-guide-to-syphilis). Thankfully, syphilis is completely treatable with antibiotics.
So what can you do? If you have a new partner, both of you should have an STI screen. If you have casual partners we recommend you have STI tests every 3 months, or if you have symptoms (such as discomfort when you wee, discharge from the penis or bum, genital lumps or sores, a rash).
If a partner or a clinic gets in touch with you to say you’ve been in contact with syphilis (or any STI for that matter) you should get to a clinic for testing and, depending on the timing and symptoms, you may be offered treatment at the same time.
If you are diagnosed with an infection and started on treatment you should avoid sex for as long as the clinic advises (this is because condoms are not 100% effective and very few people use them for oral sex which is an important way of passing STIs on).
If nothing else, remember #syphilis banana!
The Boyz Doc is Dr Laura Waters, an HIV and sexual health consultant at the Mortimer Market Centre in central London. Dr Laura answers your questions every week in Boyz. If you have a question for Dr Laura please email her at email@example.com