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Syphilis: Testing and Treatment
Medically reviewed by Dr Vafa Derakshan, MBBS, FRACGP · AHPRA MED0001663310 · Last reviewed: 23 September 2026
Syphilis is rising across Australia, with around 6,000 diagnoses a year. In August 2025 the Chief Medical Officer declared it a Communicable Disease Incident of National Significance. It's easy to test for with a blood test, and it's curable with treatment.
Symptoms
- Primary syphilis: a painless sore on the genitals, anus or mouth, appearing 10 to 90 days after infection. Because it doesn't hurt, it's easy to miss.
- Secondary syphilis: from about 6 weeks after infection, a rash (sometimes only on the palms and soles), fever and swollen glands.
- Latent syphilis: no symptoms, but the infection is still there and shows on a blood test.
- Late syphilis: without treatment, it can cause serious damage to the heart, brain and nerves years later.
How you're tested
Syphilis is diagnosed with a blood test. If you have a sore, a swab from the sore is also taken. Blood tests can miss very early infection, so if you have a sore or a recent exposure, your doctor may repeat the test after 2 weeks. We send a bulk-billed pathology request to your phone for any local collection centre.
Treatment: why it needs an in-person visit
Syphilis is treated with antibiotic injections: one dose for early syphilis, or weekly for 3 weeks for late syphilis or when the timing isn't known. Because treatment is an injection, it can't be completed by telehealth. If you test positive, we'll explain your results and refer you to a local GP or public sexual health clinic for treatment. After treatment, avoid sex for 7 days, and have follow-up blood tests at 3, 6 and sometimes 12 months to check it's worked.
Partners
Recent partners need to be tested and treated. How far back depends on the stage, from 3 months up to 12 months or more. You can tell them anonymously through Let Them Know. Syphilis is a notifiable condition, which means positive results are reported confidentially to the state health department.
Syphilis in pregnancy
Syphilis can pass to a baby during pregnancy and can cause stillbirth or serious illness. Between 2016 and 2024, 99 babies in Australia were born with congenital syphilis and 33 died. National guidelines recommend testing at the first antenatal visit, at 26 to 28 weeks, and at 36 weeks or birth. If you're pregnant or planning a pregnancy, get tested.
How often to test
If you're sexually active, test regularly, especially with new partners. Gay, bisexual and other men who have sex with men should have a full STI check, including a syphilis blood test, every 3 months. A syphilis test is part of our standard STI check.
Frequently asked questions
Can syphilis be treated online?
Not fully. Syphilis is treated with antibiotic injections, which need an in-person visit. We'll arrange a referral to a local GP or sexual health clinic if you test positive.
Is syphilis curable?
Yes. Antibiotic injections cure syphilis. Follow-up blood tests at 3, 6 and sometimes 12 months confirm the treatment has worked.
How do I get tested for syphilis?
With a blood test at any local pathology collection centre. If you have a sore, a swab from the sore is taken too. Very early infection can be missed, so your doctor may repeat the test.
Why is syphilis testing important in pregnancy?
Syphilis can pass to a baby and cause stillbirth or serious illness. National guidelines recommend testing at the first antenatal visit, at 26 to 28 weeks, and at 36 weeks or birth.
Sources: ASHM Australian STI Management Guidelines: Syphilis; Healthdirect: Syphilis; Kirby Institute: Syphilis data; Australian Prescriber: High prevalence of syphilis in Australia (2026); Chief Medical Officer statement on syphilis (2025).
