Syphilis is a sexually transmitted infection caused by a spiral-shaped bacterium called Treponema pallidum. The infection is usually transmitted through contact with a wound during sexual contact with an infected person. A mother can also pass the infection to her fetus during pregnancy (congenital syphilis). Rarely, syphilis can be transmitted through the contact-bite route. There are certain risk factors that increase the likelihood of contracting syphilis. Infection can also occur through blood – contaminated shared medical needles and non-sterile instruments. Sexual contact is the main way people get syphilis. The corkscrew shape of the bacteria allows them to penetrate the mucous membranes of the vagina or rectum, or enter microscopic cracks in the skin. In sexually active people, syphilis is transmitted almost exclusively through oral, vaginal, or anal sex. The infection can also be passed from one person to another through a kiss if one partner has a sore in their mouth, although this form of transmission is not as common. If left untreated, syphilis goes through four stages: first, second, latent and third. The risk and mode of transmission can vary according to the stage of syphilis: During the first stage, syphilis can be transmitted through contact with sores, which can be hard round or painless; During the second, it can be transmitted by contact with the syphilitic rashes; During the latent stage of infection, there are no signs and symptoms for an indefinite period of time, however, the disease can be transmitted to other people; During the third stage, the disease has spread to other organs and is highly likely to be transmitted to other people. Syphilis can hardly be transmitted through casual contact or shared use of utensils (spoons, forks, knives) or personal hygiene items (toothbrushes, dental instruments). This is because T. pallidum has a fragile shell that lacks the components needed to keep the bacterium out of the body for long periods of time. Perinatal transmission of syphilis, also known as congenital (congenital) syphilis, occurs when the bacteria in the mother crosses the placenta around the developing fetus. Although this can happen during any stage of pregnancy, the probability is highest in the second half. The risk of transmitting the infection varies depending on the stage of the mother’s infection. Syphilis of the newborn baby appears a few months after birth. Although syphilis can affect anyone, there are a number of risk factors that can increase the chance of infection. Among the most common risk factors are: Inconsistent use of condoms. This is the main cause of disease transmission in all groups; Multiple sexual partners. This poses a risk due to the increased risks of exposure to the bacteria. This is especially true among anonymous partners,that are found in online platforms; Persons with non-traditional sexual orientation; Physiological vulnerabilities, such as fragility of rectal tissues; Using common medical needles. References: 1. Centers for Disease Control and Prevention. Syphilis – CDC fact sheet 2. Cooper JM, Sánchez PJ. Congenital syphilis 3. Peeling RW, Mabey D, Kamb ML, Chen XS, Radolf JD, Benzaken AS. Syphilis 4. Verywell Health. Causes and Risk Factors of Syphilis