Syphilis is caused by a bacteria-like spirochete called Treponema pallidum subspecies pallidum. It's spread through unprotected sex and from an infected pregnant woman to her baby across the placenta. All pregnant women are offered syphilis screening as part of the antenatal screening programme and testing is also performed on all blood donations.

Infectious or early stage syphilis is characterised by three phases: primary, secondary, and early latent. Late or tertiary stage syphilis can develop in a proportion of people if the infection is undiagnosed and untreated.

Syphilis can be treated with antibiotics but it's important to treat it correctly to prevent late or tertiary stage syphilis which can occur many years later and cause serious illness.

For further information on symptoms and where to get a test, please visit the NHS Inform website.


Guidance on the management of syphilis is available on the British Association of Sexual Health and HIV (BASHH) website.


The Blood borne viruses (BBV) and sexually transmitted infections (STI) report, produced by our BBV and STI team, describes the epidemiology of Hepatitis C, Hepatitis B, human immunodeficiency virus (HIV) and other STIs in Scotland to the end of December 2016. It also describes the impact of interventions in preventing infection and associated disease and highlights public health priorities. The report also signposts readers to other existing Scottish reports and data sources, these are available on our website. The commentary is structured around the outcome indicators detailed in the Scottish Government’s Sexual Health and Blood Borne Virus (SHBBV) Framework, 2015 to 2020.

Data and surveillance

Enhanced surveillance data on diagnoses of infectious syphilis are available from the National Enhanced Surveillance of Infectious Syphilis Scotland (NESISS). This surveillance system was established in December 2002. Health Protection Scotland collates laboratory and clinical information on infectious syphilis diagnoses from two sources:

  • sexual health clinics: demographic and behavioural information on individuals diagnosed at clinics
  • diagnostic laboratories: details of test results through the Electronic Communication of Surveillance in Scotland (ECOSS) system or directly from microbiology laboratory staff

View our the latest syphilis in Scotland annual report

View Scotland's Sexual Health Information (SSHI 2013): Health Protection Scotland Slide Set

Sexual health and blood borne virus framework

The Sexual Health and Blood Borne Virus Framework, first published by the Scottish Government in August 2011 and updated in September 2015, brought together policy areas on sexual health and blood borne viruses, namely human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV). The framework supports improvements in sexual health and wellbeing and addresses the impact of blood borne virus infection in Scotland. The framework seeks to strengthen and improve multi-agency partnerships to address the five high-level outcomes:

  1. Fewer newly acquired blood borne viruses and STIs; fewer unintended pregnancies
  2. A reduction in the health inequalities gap in sexual health and blood borne viruses
  3. People affected by blood borne viruses lead longer, healthier lives
  4. Sexual relationships are free from coercion and harm.
  5. A society whereby the attitudes of individuals, the public, professionals and the media in Scotland towards sexual health and blood borne viruses are positive, non-stigmatising and supportive.