It's Back: Stomp Out Syphilis, with a man kissing a man on the cheek

Syphilis is on the rise in Wake County!

According to the CDC, reported syphilis cases increased 80% in the United States between 2018 and 2022. Wake County saw 317 new cases in 2023.

Women who can get pregnant are now becoming infected more often than they were 10 years ago. This is referred to as congenital syphilis and can cause serious risk to mothers and babies.

What is syphilis?

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent and tertiary). Each stage can have different signs and symptoms. If left untreated, syphilis can cause serious health problems.

The good news? Syphilis is easily treatable if caught early. So don’t wait, help us stomp out syphilis once and for all.

Get Tested. Get Treated.

FREE, confidential testing and treatment for syphilis:

  • Wake County HIV/STD Walk-In Evening Clinic – No appointment needed!
    • Wake County Public Health Building – Clinic E (10 Sunnybrook Road, Raleigh, NC 27610)
    • Testing for HIV, Syphilis, Chlamydia, Gonorrhea, and Hepatitis C
    • Every Tuesday and Thursday, 5:30–7:30 p.m. (follow-up test results are given on-site between 7:30–8 p.m.)
    • Questions?
  • Wake County Public Health Clinics
    • Testing and treatment of sexually transmitted diseases.
    • Appointments recommended! Walk ins are on a first come, first served basis.
    • Call to make an appointment: 919-250-4410
    • Hours: Monday–Friday, 8:30 a.m.–5 p.m.
    • Locations:
      • Public Health Center – Clinic A
        10 Sunnybrook Road
        Raleigh, NC 27610
      • Eastern Regional Center
        1002 Dogwood Drive
        Zebulon, NC 27597
      • Northern Regional Center
        350 E. Holding Ave.
        Wake Forest, NC 27587
      • Southern Regional Center
        130 N. Judd Parkway NE
        Fuquay-Varina, NC 27526

Signs and Symptoms

Know the signs and symptoms of syphilis. The infection can progress through four different stages and causes different symptoms in each stage. People are very contagious in the first and second stages and can easily pass the infection to their sexual partners. The stages of syphilis are primary, secondary, latent and late (tertiary) syphilis.

Primary Syphilis

The first stage of syphilis happens two to 12 weeks after exposure. During this stage, you may notice one or more sores (called chancre). The sores are the location where syphilis enters your body. These sores usually occur in or around the penis, vagina, anus, rectum, lips or inside of the mouth. They are painless, round and usually (but not always) firm to the touch.

The sore usually goes away on its own in a few weeks or months; however, this doesn’t mean you don’t have syphilis anymore. If you don’t receive treatment with medication, the infection moves to the second stage. You can pass syphilis through vaginal, anal or oral sex during this stage.

See examples of primary stage syphilis

Secondary Syphilis

During the secondary stage a rough, bumpy syphilis rash appears. The rash can be on the palms of your hands and soles of your feet and look rough, red or reddish-brown. The rash can show up while your primary sore is healing or several weeks after it has healed.

The rash doesn’t usually itch. You may also have symptoms such as:

  • Fever
  • Fatigue
  • Wart-like sores
  • Muscle aches
  • Weight loss
  • Headaches
  • Hair loss
  • Swollen lymph nodes

The symptoms from the secondary stage go away without treatment, but if you don’t receive the right treatment your syphilis infection will move to the next stage and can cause serious health problems.

See examples of secondary stage syphilis

Latent Stage

If you don’t receive treatment during the first two stages, the infection moves into the latent stage. You will not have visible signs or symptoms during this stage; however, without treatment syphilis can stay in your body for years.

This stage can last up to 20 years. It’s rare to pass syphilis to your sex partners during the latent stage. Without treatment, the infection progresses to the late stage.

Tertiary Stage

Developing tertiary syphilis is rare but serious. It can many organs and systems. This stage starts 10–30 years after your infection began. It damages your internal organs and can cause death.

Neurosyphilis, Ocular Syphilis & Otosyphilis

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described above.

Signs and symptoms of neurosyphilis can include:

  • Severe headache
  • Muscle weakness and/or trouble with muscle movements
  • Changes to your mental state (trouble focusing, confusion, personality change) and/or dementia (problems with memory, thinking, decision making)

Signs and symptoms of ocular syphilis can include:

  • Eye pain and/or redness
  • Changes in your vision or even blindness

Signs and symptoms of otosyphilis may include:

  • Hearing loss
  • Ringing, buzzing, roaring or hissing in the ears (“tinnitus”)
  • Dizziness or vertigo (feeling like you or your surroundings are moving or spinning)

Congenital Syphilis

Congenital syphilis is a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. It can have major health impacts on the baby. Severity depends on how long a mother had syphilis and if – or when – they got treatment for the infection.

Wake County is seeing a spike in cases of congenital syphilis is expectant mothers and their newborns.

Congenital syphilis can cause:

  • Miscarriage (losing the baby during pregnancy),
  • Stillbirth (a baby born dead),
  • Prematurity (a baby born early),
  • Low birth weight, or
  • Death shortly after birth.

For babies born with congenital syphilis, it can cause:

  • Deformed bones,
  • Severe anemia (low blood count),
  • Enlarged liver and spleen,
  • Jaundice (yellowing of the skin or eyes),
  • Brain and nerve problems, like blindness or deafness,
  • Meningitis, and
  • Skin rashes.


ALL pregnant women should be tested for syphilis at their first prenatal visit. If you’re pregnant and have not been tested, ask your doctor about getting a test at your next checkup and your individual risk factors.

Learn more about congenital syphilis.

Reduce Your Risk

How can you reduce your risk of getting syphilis? The only way to completely avoid syphilis and other STIs is to not have vaginal, oral or anal sex. If you do have sex, you can be safer by:

  • Maintaining a monogamous sexual relationship with one partner who has been tested and is not infected.
  • Condoms, when used consistently and correctly, can reduce the risk of syphilis only when the infected areas are covered or protected by the condom.
    • Always use condoms during vaginal and anal sex.
    • Use a condom for oral sex on a penis.
    • Use a barrier (dental dam or condom cut in half) for oral sex on a vagina or anus.

Contact Us

Wake County HIV/STD Program