Syphilis in Australia: why cases are rising, and what to do

If syphilis sounds like a disease from the history books, the numbers say otherwise. After being pushed close to elimination in Australia, it has come roaring back — so much so that it’s now the subject of a formal, coordinated outbreak response. The good news hasn’t changed: syphilis is easy to test for and curable with antibiotics. The problem is that too many infections are missed until they’ve done damage. Here’s the full picture.

Is there really a syphilis outbreak in Australia?

Yes — and it’s an official one, not just a rising trend. Two formal declarations are in place:

• A Multijurisdictional Syphilis Outbreak (MJSO) has been running since 2011. It began in remote northern Queensland and spread through the Northern Territory, Western Australia, Queensland and South Australia, with the affected state and territory health departments managing a joint, declared response.
• Syphilis has since been declared a Communicable Disease Incident of National Significance — the national-level escalation — triggering a coordinated national response led through the Australian Centre for Disease Control.

On top of that outbreak, national surveillance shows infectious syphilis notifications climbing across the wider population; the Kirby Institute’s most recent sexual health data reported syphilis and gonorrhoea continuing to rise. In short: this is a genuine, well-documented, ongoing outbreak.

Who’s affected, and why it matters now

The outbreak began disproportionately among young Aboriginal and Torres Strait Islander people in regional and remote communities, and that remains a serious focus. But syphilis has since spread well beyond its original groups — into the broader heterosexual population, and among gay, bisexual and other men who have sex with men.

The most alarming shift is the rise in syphilis among women of reproductive age, because that has driven the return of congenital syphilis — syphilis passed from mother to baby in pregnancy. Once rare in Australia, congenital syphilis has re-emerged, and it can cause miscarriage, stillbirth, and serious illness or death in newborns. Almost all of it is preventable with testing and treatment during pregnancy.

Symptoms: why syphilis is so easily missed

Syphilis is called “the great imitator” because its signs are easy to mistake for something else — or to miss entirely. It moves through stages:

• Primary: a single, usually painless sore (a chancre) where the infection entered — genitals, anus or mouth. Because it doesn’t hurt and heals on its own, it’s often never noticed.
• Secondary: weeks later, a rash (often on the palms and soles), flu-like symptoms, swollen glands or patchy hair loss. These also fade on their own, which can create false reassurance.
• Latent: a silent phase with no symptoms, where the infection is still present and can still be passed to a baby in pregnancy.
• Tertiary: years later, untreated syphilis can seriously damage the heart, brain and nervous system.

The takeaway: you cannot rely on symptoms to tell you whether you have syphilis. Testing is the only way to know.

How syphilis is tested

Syphilis is diagnosed with a simple blood test, which is included as standard in a full STI screen alongside HIV, chlamydia and gonorrhoea. If you’ve had a possible exposure, a syphilis test is straightforward and can be arranged Australia-wide — at any pathology lab, through a telehealth consult, so you don’t need to explain yourself in a waiting room.

Is syphilis curable?

Yes. Caught in its early stages, syphilis is cured with antibiotics — usually penicillin, given by injection. Treatment is highly effective, and the earlier it’s given, the less chance there is of any lasting harm. After treatment, follow-up blood tests confirm the infection has cleared, and recent sexual partners need testing and treatment too, to stop it being passed back or onward.

How to protect yourself

• Test regularly if you’re sexually active — syphilis is part of a standard STI screen, and it’s often silent.
• Test in pregnancy — the single most important step for preventing congenital syphilis.
• Use condoms, which lower (though don’t entirely remove) the risk.
• Tell recent partners if you’re diagnosed, so they can be tested and treated — this can be done confidentially.
• Don’t wait for symptoms. The sore is painless and the rash fades — by the time you feel unwell, the infection may be advanced.

Common questions

Is there a declared syphilis outbreak in Australia?

Yes. A Multijurisdictional Syphilis Outbreak has been formally declared and managed since 2011 across northern and central Australia, and syphilis has also been declared a Communicable Disease Incident of National Significance, prompting a coordinated national response.

How do you get tested for syphilis?

With a blood test, usually as part of a full STI screen. You can arrange it through a telehealth consult and have the blood drawn at any pathology lab in Australia, with results by SMS.

Is syphilis curable?

Yes — it’s cured with antibiotics, usually penicillin by injection, and works best when treated early. Follow-up blood tests confirm it has cleared, and recent partners should be tested and treated too.

Why is congenital syphilis a concern?

Because syphilis can pass from mother to baby in pregnancy, causing miscarriage, stillbirth or serious newborn illness. It’s almost entirely preventable with testing and treatment during pregnancy, which is why antenatal syphilis testing matters so much right now.

Can syphilis have no symptoms?

Yes. The early sore is painless and the later rash fades on its own, and there are long silent phases. Many people have no idea they’re infected, which is why regular testing is the only reliable way to know.

Who should get tested for syphilis?

Anyone sexually active, as part of routine STI screening; anyone pregnant or planning a pregnancy; and anyone with a possible exposure or symptoms. Because syphilis is rising across the population, it’s worth including in a regular check even if you feel well.