Seeking the truth about Syphilis

[stdscared411]

I am a married male and 60 days ago I had brief oral sex with another married male.  He assured me at the time that he was completely "clean".   We did not exchange any bodily fluid, engage in other behavior or kiss and the encounter was brief.  I did not notice any sores on his penis.  I am aware that M2M is the biggest group affected by STD's.  

2 days ago I discovered a chancre sore on the top of my mouth.  It is not very sore...although, I can feel it with my tongue.

What is the risk of catching syphilis from:

1.  Oral sex with another male?
2.  Exchanging mutual nude massage, no sex.
3.  Kissing
4.  Mutual fingering

Thank you in advance for your time and answer.  There is so much information on the web that it has caused me a lot of anxiety and I find it very confusing whom to trust.  

[Edward W Hook, MD]

Ten days would be quite early for a syphilis sore to appear.  I though you said it did not appear until 60 days?

If you are not inimate, tehre should be no meaningful risk for transmission.  I would not be concerned.

Before you get too far into the "what ifs" however, I suggest you go get tested and find out once and for all if you do have syphilis.  I doubt that you do. EWH

[stdscared411]

Thank you for your comment.  I have a couple of other questions...related to the 1st.  
Can a sore appear as early as 10 days?  Can syphilis be spread to members of ones household, whom they are not being intimate with?  I am not intimate with my wife, so should I be concerned there??

Thank you again for your help.

[Edward W Hook, MD]

Glad to help.  EWH

[Vance2335]

Yes was thinking about the dry not open ones that I have seen pictures of, thank you Dr.Hook for the detail.

[Edward W Hook, MD]

Great question Vance. The research on this subject shows that there are treponemes (the syphilis bacteria) present in the lesions (usually a rash) of secondary syphilis but not all lesions are "created equal", at least in terms of transmission.  If the secondary syphilis lesion is ulcerated and weepy, infection could occur.  Most lesions of secondary syphilis however are dry and not open and therefore are not infectious.  It is clear that the lesions of secondary syphilis are considerably less infectious than the lesion (sore/chancre) of secondary syphilis.

It is confusing but I hope that this information is helpful.

...and thanks for all that you do on our Community sites Vance.  EWH

[Vance2335]

Hello Dr.Hook I am wondering if you would be able to help me out with something. I answer questions on the free STD forum a lot and have gotten into a discussion with another person who answers about syphilis transmission.

We all agree that a canker can/will transmit syphilis but this other person believes that the rash that is associated with the 2nd stage will also transmit syphilis, and even found it on some websites.

I assume that if this was true that most people with this rash would not be engaging in sexual activity so it is not really classified as a mode of transmission. Or is it not possible to transmit form the sore stage?

Thanks

[Edward W Hook, MD]

Welcome to our Forum. I'll be glad to comment. The likelihood that the lesion you have noted is syphilis is low and even that low possibility can be eliminated with a blood test at this time.

Syphilis is a rare disease in the U.S.  This year there will be 10-12,000 new cases of syphilis in our national population of over 350 million.  About 2/3 of those cases will occur among men who have other men as sex partners.  

The disease is transmitted by DIRECT contact with an infectious lesion.  Lesions can occur just about anywhere so any of the sorts of contact you mention could, at least in theory, lead to transmission however, if  you handled or examined your partner’s penis and did not see a lesion, then it is unlikely that he had syphilis to transmit to you.  Further, if he had transmitted syphilis, you would be expected to have developed a sore within a month (average 21 days) of your exposure, not out to 60 days.

the odds that the sore you have noted is due to syphilis are very, very low.  You can completely rule out the possibility however with a blood test.  If you are tested at this time and your test is negative, they the sore in your mouth is not syphilis.

I hope this comment is helpful. EWH