This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

Syphilis is a bacterial infection that has been known for centuries, and it is still part of public health work in Orange County today. It can cause very different signs at different times, and sometimes it causes none that a person notices.

This guide explains how syphilis behaves, what the symptoms and the rash can look like, how blood tests work, and how a clinician treats it. It also covers the Orange County and Florida numbers and the places in Orlando that offer free or low-cost testing.

Nothing here can tell you whether you have syphilis. Only a clinician and a blood test can do that.

The short answers

Many readers arrive with the same few questions, so here they are first.

Is syphilis curable? Yes. The CDC STI Treatment Guidelines (2021) say penicillin G is the preferred treatment for all stages, and a clinician prescribes it. Treatment can stop the infection from progressing. It cannot reverse damage that has already happened, which is one reason finding it early matters.
How is it found? Usually with a blood test. A clinician may also test fluid from a sore in some situations.
Can it be missed? Yes. The CDC notes that the early sore can go unnoticed and that signs of the later stages can fade without treatment. A test is the only way to learn more.
Where can I get tested in Orlando? Several clinics offer free or low-cost testing. They are listed further down.

What causes syphilis: the organism

This section covers the science that usually goes under the heading of composition. Syphilis is not caused by a chemical. It is caused by a bacterium called Treponema pallidum, subspecies pallidum, which is a spiral-shaped organism known as a spirochete.

Research suggests a few features of this organism explain why syphilis behaves the way it does.

It is thin and fragile outside the body. It does not survive well in the environment, which is why the CDC describes spread as happening through direct contact with a syphilis sore during vaginal, anal or oral sex.
It moves through tissue and the bloodstream. Observations from decades of clinical work show that the bacteria can spread through the body early in infection. This helps explain why a rash can appear far from the original sore.
It is hard to grow in a lab. Researchers have long reported that T. pallidum is difficult to culture. That is why diagnosis relies mostly on blood tests that look for the body's response, not on growing the bacteria.
It has stayed sensitive to penicillin. The CDC guidelines state that penicillin resistance has not been documented in T. pallidum. This is a major reason penicillin remains the standard.

Penicillin belongs to a drug class that interferes with how bacteria build their cell walls. A clinician chooses the exact product and schedule. This article does not give doses, because they depend on the stage and on each person's health.

The stages of syphilis and what they can look like

The CDC describes syphilis in stages. Not everyone moves through each one in a neat order, and the timing varies a great deal from person to person.

Primary stage

The CDC describes the first sign as a sore called a chancre. It often appears where the bacteria entered the body, such as the genitals, anus or mouth. It is usually firm, round and painless.

Because it can be painless and can sit inside the vagina, rectum or mouth, it is easy to miss. The CDC says the sore heals on its own, usually within a few weeks, even without treatment. Healing does not mean the infection is gone.

Secondary stage

This is the stage where the syphilis rash often appears. According to the CDC, the rash can show up as the first sore heals or several weeks after. It may look like rough, reddish-brown or pink spots, and it often involves the palms of the hands and the soles of the feet. It usually does not itch.

The rash can also be faint, or it can look like other skin conditions. The CDC notes that it may be so mild that it goes unnoticed.

Other syphilis symptoms in this stage that the CDC lists include:

Fever
Swollen lymph nodes
Sore throat
Patchy hair loss
Headaches
Weight loss
Muscle aches
Tiredness
Moist, wart-like patches in warm areas of the body

Many of these are common to many illnesses. A rash on its own is not a way to tell what is going on. A clinician can look at it and order a test.

Latent stage

The CDC describes a stage with no visible signs, where the infection is still present. A blood test is the only way it is detected. It can last for years.

Tertiary stage

The CDC says that without treatment, some people go on to develop serious problems years or even decades later. These can involve the heart, blood vessels, brain and nervous system, and other organs. This stage is uncommon where treatment is available, and it is one of the main reasons public health agencies encourage testing.

Neurologic, eye and ear involvement

The CDC states that syphilis can affect the nervous system, the eyes or the ears at any stage. Changes in vision, hearing loss, severe headache or confusion are reasons to see a clinician promptly. A clinician decides what tests and care are appropriate.

Why the national rise matters

The CDC reports in its national surveillance data that syphilis cases have risen over most of the past two decades, after having fallen to historic lows around the year 2000. The CDC has also reported a sharp rise in congenital syphilis, which is syphilis passed from a pregnant person to a baby.

That matters for a few practical reasons.

It is not limited to one group. The CDC describes increases among men who have sex with men, and also among women and heterosexual men. Anyone who is sexually active can be exposed.
Congenital syphilis is preventable. The CDC says testing during pregnancy and treatment on time can prevent it. This is why prenatal screening is part of routine care.
Signs are easy to miss. When a condition is rising and often silent, regular testing does more than waiting for symptoms.

The USPSTF recommends syphilis screening for pregnant people and for people at increased risk of infection. A clinician can help you work out which applies to you.

Orlando and Florida numbers

The Florida Department of Health publishes case counts through FLHealthCHARTS. The figures below are for 2025 and are for Orange County as a whole. No Orlando city-only figure was available.

Infectious syphilis (FLHealthCHARTS indicator): Orange County recorded 9.3 cases per 100,000 people, or 143 cases. Florida as a whole recorded 12.4 per 100,000, or 2,903 cases.
New HIV diagnoses: Orange County recorded 25.1 per 100,000 (385 new diagnoses), compared with 15.0 per 100,000 (3,512) statewide, according to FLHealthCHARTS. This is worth knowing because syphilis and HIV can occur together, and a clinician may suggest testing for both.

The county rate for this syphilis indicator is lower than the state rate. Rates are not a measure of any one person's chance of having an infection. They describe how many cases were reported. Many infections are never tested for, so the real number is likely higher.

FLHealthCHARTS did not provide a congenital syphilis figure for Orange County that could be confirmed for this article. To ask about local congenital syphilis data, contact the Florida Department of Health in Orange County.

How blood tests for syphilis work

The CDC STI Treatment Guidelines (2021) describe two kinds of blood tests. Most testing uses both, because together they give a clearer picture than either one alone.

Treponemal tests

These look for antibodies that the body makes in response to the T. pallidum bacterium itself. Examples named in the guidelines include enzyme immunoassays, chemiluminescence immunoassays, the TP-PA test and the FTA-ABS test.

The CDC notes that these tests usually stay positive for life, even after successful treatment. A positive result alone cannot tell a clinician whether an infection is recent, old or already treated.

Non-treponemal tests

These include the RPR and VDRL tests. They measure a different kind of antibody response, one connected to the tissue damage the infection causes. The result is reported as a number called a titer, such as 1:8.

The CDC explains that titers tend to rise with active infection and fall after treatment. That makes them useful for following how someone responds to care over time.

Why two tests

A clinic or laboratory may run the tests in either order. The CDC guidelines note that each test alone can produce results that need a second look. A clinician reads them together with your history and any physical findings.

What about the timing after an exposure?

Antibodies take time to appear after infection, so a test taken very soon after an exposure may not show it yet. The CDC does not publish one fixed window period for syphilis that is suited to every test. A clinician can advise you about timing and whether to repeat a test. If you are unsure, ask the clinic when you call.

Treatment: what a clinician prescribes

The CDC guidelines name penicillin G as the preferred treatment for syphilis at every stage. The form and length of treatment depend on the stage, and a clinician decides this. Please do not try to treat syphilis with leftover or borrowed antibiotics. They may not work, and they can hide signs while the infection continues.

Here is what the CDC says about the cure question:

Treatment is considered curable for the infection itself. Because of this, the answer to is syphilis curable is yes.
Treatment stops further damage but cannot repair damage that has already occurred.
Being treated once does not protect against getting syphilis again. A person can be re-infected.

The CDC also advises that sexual partners may need testing and treatment. A clinician or the health department can explain how this works. The Florida Department of Health in Orange County handles STD surveillance and can answer questions about talking to partners.

Safety profile and contraindications

Penicillin has been used for syphilis for many decades, and the CDC guidelines treat it as the standard. A few points about safety come up often.

Penicillin allergy

Some people have a documented penicillin allergy. Many people who think they are allergic turn out not to be when a clinician evaluates them. The CDC suggests allergy assessment when it is possible. For people who are not pregnant, a clinician may consider other medicines, and the guidelines describe a closer follow-up approach for those options.

Tell the clinician about any past reaction, including what happened and when. This is the most important safety step.

Pregnancy

The CDC guidelines state that penicillin is the only recommended treatment known to prevent passing syphilis to a baby. Pregnant people with a penicillin allergy are generally referred for allergy evaluation and desensitization so they can still be treated with penicillin. A prenatal care clinician handles this.

The Jarisch-Herxheimer reaction

The CDC describes a short-term reaction that can occur within the first day after treatment starts. It can include fever, chills, headache and muscle aches. It usually passes within about a day. It is not an allergy, but it can feel unpleasant. Ask the clinician what to expect and when to call if symptoms are strong.

HIV and other conditions

People who also have HIV may have a different follow-up schedule. Anyone with a weakened immune system, or with neurologic, eye or ear symptoms, may need additional evaluation. A clinician decides.

Follow-up blood tests

Treatment is not the last step. The CDC guidelines describe follow-up blood tests to check that the non-treponemal titer is falling as expected.

For primary and secondary syphilis, the CDC recommends clinical and blood test follow-up at 6 and 12 months after treatment.
For later stages and for some other situations, the schedule is different, and a clinician sets it.
A titer that does not fall as expected may lead a clinician to look further, including re-checking for re-infection or considering more evaluation.

The CDC notes that the treponemal test can stay positive for life, and that some people keep a low non-treponemal titer after treatment. This is sometimes called a serofast state. It does not automatically mean treatment failed. A clinician interprets it.

Keep a copy of your results if you can. If you later visit another clinic, they can compare your numbers with earlier ones.

Pregnancy and Florida's testing rules

The Florida Department of Health sets prenatal testing rules. Under Florida Administrative Code Rule 64D-3.042, practitioners providing prenatal care must test for sexually transmissible diseases at the first examination for the pregnancy and again at 28 to 32 weeks.

The same rule treats people who reach delivery with no prenatal care, no test record, or no test after the 27th week as high risk. They must be tested for hepatitis B surface antigen, HIV and syphilis before discharge.

Florida Statute 384.31 also requires anyone attending a pregnant person for pregnancy-related care to have them tested, including for HIV. The statute allows a person to refuse by signed written objection. If you are pregnant, ask your care team which tests are planned and when.

Prevention, including doxy-PEP

The CDC lists several ways to lower the chance of syphilis:

Using condoms consistently and correctly lowers the chance of contact with a sore, but sores can be in places a condom does not cover.
Regular testing, with a schedule a clinician helps set based on your life and partners.
Talking with partners about testing.

In 2024 the CDC issued guidance on doxycycline taken after sex, often called doxy-PEP. The CDC describes it as an option clinicians may discuss with gay, bisexual and other men who have sex with men, and with transgender women, who have had a bacterial STI in the past 12 months. Research suggests it lowers the chance of syphilis, chlamydia and gonorrhea. It is a prescription decision made with a clinician. It is not a treatment for an infection that is already present.

Florida law: privacy, minors and reporting

Minors: Florida Statute 384.30(1) says a parent's or guardian's consent is not a prerequisite for a minor's examination or treatment for a sexually transmissible disease. The statute states no minimum age.
Confidentiality for minors: Section 384.30(2) says the fact of a minor's consultation, examination and treatment is confidential and may not be shared directly or indirectly, such as by sending a bill to a parent or guardian, except as provided in s. 384.29.
Reporting: Under Florida Statute 381.0031(2) and Rule 64D-3.029 of the Florida Administrative Code, syphilis, including syphilis in pregnant people and newborns, is a reportable condition. Clinicians and laboratories report it to the Department of Health. This is a public health routine that supports partner notification and tracking.
Telling partners: Florida Statute 384.24(1) applies an inform-and-consent rule to people who know they have certain infections, including syphilis. A clinician or the health department can explain what this means in practice.

Where to get tested in Orlando

The clinics below offer syphilis testing or list it on the CDC's GetTested directory. For a longer comparison, see our guide to STD testing in Orlando, where to get tested and what it costs. You can also browse the local testing list. The CDC's own directory at gettested.cdc.gov lets you search by ZIP code.

Hours and policies change. Call before you go.

Clinic	Address and phone	What the published sources say
Florida Department of Health in Orange County STD Clinic (Central Health Center, Building 1)	832 West Central Blvd, Orlando, FL 32805. 407-858-1400	Walk-in, first come first served. The county STD page lists Monday to Friday, 7:30 a.m. to 4 p.m., closed 12 to 1 p.m. Picture ID required. Low- or no-cost testing for chlamydia, gonorrhea, syphilis and HIV. Fees start at $20, with a sliding scale. Results take about one week. Other county pages show different hours, so call first.
Florida Department of Health in Orange County, Lila Mitchell Health Center	5151 Raleigh St, Ste B, Orlando, FL 32811. (407) 723-5004	CDC GetTested lists syphilis, chlamydia, gonorrhea and HIV tests, a sliding scale, and appointment required. Hours are not listed.
The Center Orlando, Testing Center	942 N Mills Ave, Orlando, FL 32803	Walk-in only. The Center's testing page lists syphilis at $15, and HIV and hepatitis C at $0. STI testing is provided by NPS Healthcare. No phone number was listed, so check The Center's website for current hours.
Miracle of Love, Executive Office	1301 W Colonial Dr, Ste 201, Orlando, FL 32804. (407) 843-1760	CDC GetTested lists free HIV and STI tests including syphilis, with appointment required. The organization's page says to contact them to schedule. It does not perform gonorrhea or chlamydia swabs, which are not needed for a syphilis blood test.
Orange Blossom Family Health, Downtown Orlando	232 N Orange Blossom Trail, Orlando, FL 32805. 407-428-5751	CDC GetTested lists syphilis testing, a sliding scale and appointment required. Hours are not listed.
AHF Healthcare Center, Orlando	707 E. Colonial Drive, Orlando, FL	AIDS Healthcare Foundation says the site offers free STD/STI prevention and treatment services, Monday to Friday, 8 a.m. to 5 p.m. A phone number was not found, so check AHF's website.
Hope & Help Center of Central Florida (Winter Park)	4122 Metric Dr, #800, Winter Park, FL 32792. (407) 645-2577	Serves the Orlando area from Winter Park. Its testing page lists syphilis, says testing is free and that no appointment is necessary. Testing hours are Monday to Thursday, 8 a.m. to 4 p.m. Confirm which tests are offered by phone.
Planned Parenthood East Orlando Health Center	11500 University Blvd, Ste B, Orlando, FL 32817. 407-246-1788	The CDC NPIN listing shows syphilis testing and appointment required. Confirm hours and current availability with the clinic.

If cost is a worry, say so when you call. The county page says the Orange County clinic uses a sliding scale with eligibility screening and accepts cash, card, Medicaid and Medicare. If a price is not published, the clinic can tell you.

Sourcing and quality indicators: how to judge a test and a clinic

In a deep dive on a product, this section would be about sourcing and purity. For testing, the equivalent is knowing what a reliable test looks like. These are signs that a testing site is following the practices described in CDC guidance:

The clinic can name the tests. They can tell you whether they use a treponemal test, a non-treponemal test, or both.
A licensed clinician reviews the results. Results come with a way to ask questions, not only a number.
There is a plan for a positive result. The clinic can explain treatment, partner notification and follow-up testing.
Results are kept private. Ask how results are delivered. The county clinic says results are given in person or by coded text with signed consent.
Prices are stated up front. If a clinic's page lists no price, call and ask.
The test checks for other infections when you want that. Many clinics offer HIV, chlamydia and gonorrhea testing at the same visit.

Be careful with any site that promises results with certainty, or that sells treatment without a clinician. No test is perfect, and treatment for syphilis must come from a licensed prescriber.

Questions to bring to your visit

Which syphilis tests do you run, and how long do results take?
Based on my last possible exposure, should I test again later?
What would follow-up testing look like if I were treated?
Do you also test for HIV, chlamydia and gonorrhea at the same visit?
What does it cost, and is there a sliding scale?
Do I have any allergy that should change my care?

The bottom line

Syphilis is a curable bacterial infection, and penicillin from a clinician is the standard care. It can be quiet for a long time, and it can show up as a sore, a rash or no visible sign at all. That is why a blood test is the way to find out, and why the CDC and the USPSTF encourage testing for people at increased risk and during pregnancy.

Orlando has several places to start, including a county walk-in clinic and community testing sites. If you are not sure where to go, call the Florida Department of Health in Orange County at 407-858-1400 or search the CDC's directory at gettested.cdc.gov.

Syphilis in Orlando: Symptoms, Testing and Treatment