Syphilis is a STI that can cause very serious health problems if left untreated. Syphilis is divided into stages: primary, secondary, latent, and tertiary. There are different signs and symptoms associated with each stage. Primary syphilis typically has one or more sores at the original site of infection that are usually firm, round, and painless. Secondary syphilis may include a skin rash, swollen lymph nodes, and fever. Primary and secondary syphilis symptoms can be mild and might go unnoticed. During the latent stage, there are no signs or symptoms. Tertiary syphilis is associated with severe health problems that can affect the heart, brain, and other organs of the body. Syphilis is curable with the right antibiotics. In 2018, Hawai‘i ranked 28th in the U.S. for rates of primary and secondary syphilis cases (6.4 per 100,000 population).