The correct option is D All of these
Treponema pallidum causing syphilis spreads through the sexual contact of any kind, that is oral, vaginal or anal sex.
Primary or early stages of syphilis manifests as red, painless ulcerations on genitals at the site of bacterial entry. These ulcerations become hard and deeper after which they resolve. After this, patients often notice enlargement of the lymph nodes in the groin region. In the secondary stage there are skin rashes all over the body; including palms of hand and soles of feet.