- All applicants aged 18 to 44 years must be tested for evidence of syphilis.
- Applicants aged less than 18 years or greater than 44 years must be tested if there is reason to suspect infection with syphilis.
Medication
Based on a review of the evidence, the task force recommends screening for syphilis infection in people who are at increased risk for infection. This is an “A” statement, and applies to asymptomatic nonpregnant adolescents and adults who have ever been sexually active and are at increased risk for infection.
Self-care
In conclusion, we emphasize that for syphilis diagnosis the clinical history and the physical examination should be considered together with serology. Along with the laboratory results, the clinical follow-up is mandatory to exclude progression towards late complications after therapy.
Nutrition
The study found that screening in this population was associated with increases in the detection of early asymptomatic syphilis and decreases in secondary syphilis, which suggested that screening is likely to interrupt syphilis progression.
Who should be screened for syphilis?
The chaperone must be a staff member of the gender the patient feels most comfortable with and not a family member. However, family members may be present for the exam if the applicant requests. Sores consistent with syphilis are typically painless, indurated, clean-based genital, rectal or oral ulcers.
How is syphilis diagnosed and treated?
Does syphilis screening prevent syphilis progression?
Can a family member be present during a syphilis exam?
Who should be screened for syphilis?
Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STD should also be tested for gonorrhea and chlamydia every year. Everyone who is pregnant should be tested for syphilis, HIV, hepatitis B, and hepatitis C starting early in pregnancy.
How does a healthcare professional test for syphilis?
Tests used to confirm a syphilis infection include: Enzyme immunoassay (EIA) test. This blood test checks for syphilis antibodies. A positive EIA test should be confirmed with either the VDRL or RPR tests.
Can my doctor treat me for syphilis?
This can be done in the doctor's office or at a clinic. A few people have to go to the hospital to be treated with penicillin intravenously (through an IV). If you're pregnant, it's very important to get treated right away. Syphilis can cause birth defects and even death in an unborn baby.
Do you report syphilis to CDC?
STI and HIV/AIDS cases should be reported in accordance with state and local statutory requirements. Syphilis (including congenital syphilis), gonorrhea, chlamydia, chancroid, and HIV are reportable diseases in every state.
When should you test for syphilis?
You should get tested for syphilis if you have symptoms of syphilis or if your sexual partner was recently diagnosed with syphilis. Symptoms usually appear about two to three weeks after infection and include: Small, painless sore (chancre) on the genitals, or in the mouth, anus, or rectum.
Can doctors tell who gave who an STD?
How can I know who gave me a sexually transmitted disease (STD)? Unless you and your sexual partner were both virgins to sexual activity and neither of you have EVER been outside of your relationship for sexual activity, you cannot know.
Does a doctor have to tell a spouse about STD?
The responsibility for STD reporting and partner notification currently lies in the hands of individual states – there is no universal “duty to warn” law in place at the present time, although STD diagnoses do sometimes trigger actions beyond the physician's care of their patient and may involve consideration of the ...
What gender is more affected by syphilis?
Most cases of syphilis in the United States are among gay, bisexual, and other men who have sex with men (MSM). Syphilis also has increased nearly every year among MSM, for about two decades.
Nontreponemal Tests and Traditional Algorithm
False-positive nontreponemal test results can be associated with multiple medical conditions and factors unrelated to syphilis, including other infections (e.g., HIV), autoimmune conditions, vaccinations, injecting drug use, pregnancy, and older age ( 566, 569 ).
Treponemal Tests and Reverse Sequence Algorithm
The majority of patients who have reactive treponemal tests will have reactive tests for the remainder of their lives, regardless of adequate treatment or disease activity. However, 15%–25% of patients treated during the primary stage revert to being serologically nonreactive after 2–3 years ( 570 ).
Cerebrospinal Fluid Evaluation
Further testing with CSF evaluation is warranted for persons with clinical signs of neurosyphilis (e.g., cranial nerve dysfunction, meningitis, stroke, acute or chronic altered mental status, or loss of vibration sense).
Special Considerations
Parenteral penicillin G is the only therapy with documented efficacy for syphilis during pregnancy. Pregnant women with syphilis at any stage who report penicillin allergy should be desensitized and treated with penicillin (see Management of Persons Who Have a History of Penicillin Allergy).
Management of Sex Partners
Sexual transmission of T. pallidum is thought to occur only when mucocutaneous syphilitic lesions are present. Such manifestations are uncommon after the first year of infection.
How old do you have to be to get a syphilis test?
All applicants 15 years of age or older must be tested for evidence of syphilis. Applicants younger than age 15 must be tested if there is reason to suspect infection with syphilis or if there is a history of syphilis.
What is the syphilis screening?
Syphilis Screening. Syphilis is a sexually transmitted, systemic disease caused by the bacterium Treponema pallidum subspecies pallidum. The disease has often been called “the great imitator” because of its wide variety of signs and symptoms, with different stages having different clinical manifestations.
What is the CDC's method for testing for syphilis?
Although various laboratory testing approaches exist for syphilis screening, CDC continues to recommend the traditional testing algorithm starting with a nontreponemal test rather than a reverse testing algorithm starting with a treponemal test. The traditional algorithm is the approach that must be used by panel physicians.
What is a Class A test for syphilis?
Applicants with a positive (or reactive) nontreponemal screening test (i.e. RPR or VDRL) and a positive treponemal-specific confirmatory test are Class A for syphilis and will remain Class A until treated. After completing treatment, applicants are classified as Class B.
How many stages of syphilis are there?
There are three infectious stages (primary, secondary, and early latent disease) and two noninfectious stages (late latent and tertiary disease). Untreated syphilis can progress and lead to serious long-term sequelae and, rarely, death.
How long does it take to get a post evaluation for syphilis?
Adult applicants treated for syphilis should be informed by panel physicians that they will need follow-up care for clinical and serologic re-evaluation in 6 months (3 months if HIV positive and treated for primary or secondary syphilis).
What should be included in obtaining a medical history?
Obtaining the applicant’s medical history should include inquiring about prior history and treatment for syphilis; a sexual partner with syphilis; or any history of painless sores on the genitals, anus, or mouth or a rash on the body , especially on the palms of the hands or soles of the feet.
When should you repeat syphilis screening?
Repeat screening for pregnant women at high risk and in areas of high prevalence at 28 weeks and at delivery. Treat Women Infected with Syphilis Immediately.
What to do if a woman has syphilis?
If a woman has syphilis or suspected syphilis, treat her immediately with long-acting penicillin G , especially if she is pregnant, according to CDC’s STD Treatment Guidelines. Test and treat the infected woman’s sex partner (s) to avoid reinfection.
How often should a pregnant woman be tested for syphilis?
Before discharging the mother or infant from the hospital, make sure the mother has been tested for syphilis at least once during pregnancy or at delivery. If she tests positive, manage the infant appropriately. All women who deliver a stillborn infant should be tested for syphilis.
Is syphilis on the rise?
Because recent data show that syphilis rates are on the rise. Rates of primary and secondary (P&S) syphilis—the most infectious stages of the disease—increased a troubling 11% between 2018 and 2019. While rates have increased among both men and women, men account for 83% of all P&S cases. Gay, bisexual, and other men who have sex with men (MSM) ...
Do physicians have to be trained in syphilis?
1 in 3 physicians have not received any post-medical school training in sexually transmitted diseases. And if knowing syphilis is knowing medicine, then too many providers now find themselves at a great disadvantage. If you have had limited, or no, experience with diagnosing and treating syphilis, do you know where to turn? Simply look to CDC’s STD Treatment Guidelines for recommendations and strategies that you can use to help prevent and treat this ancient disease.
Can syphilis cause hearing loss?
The troubling reality is that when not adequately treated, syphilis can lead to visual impairment, hearing loss, stroke, and other neurological problems. Syphilis infection can also increase a person’s risk for getting HIV or giving it to others.
How old do you have to be to get a syphilis test?
All applicants 15 years of age or older must be tested for evidence of syphilis. Applicants younger than age 15 must be tested if there is reason to suspect infection with syphilis or if there is a history of syphilis.
What is the syphilis screening?
Syphilis Screening. Syphilis is a sexually transmitted, systemic disease caused by the bacterium Treponema pallidum subspecies pallidum. The disease has often been called “the great imitator” because of its wide variety of signs and symptoms, with different stages having different clinical manifestations.
What is the traditional algorithm for syphilis screening?
The traditional algorithm is the approach that must be used by civil surgeons.
What is a Class A test for syphilis?
Applicants with a positive (or reactive) nontreponemal screening test (i.e. RPR or VDRL) and a positive treponemal-specific confirmatory test are Class A for syphilis and will remain Class A until treated. After completing treatment, they are classified as Class B.
How long does it take to get a post evaluation for syphilis?
Adult applicants treated for syphilis should be informed by civil surgeons that they will need follow-up care for clinical and serologic re-evaluation in 6 months (3 months if HIV positive and treated for primary or secondary syphilis).
How many stages of syphilis are there?
There are three infectious stages (primary, secondary, and early latent disease) and two noninfectious stages (late latent and tertiary disease). Untreated syphilis can progress and lead to serious long-term sequelae and, rarely, death.
What is the best treatment for syphilis?
Benzathine penicillin G ( BPG) is the preferred treatment regimen for syphilis. Although alternative regimens are known to be effective, applicants should be informed that BPG is the first-line recommendations in the Treatment Guidelines.
Testing
Unlike testing for other conditions, syphilis testing is complicated and needs to be explained in more detail.
Who should be screened for syphilis
People should be screened for syphilis is they are symptomatic or high risk by asymptomatic.
Interpretation of syphilis tests
Test interpretation is more complex with syphilis than with other infectious diseases. A positive test can mean multiple things, from newly diagnosed to previously treated syphilis.
Causes of false-positive syphilis tests
The chance of a false-positive syphilis test is about 1% to 2%. “False positive” means the test is positive but the patient, in reality, does not have syphilis.
Positive syphilis test interpretation
In this section, our expert doctor will answer real-life patient questions on syphilis testing. Most questions are grouped so it’s easier to cover more topics. Dr. Fuzayloff has been a practicing physician at a busy STD center in Midtown Manhattan, NYC, for over two decades.
How to treat congenital syphilis?
The best treatment for congenital syphilis is prevention by detecting and treating the infection in women early in their disease course. Only with thorough and effective screening can syphilis be treated and its spread mitigated.
What are the two categories of syphilis tests?
Serologic assays for syphilis diagnosis fall into two categories: non-treponemal and treponemal (Figure 1).
How many tests are needed for a nontreponemal test?
In laboratories and low-resource settings that lack automated testing, nontreponemal tests remain a mainstay of first line testing. Use of the forward algorithm also requires that labs perform only two tests, compared to the three tests needed for CDC's reverse algorithm.
How long has syphilis been stigmatized?
Syphilis has been stigmatized for hundreds of years, and its varying presentations and stages have historically often made this formidable contagion difficult to recognize and diagnose. Syphilis has early and late stages. Early stages occur within the first year following infection and late stages at greater than 1 year from infection.
What is a false positive for syphilis?
In this article, the term false positives refers to patients never exposed to syphilis, but some papers in the literature consider past treated syphilis positivity in the screening algorithm to be a false positive as it requires no intervention .
Can syphilis be treated with penicillin?
Today standard clinical laboratory testing detects syphilis easily, and the infection when detected at an early stage is, generally speaking, easily treated with penicillin.
Is syphilis contagious in the early stages?
Early stages include primary (chancre), which if untreated will progress to secondary (rash) syphilis. These two stages are the most contagious. Early latent syphilis is asymptomatic but acquired within the last year and is considered an early stage of syphilis.
Nontreponemal Tests and Traditional Algorithm
Treponemal Tests and Reverse Sequence Algorithm
Cerebrospinal Fluid Evaluation