Syphilis Flashcards
(32 cards)
Is syphilis a nationally notifiable disease?
Yes.
Routine - labs and doctors
Which organism causes syphilis?
Treponema pallidum
Spirochete
How is syphilis transmitted?
Direct contact with skin lesions/mucous membranes during sex (oral, vaginal, anal)
Rarely through non-sexual contact
What are the clinical features of syphilis?
Highly variable and complex.
Primary, secondary, tertiary, pregnant women, congenital syphilis.
What are the clinical features of primary syphilis?
Chancre - usually single indurated painless ulcer +/- regional LA.
Heals within few weeks.
What are the clinical features of secondary syphilis?
Headache, LA, fever, sore throat, rash, mucocutaneous lesions.
Lasts 3-12 weeks, may relapse in next 12 months.
Occurs 4-10 weeks after onset of primary.
What are the clinical features of tertiary (late) syphilis?
Bone disease, cardiovascular syphilis, neurosyphilis.
25-30% of untreated cases.
What is early latent syphilis?
Asymptomatic; evidence of less than two years duration
What is late latent syphilis?
Asymptomatic; more than two years duration (unlikely infectious)
What are the clinical complications of pregnant women with syphilis?
Miscarriage, FDIU, stillbirth, prematurity.
What are the clinical features of congenital syphilis?
At birth - hydrops, ascites, hepatomegaly, anaemia
OR
Initially asymptomatic and presents within 3 months with failure to thrive, pneumonia.
Which groups are high-risk for syphilis?
- MSM
- First Nations people (especially remote)
- Female partners of MSM
- Unprotected sex in high prevalence countries
- Sex workers
- Prisoners
What are the case definitions for syphilis?
3 classifications:
(1) infectious syphilis – less than 2y duration (both confirmed and probable).
(2) syphilis – more than 2y or unknown duration (confirmed only);
(3) congenital syphilis (both confirmed and probable).
Definitions include lab, clinical, epi evidence.
Infectious syphilis includes primary, secondary, early latent. Syphilis > 2 years refers to late syphilis and includes late latent and tertiary syphilis.
How is syphilis diagnosed?
Includes:
- PCR
- Serology
- Hx/Ex.
PCR – swab from ulcer.
Serology: treponemal (TPPA/TPHA) + non-treponemal (RPR/VDRL) tests.
TPPA positive for life.
RPR marker of disease activity/treatment response.
Reinfection: RPR, clinical.
RPR = rapid plasma reagin. Detects non-treponemal antibodies in the blood, which are produced in response to the infection
What is the incubation period for syphilis?
10 to 90 days.
Median 3 weeks (to primary illness).
What is the infectious period for syphilis?
First two years of infection if untreated.
Most infectious in primary and secondary phases, including for vertical transmission (risk close to 100%).
What is the outbreak definition of syphilis?
How are outbreaks of syphilis managed?
How is syphilis prevented?
- Safe sex
- Early detection
- Early treatment
What public health activities are required for the prevention of syphilis?
Multiple, coordinated prevention activities.
- Health promotion campaigns
- Awareness of syphilis
- Safer sex practices
- Regular testing
- Prioritisation for high-risk groups
- Cultural safety
What is the frequency of syphilis screening in pregnany?
Routine screening - minimum of 3 syphilis tests for every pregnant person during each pregnancy:
- First antenatal visit
- 26-28 weeks
- 36 weeks or birth (whichever is earlier)
What are the STI screening guidelines for syphilis?
- Regular for anyone sexually active
- At least yearly / more frequently if multiple partners
- 3/12 months for MSM (STIGMA guidelines)
- Opportunistic testing for high-risk people
What resources are available for public health management of syphilis?
How are cases of syphilis managed?
