Syphilis – less than two years duration (infectious – primary, secondary and early latent)

Reporting

Only confirmed cases should be notified.

Confirmed case

A confirmed case requires either:

1. Laboratory definitive evidence

or

2. Laboratory suggestive evidence and clinical evidence.

Laboratory definitive evidence

1. Seroconversion in past two years: specific treponemal test (e.g. IgG enzyme immunoassay, Treponema pallidum haemagglutination assay, Treponema pallidum particle agglutination, Treponema pallidum immobilisation assay, or fluorescent treponemal antibody absorption) reactive when previous treponemal test non-reactive within past two years and the latest result is confirmed by either a reactive non specific treponemal test or a different specific treponemal test result

or

2. A four-fold or greater rise in non-specific treponemal antibody titre (e.g. Venereal Disease Research Laboratory, Rapid Plasma Reagin) in the past two years, and a reactive specific treponemal test (e.g. IgG enzyme immunoassay, Treponema pallidum haemagglutination assay, Treponema pallidum particle agglutination, Treponema pallidum immobilisation assay, or fluorescent treponemal antibody absorption).

Laboratory suggestive evidence

1. Demonstration of Treponema pallidum by dark field microscopy (not oral lesions), direct fluorescent antibody microscopy tests, equivalent microscopic methods (e.g silver stains), or nucleic acid testing

or

2. A reactive specific treponemal test (e.g. IgG enzyme immunoassay, Treponema pallidum haemagglutination assay, Treponema pallidum particle agglutination, Treponema pallidum immobilisation assay, or fluorescent treponemal antibody absorption), confirmed either by a different specific test or a non-specific treponemal test

or

3. A reactive non-specific treponemal test (e.g. Venereal Disease Research Laboratory, Rapid Plasma Reagin) confirmed by a specific treponemal test (e.g. IgG enzyme immunoassay, Treponema pallidum haemagglutination assay, Treponema pallidum particle agglutination, Treponema pallidum immobilisation assay, or fluorescent treponemal antibody absorption).

Clinical evidence

1. Presence of a primary chancre (or ulcer)

or

2. Clinical signs of secondary syphilis.