When Is It Ordered
A syphilis test may be ordered when a person has signs and symptoms, such as:
- A chancre on the genitals or throat
- A skin rash that often is rough, red, and spotted, appearing frequently on the palms of the hands and the bottoms of the feet and that usually does not itch, with or without other symptoms, such as fever, fatigue, swollen lymph nodes , sore throat, and body aches
Screening for syphilis is recommended, regardless of symptoms, when a person:
- Is being treated for another sexually transmitted disease, such as gonorrhea
- Is pregnant, during the first prenatal visit and again in the third trimester and at delivery if the woman is at high risk
- Is a man who has sex with men testing should be done at least yearly or every 3-6 months if at high risk
- Engages in high-risk sexual activity, such as having unprotected sex with multiple partners
- Has HIV infection, when first diagnosed and then at least yearly may be done more frequently if at high risk
- Has one or more partners who have tested positive for syphilis
- Has been informed by public health officials that he or she has been exposed to an infected partner
The CDC recommends follow-up testing, such as measuring the level of antibodies , when a person has been treated for syphilis to be sure that treatment is successful and the infection cured.
How Common Is Syphilis
During 2019, there were 129,813 reported new diagnoses of syphilis , compared to 37,968 new diagnoses of HIV infection in 2018 and 616,392 cases of gonorrhea in 2019.1, 2 Of syphilis cases, 38,992 were primary and secondary syphilis, the earliest and most transmissible stages of syphilis. In 2019, the majority of P& S syphilis cases occurred among gay, bisexual, and other men who have sex with men . Specifically, MSM only and men who have sex with men and women accounted for 47% of all P& S syphilis cases, as well as 56% of all male P& S syphilis cases. However, in recent years, the rate of P& S syphilis has been mostly increasing among MSM as well as heterosexual men and women.
Congenital syphilis continues to be a concern in the United States. According to preliminary 2020 data, more than 2,000 cases of congenital syphilis were reported, compared to 65 cases of perinatal HIV infection during 2018.1, 9 Preliminary data also showed rates of congenital syphilis are highest among mothers who were non-Hispanic American Indian or Alaska Native , followed by mothers who were non-Hispanic Native Hawaiian or other Pacific Islander and mothers who were non-Hispanic Black or African American .9
How Will This Agreement Help Move Us Closer To Who Elimination Goals
The agreement will contribute to the WHOs triple elimination agenda of eliminating mother-to-child transmission of HIV, syphilis, and hepatitis B.
By simply testing women for syphilis at current HIV testing rates and strengthening syphilis treatment in the 20 highest-burden countries, a third of the adverse outcomes resulting from congenital syphilis globally can be prevented, resulting in at least 74,000 lives saved and 53,000 severe illnesses averted annually.
An additional third of cases can be prevented by continuing to expand access to HIV and syphilis testing within these same 20 countries so that the WHOs targets for elimination 95 percent antenatal care attendance, 95 percent screened for syphilis, and 95 percent treated for syphilis are met. These system strengthening efforts will not only reduce the burden of congenital syphilis but can improve HIV programming and reduce new infections of HIV among newborns.
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Questions For Your Doctor About Test Results
If youve recently received the results of a syphilis test, it may be beneficial to ask your doctor for additional information in understanding your result and planning for future testing. Helpful questions for you doctor include:
- What is my syphilis test result?
- Based on my test results, are any additional tests needed?
- How can I talk to my sexual partners about my test result?
- How often should I be tested for syphilis and other STDs?
What Is The Link Between Syphilis And Hiv
In the United States, approximately half of MSM with primary and secondary syphilis were also living with HIV. In addition, MSM who are HIV-negative and diagnosed with P& S syphilis are more likely to be infected with HIV in the future. Having a sore or break in the skin from an STD such as syphilis may allow HIV to more easily enter your body. You may also be more likely to get HIV because the same behaviors and circumstances that put you at risk for getting other STDs can also put you at greater risk for getting HIV.
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What Do The Results Mean
If your screening results were negative or normal, it means no syphilis infection was found. Since antibodies can take a couple of weeks to develop in response to a bacterial infection, you may need another screening test if you think you were exposed to the infection. Ask your health care provider about when or if you need to be re-tested.
If your screening tests show a positive result, you will have more testing to rule out or confirm a syphilis diagnosis. If these tests confirm you have syphilis, you will probably be treated with penicillin, a type of antibiotic. Most early-stage syphilis infections are completely cured after antibiotic treatment. Later-stage syphilis is also treated with antibiotics. Antibiotic treatment for later-stage infections can stop the disease from getting worse, but it can’t undo damage already done.
If you have questions about your results, or about syphilis, talk to your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
What Is Being Tested
Syphilis is an infection caused by the bacterium Treponema pallidum that is most often spread by sexual contact, such as through direct contact with a syphilis sore , a firm, raised, painless sore. The most common syphilis tests detect antibodies in the blood that are produced in response to a T. pallidum infection. Some methods that are used less commonly directly detect the bacterium or its genetic material .
Syphilis is easily treated with antibiotics but can cause severe health problems if left untreated. An infected mother can also pass the disease to her unborn child, with serious and potentially fatal consequences for the baby.
There are several possible stages with syphilis:
Syphilis is most infectious during the primary and secondary stages. In 2014, about one-third of over 63,000 new cases of syphilis reported to the Centers for Disease Control and Prevention were primary or secondary stage syphilis. Eighty-three percent of these cases were among men who have sex with men.
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Who Is At Risk For Syphilis
All people who are sexually active can be at risk for syphilis. People living with HIV are at greater risk of acquiring syphilis than HIV-negative people. Both men and women can get syphilis but more cases have been reported among men than women. Most of the new cases reported have been in men who have sex with men.
Is The Concern For Syphilis Biological False Positive The Same As With Traditional Testing
The term biological false positive for syphilis is defined as a positive reaction to regain tests , but negative reaction to treponemal tests. Non-trep such as RPR, are looking for anti-cardiolipin antibodies which are not specifically associated with treponemal infections, so having a positive RPR and negative Treponemal test is what is usually referred to as a biological false positive when the traditional algorithm is used.
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Why Do We Care
- Globally, syphilis caused 300,000 stillbirths and neonatal deaths in 2008,and 390,000 children were newly infected with HIV in 2010- These are preventable deaths
- Newborns in Zambia are at great risk- 5.3% of antenatal attendees are seropositive for syphilis- 12.3% of antenatal attendees are seropositive for HIV- Syphilis-positive pregnant women are two times more likely to be seropositive for HIV
- We have an opportunity to make a difference in Zambia- 94% of antenatal attendees were tested for HIV- Only 43% of antenatal attendees were tested for syphilis
- Innovative strategies are needed to ensure that all pregnant women are testedfor syphilis and HIV in early pregnancy
Can A Syphilis Test Detect Herpes
4.7/5syphilistestssyphilisHSVherpesrelated to it here
Tests for herpes and syphilis are warranted. Herpes viral culture of the lesion is recommended. Serologic testing with a nontreponemal syphilis test, a rapid plasma reagin test , or a Venereal Disease Research Laboratory test, are also acceptable alternatives.
One may also ask, can Vdrl test detect herpes? A VDRL test is only a test for syphilis. It doesn’t test for any other STDs, particularly not viral STDs. The VDRL test won’t detect HIV, HPV, herpes, or hepatitis B. It stands for venereal disease research laboratory rather than referring to a virus.
Hereof, can syphilis be mistaken for herpes?
Initial symptoms of syphilis are one or more sores in or near the genitals, anus, or rectum that might be mistaken for herpes. Generally, the sores are round and firm, but they don’t hurt.
Can chancroid be mistaken for herpes?
A few days after a person is infected, chancroid might look like one or more little red sores. Diagnosing chancroid is its own challenge. The symptoms are often confused with those of herpes and syphilis. If a doctor suspects a patient’s symptoms are caused by chancroid, she would have no easy diagnostic test to use.
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How Do People Get Syphilis
Syphilis is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres can occur on or around the external genitals, in the vagina, around the anus , or in the rectum, or in or around the mouth. Transmission of syphilis can occur during vaginal, anal, or oral sex. In addition, pregnant women with syphilis can transmit the infection to their unborn child.
Who Will Be Impacted
The partnership includes low- and-middle income countries that account for 98 percent of the global burden of congenital syphilis and 93 percent of the global HIV burden. Uptake of the dual tests across these countries would help to bridge the testing gap of over six million pregnant women in the highest-burden countries who know their HIV status but are currently not tested for syphilis.
The price reduction will translate to direct cost-savings for governments, as well as millions in indirect savings from integrating testing programs and avoiding the significant adverse outcomes from syphilis.
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Do I Need To Have This Test
It’s your choice to be tested for any or all of these infections.
The tests are recommended to:
- protect your health through early treatment and care
- reduce any risk of passing an infection on to your baby, partner or other family members
If you test positive for hepatitis B, HIV or syphilis, your partner and other family members may be offered a test for the infection.
Some People Are More Likely To Get Syphilis Than Others
Syphilis had become rare in the UK, however over the last decade there has been an ongoing increase in the number of diagnoses. The increase has been greatest among men although there have also been growing numbers of infections among women.
In 2018 three quarters of syphilis cases in the UK were among men who have sex with men as these things put you at higher risk of catching syphilis:
- having anal sex without condom
- having group sex
- having sex while taking drugs .
Public Health England and the British Association for Sexual Health and HIV recommend that MSM who have condomless sex with new or casual partners should have a syphilis testevery 3 months.
All pregnant women are screened for syphilis as part of their antenatal care because the infection can be passed from a mother to her baby with serious consequences for the baby. This is very rare in the UK.
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Performance And Operational Characteristics/statistics
The sensitivity and specificity values with their 95% confidence intervals were determined in comparison with the reference results, using the exact binominal method. Additionally, the invalid rate and inter-reader variability were calculated for each assay . The invalid rate was expressed as the number of invalid test results over the total number of tests used . For each test band the inter-reader variability was expressed as the percentage of specimens for which initial results were differently interpreted by the independent readers.
The operational characteristics, such as ease of use, number of steps and ease of interpretation, were assessed by the lab technician who performed the tests.
Statistical analyses were performed using R version 3.3.2.
What Is Syphilis And Can A Blood Test Detect It
Syphilis is a common but serious sexually transmitted disease caused by the bacterium, Treponema pallidum. When a person has direct physical contact with another person who has a syphilitic sore or lesion, more commonly known as a chancre, there is a likelihood of transmission. Initially painless and circular, chancres can be found on or around the external genitals, in the vagina, or around the anus. They can also appear in the rectum and in or around the mouth.
The most common transmission of syphilis is through anal, vaginal, or oral sex with a partner. If a person has a minor cut or abrasions on the surface of the skin, the bacteria find their way of entering the body through that opening. They can also enter through mucous membranes. Pregnant women who have the syphilis infection are also prone to transmit the infection to their unborn child. The baby is then susceptible to birth deformities, stillbirth, or death. Sharing the same toilet, tubs, clothes, or eating utensils will not result in a person contracting syphilis.
Symptoms of syphilis can resemble other diseases therefore, a person may think he or she has gonorrhea. However, syphilis is a disease that progresses through four stages, each separated by months and can even range in years, depending on how soon the person seeks treatment.
The following tests are used to confirm syphilis:
- Fluorescent treponemal antibody absorption test
- Darkfield microscopy
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Linking Syphilis Infection And Hiv Prevention
Another important development in understanding the link between syphilis and HIV is the growing recognition that new diagnoses of sexually transmitted infections represent opportunities for prevention. Several groups of researchers have found that men who have sex with men who are newly diagnosed with syphilis are at very high risk of then becoming infected with HIV.
The implication? Use new syphilis infections to prioritize getting men access to pre-exposure prophylaxis . Providing high-risk men with PrEP can lower their risk of acquiring HIV by treating them in advance of infection. Prioritizing high-risk men can also make PrEP more cost-effective, as it makes certain the treatment first gets to the individuals who need it most. In this case, targeting MSM with syphilis diagnoses identifies a high-risk population who are clearly both being exposed to STDs and not reliably practicing safer sex.
Why Is Having Syphilis A Problem During Pregnancy
Syphilis in pregnancy can cause many health problems for the infant, including low birth weight, premature delivery, and even stillbirth. In 2014, the U.S. Centers for Disease Control and Prevention received 458 reports of syphilis cases in children who contracted syphilis from their mothers, known as congenital syphilis. Sometimes newborns with syphilis may not have signs of the disease. However, without immediate treatment, the newborn could develop cataracts, deafness, or seizures. According to the American Sexual Health Association, many cases of congenital syphilis go unnoticed until symptoms appear in childhood or adolescence.
The CDC and the U.S. Preventive Services Task Force recommend that pregnant women be tested for syphilis, preferably at the first prenatal visit. The CDC also recommends testing during the third trimester for higher risk women.
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Differences In Clinical Presentation Of Syphilis In Patients With And Without Hiv
|CSF, cerebrospinal fluid VDRL, venereal disease research laboratory.|
CDC. Clinical advisory: ocular syphilis in the United States. 2016 Nov 3.
Flood JM, Weinstock HS, Guroy ME, et al. Neurosyphilis during the AIDS epidemic, San Francisco, 1985-1992. J Infect Dis 1998 177:931-40.
Garcia-Silva J, Velasco-Benito JA, Pena-Penabad C. Primary syphilis with multiple chancres and porphyria cutanea tarda in an HIV-infected patient. Dermatology 1994 188:163-5.
Interpretation Of Reactive Tests
A reactive treponemal test most likely indicates infection by T pallidum but is not sufficient to determine disease activity and make treatment decisions . A reactive test can be seen in patients with a history of syphilis who has been treated. Consequently, it is important to determine if disease is active based on history, physical examination, and nontreponemal testing.
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