Syphilis makes its comeback
The old foe called Syphilis
- Syphilis, caused by Treponema pallidum, is a sexually transmitted disease (STD) that can have very serious complications.1
- Syphilis is divided into stages (primary, secondary, latent, and tertiary).
- Different signs and symptoms are associated with each stage.
- Tertiary syphilis can affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints.1
- Control of syphilis is mainly dependent on the timely diagnosis and prompt treatment of infected individuals and their contacts with benzathine penicillin G (BPG), the first-line drug for all stages of syphilis.2
- Symptoms are often confused with other diseases, thus Syphilis` nickname is the “great pretender”.
- The fact that many doctors have not treated a case since the ‘90s or ever, is leading to misdiagnosis.
Syphilis in numbers
- EU/EEA Member States: In 2014, 24 541 syphilis cases were reported with an overall rate of 5.1 per 100 000 population.3,6
- Reported syphilis rates were six times higher in men than in women.3
- Almost two-thirds (63%) of the syphilis cases with information on transmission category were reported in men who have sex with men (MSM).3
- Trends since 2010 show that overall syphilis rates have been increasing, particularly among men, mainly due to increased cases among MSM, likely linked to changes in sexual behaviour.3,6
- US: The total number of syphilis cases (all stages) reported to the CDC increased 13% during 2012-2013 to 56,471 cases for a rate of 18 cases per 100,000 population.4
- China: In 2013, 444,952 cases of syphilis were reported with a rate of almost 33 cases per 100,000 population.5
Unmask the “great pretender” or… why FTD kits instead of traditional methods?
- Technicians performing dark-field microscopy require great experience and expertise.7
- If you send a swab for herpes and don't also send syphilis serology, you miss it.
- Antibodies are earliest detectable 2-3 weeks after infection.8
- False-negative serology possible and therewith follow-up visits with re-tests needed.8
- Avoid treatment delays and progression of disease.7
- False-positive serology results due to old infections.
- Positive serology results need confirmatory testing.
- Molecular amplification of Treponema pallidum DNA by RT-PCR has been proven useful in the diagnosis of early syphilis.9
- FTD kit results come up one day before serology.
- Ease of performance.
- Syphilis is "free" in our multiplex if you buy herpes.
Figures: Surveillance data of Syphilis reported cases in EU/EEA member states. A Distribution of reported cases in different countries. B Total number of reported Syphilis cases in all EU/EEA member states.6
2 Workowski KA and Bolan GA (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 64(RR-03): 1-137
4 Centers for Disease Control and Prevention (2014). 2013 Sexually transmitted diseases surveillance. Syphilis
5 Stamm LV., Re-emergence of an old foe, Microb Cell. 2016 Jun 27;3(9):363-370. doi: 10.15698/mic2016.09.523
8 Heymans et al., Clinical value of Treponema pallidum real-time PCR for diagnosis of syphilis, J. Clin. Microbiol. February 2010 vol. 48 no. 2 497-502
9 Meyer et al., Schnelltest-Diagnostik sexuell übertragbarer Infektionen in niedrigschwelligen Einrichtungen : Gemeinsame Stellungnahme des RKI, PEI und der DSTIG Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2017 Feb;60(2):245-254. doi: 10.1007/s00103-016-2496-3
10 Dubourg, G., Edouard, S., Prudent, E., Fournier, P.-E., & Raoult, D. (2015). Incidental Syphilis Diagnosed by Real-Time PCR Screening of Urine Samples. Journal of Clinical Microbiology, 53(11), 3707–3708. http://doi.org/10.1128/JCM.01026-15