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.

 

FTD Vaginal swab and FTD Genital ulcer kits can detect Treponema pallidum and other STI relevant pathogens.

 

A.News_Syphilis1

B.News_Syphilis2

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

 

 

1 https://www.cdc.gov/std/syphilis/stdfact-syphilis.html

2 Workowski KA and Bolan GA (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 64(RR-03): 1-137

3 https://ecdc.europa.eu/en/publications-data/syphilis-annual-epidemiological-report-2016-2014-data

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

6 https://ecdc.europa.eu/en/syphilis/surveillance-and-disease-data/disease-data-atlas

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