National case definition: Syphilis

Date of last revision/review: May 2008

National notification

Only confirmed cases of disease should be notified

Type of surveillance

Routine case-by-case notification to the federal level

Case classification

Confirmed case: Primary syphilis

Laboratory confirmation of infection:

or

or

Confirmed case: Secondary syphilis

Laboratory evidence of infection:

or

Confirmed case: Early latent syphilis (< 1 year after infection)

Laboratory confirmation of infection:

Confirmed case: Late latent syphilis (> 1 year after infection or of unknown duration)

Laboratory confirmation of infection:

Confirmed case: Neurosyphilis

Infectious (< 1 year after infection)

Laboratory confirmation of infection:

Non-infectious (> 1 year after infection)

Laboratory confirmation of infection:

Confirmed case: Tertiary syphilis other than neurosyphilis

Laboratory confirmation of infection:

and

Laboratory comments

Diagnosis of syphilis requires a combination of history, including epidemiologic risk factors or exposure, physical examination and laboratory tests, as there is no single optimum diagnostic criterion.

Dark-field microscopy testing for T. pallidum is not reliable for oral/rectal lesions, as non-pathogenic treponemes may be present. Instead, direct fluorescent antibody test for T. pallidum should be used on such specimens.

ICD code(s)

ICD-11 code(s)

1A61, 1A62

ICD-10 code(s)

A51, A52

Comments

Each category is mutually exclusive.

The possibility of a prozone reaction should be considered in individuals who are suspected of having secondary syphilis but whose non-treponemal test is non-reactive.

A prozone reaction refers to a false-negative response resulting from overwhelming antibody titres that interfere with the proper formation of the antigen-antibody lattice network that is necessary to visualize a positive flocculation test.

References

Case definitions for diseases under national surveillance. CCDR 2000;26(S3).

Retrieved May 2008, from http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/00vol26/26s3/index.html

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