Syphilis: Prevention and control

This guide is about management of primary, secondary, latent and tertiary syphilis. Some information about neurosyphilis and congenital syphilis is included, however their treatment is outside the scope of this document. Individuals with these conditions should be managed by or in consultation with an infectious disease specialist or an experienced colleague.

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General Sexually transmitted and blood-borne infection (STBBI) prevention and control

Case finding, education, counselling, partner notification and treatment are critical to control infection.

Healthcare providers should offer STBBI screening as part of their prevention and control strategies. Since many STBBI are frequently asymptomatic and can lead to serious complications if left undiagnosed and untreated, offer STBBI screening in the course of routine medical care, with special attention to those with risk factors. Normalizing screening in this way can reduce barriers to testing and the stigma associated with STBBIs.

Integrate STBBI prevention strategies such as counselling, vaccination and education on preventive practices into care. Motivational interviewing may be used to identify barriers to prevention practices and the means to overcome them.

Offer vaccination for hepatitis B (HBV), hepatitis A (HAV) and human papillomavirus (HPV) to people at risk, as per the Canadian Immunization Guide.

Partner notification has public health benefits (e.g. disease surveillance and control) and reduces the risk of re-infection for the index case.

Prevention and control of syphilis

Measures to prevent and control the transmission of syphilis include counselling, prompt diagnosis and appropriate treatment of the person and their sexual partners.

Counsel people with suspected or confirmed syphilis at the time of diagnosis about:

References

Footnote 1

Kerani R, Lukehart S, Stenger M, Marra C, Pedersen R, Golden M. Is early latent syphilis more likely in patients with a prior syphilis infection. London: British Society for Sexual Health and HIV, Presentation at: 18th International Society for STD Research. 2009.

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Footnote 2

Morgan CA, Lukehart SA, Van Voorhis WC. Protection against syphilis correlates with specificity of antibodies to the variable regions of treponema pallidum repeat protein K. Infect Immun. 2003;71(10):5605-5612.

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Footnote 3

Ivens D, Patel M. Incidence and presentation of early syphilis diagnosed in HIV-positive gay men attending a central london outpatients' department. Int J STD AIDS. 2005;16(3):201-202.

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Footnote 4

Tosca A, Lehou J, Hatjivasiliou M, Varelzidis A, Stratigos JD. Infiltrate of syphilitic lesions before and after treatment. Genitourin Med. 1988;64(5):289-293.

Return to footnote 4 referrer

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