SYPHILIS
Causative organism | Treponema pallidum spp pallidum |
Incubation period | 9-90 days (mean 30) to primary syphilis; 30-150 days to secondary syphilis; early latent presents post-secondary syphilis less than 2 years post last negative test; late latent presents more than 2 years post last negative test; 5-35 years to tertiary syphilis. |
How far back to trace |
According to sexual history and clinical stage of infection: Primary syphilis — 3 months plus duration of symptoms or last negative test; Secondary syphilis — 6 months plus duration of symptoms or last negative test; Early latent syphilis — 12 months or most recent negative test Late latent/tertiary syphilis: Test current partner/s. If any doubt as to whether the patient has early latent or late latent syphilis, contact trace as for early latent syphilis. If the stage of syphilis is unclear, contact your local specialist service for advice |
Usual testing method | Serology for syphilis. PCR can be done from ulcers/rash or other lesions |
Common symptoms |
Anogenital or oral ulcers Rash Early infection commonly asymptomatic |
Likelihood of transmission per act of unprotected intercourse |
Early syphilis (primary, secondary, early latent): >20 % Late latent and tertiary: usually not infectious |
Likelihood of long-term sexual partner being infected |
Up to 50% if early syphilis; <1% if no contact during infectious period |
Protective effect of condoms | High if lesions covered by condoms. However, close sexual contact and oral sex are modes of transmission |
Transmission by oral sex | Probably common |
Duration of potential infectivity | Up to 24 months (rare after 12 months). Late latent/yeryiary syphilis are usually not infectious |
Important sequelae |
Congenital infections in pregnancy Neurosyphilis, cardiovascular syphilis, enhanced HIV transmission |
Direct benefit of detection and treatment of contacts | Cure, and prevention of transmission and congenital syphilis |
Usual management of contacts |
Consultation with sexual health physician in all cases is suggested
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Contact tracing priority | High |
Notification |
Notifiable by doctors in all Australian states and territories, and in New Zealand; as well as laboratories in some Australian states and territories Where a syphilis register exists in your State, Territory or region, ensure you promptly report the required details. Where there are any concerns or ambiguity contact your local public health service for additional support. Syphilis RegistersQueensland: 1800 032 238
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Reference:
- Devchand M, Trubiano JA. Penicillin allergy: a practical approach to assessment and prescribing. Aust Prescr 2019;42:192–9. https://doi.org/10.18773/austprescr.2019.065
Page last updated April 2021