SYPHILIS
Causative organism | Treponema pallidum spp pallidum |
Incubation period | 9-90 days (mean 30) to primary syphilis; 30-150 days to secondary syphilis; 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; Secondary syphilis — 6 months plus duration of symptoms; Early latent syphilis — 12 months. |
Usual testing method | Serology for syphilis. Ulcer swab can be tested by nucleic acid amplification |
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 |
Transmission by oral sex | Probably common |
Duration of potential infectivity | Up to 24 months (rare after 12 months) |
Important sequelae | Neurosyphilis, cardiovascular syphilis, and congenital infection. Enhanced HIV transmission and incidence, so a diagnosis of syphilis is an indication for HIV pre-exposure prophylaxis (PrEP) in gay men |
Direct benefit of detection and treatment of contacts | Cure, and prevention of transmission |
Usual management of contacts |
Consultation with sexual health physician in all cases is suggested
|
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 |