The CDC's new guidelines in the Morbidity and Mortality Weekly Report outline comprehensive testing protocols for syphilis diagnosis, emphasizing the combined use of nontreponemal and treponemal tests to improve detection and management of the disease in the U.S.
By Hugo Francisco de SouzaFeb 11 2024Reviewed by Susha Cheriyedath, M.Sc. In a recent report published in the Morbidity and Mortality Weekly Report , the United States Centers for Disease Control and Prevention shares its recommendations for the tests and protocols required to diagnose syphilis in the US.
Alarmingly, the global burden of syphilis is rising rapidly, especially in wealthy and developed countries, with approximately 6 million new cases in 2021 alone. Reports from the United States of America observe an increase of 2,140% in syphilis incidence rates between 2000 and 2020 , suggesting a local epidemic within the country. Research has characterized this epidemic as displaying significant health disparities, with gender and sexual minorities being the worst affected.
Serologic Laboratory Testing The first section of the report summarises progress in syphilis serological testing since the invention of the Wassermann test through to current nontreponemal and treponemal tests. In brief, when patients display symptoms or signs of syphilis or have had known sexual contact with a diagnosed syphilis patient, nontreponemal tests are recommended for laboratory screening.
Treponemal tests are used to validate nontreponemal test results and to diagnose early syphilis infections that cannot be detected by nontreponemal tests. Most of these tests are conducted manually, but some can be automated for high throughput. In most patients, treponemal antibodies are detectable for life and are helpful to indicate a past, successfully treated syphilis infection.
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