Syphilis education video for clinicians
Syphilis infections are increasing in Melbourne. Syphilis is a serious public health problem and can eventually cause brain infections, dementia, lung and heart failure, blindness and even death if left untreated.
Early detection is key to reducing transmission. Early symptoms may look like herpes. If you test for herpes, test for syphilis on same swab
Resources available to guide result interpretation and treatment.
Part 1: Syphilis - What is the problem and how are we testing?
Syphilis is an important global health problem which leads to serious complications including neurological problems and stillbirth. Despite availability of tests and treatment, rates of syphilis have climbed dramatically across Melbourne, affecting men, women and putting infants at risk.
Early detection is key. As a result, Melbourne Pathology has adopted a multiplex assay that enables simultaneous testing of herpes viruses and syphilis on a single swab. This will be run on all herpes PCR swabs labelled as collected from a genital site in order to detect early syphilis infections.
Part 2: Syphilis stages, signs and testing
Primary syphilis can mimic herpes. Swab all genital lesions. Secondary syphilis is the most infectious stage. All STI screening should include syphilis serology.
Part 3: Interpreting a syphilis result
A positive syphilis PCR confirms infectious syphilis. A syphilis history is essential to guide interpretation of serology.
Use the ASHM tool to guide result interpretation and contact Melbourne Sexual Health Centre doctors line on 1800 009 903 if you require further support.
Part 4: Management of a positive syphilis result
Confirm syphilis history, interpret results, determine treatment need, treat, notify DOH and conduct contact tracing (partner management). Assess for pregnancy in women of reproductive age
References for Clinicians
Decision making in syphilis tool (ASHM)
Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)
This 2 page resource summarises syphilis manifestations, testing indications and methods, result interpretation, treatment and follow up.
Australian STI Management Guidelines: For Use In Primary Care (ASHM)
Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)
Provides general guidance for STI testing in general practice
STI Atlas
Melbourne Sexual Health Centre (MSHC)
For images of STIs and syndromes
Electronic notification to the Department of Health (Victoria)
The Department of Health
Resources for patients
The Australian Department of Health
A collection of resources about syphilis, including fact sheets, posters and a video.
Partner management
"Let them know" website - Melbourne Sexual Health Centre
Partner management (anonymous notification)
Victorian Investigation of Complex STI's team (VICS team)
Department of Health - 03 9096 3367