Syphilis Is Still Out There – Information for Health Professionals

 

While we deal with the COVID-19 pandemic, the syphilis outbreak in South Australia continues.

It’s essential that during this time we continue to test, treat, cure* and notify partners.

The outbreak of infectious syphilis in South Australia was originally reported in November 2016, affecting rural and remote Aboriginal communities in the Far North and Eyre and Western regions of South Australia before extending to metropolitan Adelaide. This outbreak is part of a multi-jurisdictional outbreak of syphilis occurring across northern Australia in predominantly rural and remote Aboriginal and Torres Strait Islander communities.

*More information regarding syphilis symptoms, serology and treatment can be found in the resources below. If you’re looking for non-health professional information read the Syphilis Fact Sheet.

What is syphilis

Syphilis is a sexually transmitted infection. It is caused by the spirochete bacterium, Treponema pallidum, subspecies pallidum that can cause serious health problems if left untreated. Syphilis is usually passed on during anal, oral or vaginal sex. It is transmitted through skin-to-skin contact with an infected area. There are four stages of syphilis infection: primary, secondary, latent and tertiary. Each of these stages present different symptoms.

 

Syphilis is highly infectious during the first two years of infection. Pregnant women can transmit syphilis to their babies, which can result in perinatal death, premature delivery, and congenital abnormalities. Since 2016, South Australia has had five cases of infectious syphilis in pregnant people, and one child has been born with congenital syphilis. It’s important to know that syphilis also increases the risk of HIV transmission.

 

Despite the serious health problems associated with syphilis it can be easy to cure if treated early. Therefore it is essential that medical practitioners understand the importance of testing and treatment of syphilis as well as the partner/s of those with infectious syphilis.

 

 

Advice for health professionals in outbreak areas

SA Health provide the following advice for health professionals:

Medical practitioners in the outbreak areas and surrounding regions are advised to:

Offer syphilis testing to Aboriginal and Torres Strait Islander people and their partners in the following circumstances:

  • Where there is a clinical suspicion of syphilis.
  • During routine sexually transmitted infection (STI) screening in 16-40 year olds (offer HIV testing as well).
  • In anyone who is diagnosed with another STI such as chlamydia, gonorrhoea or trichomonas (offer HIV testing as well).
  • In anyone aged 16-40 years who is having a blood test for another reason – e.g. during an adult health check, or emergency department presentation.
  • During antenatal testing – in addition to testing at the first visit (10-12 weeks), repeat testing at 28 weeks, 36 weeks, at delivery, and at the 6 week post-natal check.

Testing pregnant people outside of these interval visits should also be considered. Pregnant people at risk of inadequate antenatal care should be screened opportunistically, outside of the set interval where appropriate, whenever they present for care.

  • Offer screening for syphilis in all sexually active patients, if considered at risk.

Contact SA Pathology on (08) 8222 3000, or Adelaide Sexual Health Centre on (08) 7117 2800 if assistance with interpretation of syphilis serology results is required.

 

Medical practitioners should:

  • Treat infectious syphilis (duration <2 years) with:
  • Intramuscular (IM) benzathine penicillin 1.8g (2.4 million units).
  • People diagnosed in the third trimester of pregnancy should be treated with a second dose of IM benzathine penicillin 1.8g (2.4 million units) 7 days later.
  • Treat patients likely to have had untreated syphilis for longer than 2 years, or of unknown duration, with three doses of IM benzathine penicillin 1.8g (2.4 million) given 7 days apart.
  • If there is a history of penicillin allergy, consult with an Infectious Diseases or Sexual Health Physician.
  • Test and treat for syphilis on the same day of presentation for all people with genital ulcers – do not wait for a positive result.
  • Notify cases of syphilis to the Communicable Disease Control Branch on 1300 232 272.

 

Locating, testing, and treating partners of infectious cases is essential in controlling syphilis.

 

 

More information

The following organisations can provide advice and guidance around syphilis testing and treatment.

 

Aboriginal Health Council of South Australia

220 Franklin Street, Adelaide SA 5000

(Postal address: GPO Box 719 Adelaide SA 5001)

Phone: (08) 8273 7200

 

Adelaide Sexual Health Centre

1st Floor, 275 North Terrace, Adelaide SA 5000

Phone: (08) 7117 2800

 

SHINE SA

Phone: (08) 8300 5300

 

Nganampa Health Council

Phone: (08) 8954 9040

 

Share this campaign

This campaign is a partnership between Aboriginal Health Council of South Australia and SHINE SA.

Help us share this campaign by downloading our social media tiles to share on Facebook, Instagram, Twitter and LinkedIn. Use the hashtag #SyphilisIsStillOutThere

Download the files here as a zipped folder: Syphilis Is Still Out There Campaign

 

Syphilis resources

AHCSA Sexually Transmitted Infections & Blood-Borne Viruses Handbook

SA Syphilis Register

SA Health Infectious syphilis outbreak – Fact Sheet for Health Professionals

New Video Resources for Clinicians: Syphilis Symptoms, Serology and Treatment

Sexually transmitted infections Guidelines – Syphilis

South Australian Perinatal Practice Guideline Syphilis in Pregnancy

SA Health Management of syphilis during pregnancy

 

 

COVID-19 and Sexual Health resources

ASHM COVID-19 resources

Thorne Harbour Health COVID-19 resources

 

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