Syphilis in adults: updates on testing, prevention and treatment

Area of Science:

• Public Health
• Infectious Diseases
• Clinical Medicine

Background:

• Syphilis re-emergence in Australia poses a significant public health challenge.
• Rising notification rates and congenital syphilis cases highlight diagnostic and testing gaps.
• Syphilis presents diagnostic challenges due to varied presentations mimicking other diseases.

Purpose of the Study:

• To provide a contemporary summary of syphilis epidemiology, diagnosis, and management in Australia.
• To discuss advancements in syphilis diagnostics and prophylaxis.
• To emphasize the importance of physician awareness and confident management of syphilis.

Main Methods:

• Review of evolving epidemiology and staging of syphilis infections.
• Discussion of serological test interpretation.
• Outline of management strategies including partner notification and follow-up.
• Highlighting advances in diagnostics (NAATs, POC tests) and post-exposure prophylaxis (doxycycline).

Main Results:

• Syphilis notification rates are decreasing in some Australian jurisdictions.
• New diagnostic tools facilitate earlier detection of syphilis infections.
• Doxycycline offers potential for preventing syphilis infections in at-risk populations.
• Global shortage of benzathine benzylpenicillin necessitates alternative treatment regimens.

Conclusions:

• Syphilis management requires ongoing physician vigilance and confidence in testing and treatment.
• Interventions implemented as part of the national syphilis response are showing positive effects.
• Continued efforts are needed to address diagnostic challenges and ensure effective treatment, especially concerning congenital syphilis.