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[Syphilis, infection and serology]
Insights
Switzerland diagnoses 300-400 syphilis cases annually. Modern serological tests like TPHA and FTA-ABS are crucial for diagnosis, while Card-CFT and VDRL aid treatment monitoring.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Public Health
Background:
- Syphilis diagnosis in Switzerland involves 300-400 new cases yearly, primarily primary syphilis.
- Serological diagnostic methods for syphilis have evolved significantly.
- Classical tests like Card-CFT and VDRL remain relevant for post-treatment monitoring.
Observation:
- TPHA and FTA-ABS tests are now essential for syphilis diagnosis.
- These highly specific tests detect syphilis 2-3 weeks post-inoculation.
- FTA-ABS-19S-IgM positivity indicates a need for treatment.
Findings:
- Cardiolipin complement binding test (Card-CFT) and VDRL are valuable for monitoring treatment efficacy.
- TPHA and FTA-ABS offer high specificity and early detection of syphilis.
- These newer tests are not suitable for assessing treatment response.
Implications:
- Accurate syphilis diagnosis relies on a combination of established and modern serological tests.
- Early detection through TPHA and FTA-ABS facilitates timely intervention.
- Interpreting diverse serological reactions is key for effective patient management and public health surveillance.
Abstract:
The in- and out patient departments of Dermatology report in Switzerland every year between 300 to 400 newly diagnosed cases of syphilis--mostly primary syphilis--to the federal public health service. The serological tests decisive for such a diagnosis have been fundamentally changed in the last few years. Among the classical tests only the cardiolipin complement binding test (Card-CFT) and the VDRL test remain still valuable. They are suitable for controlling the course of disease after treatment. Nowadays two tests are essential for the diagnosis, i.e. the TPHA and the FTA-ABS. They are highly specific for syphilis and become already positive between the 2nd and the 3rd week after inoculation. On the other hand these tests are of no value for the follow-up after therapy. A positive FTA-ABS-19S-IgM test indicates the necessity of treatment. Practical examples may illustrate the interpretation of different reactions.