Providers Syphilis Screening Kentucky Reportable Disease Form EPID 200 Form Kentucky Reportable Disease Form Fax #: 859.288.7512 Please complete and send this form via fax within 24hrs of reactive results. Please enable JavaScript in your browser to complete this form.Is the patient pregnant?DefaultYesNoWho is being screened?DefaultSCREENING AND DIAGNOSIS OF SYPHILIS IN PREGNANT WOMEN WITHOUT PRIOR SYPHILISSCREENING FOR SYPHILIS IN PREGNANT WOMEN WITH PRIOR SYPHILISWho is being screened? DefaultSCREENING FOR SYPHILIS IN ADULTS WITHOUT PRIOR INFECTIONSCREENING FOR SYPHILIS IN ADULTS WITH PRIOR INFECTIONSCREENING FOR SYPHILIS IN ADULTS WITHOUT PRIOR INFECTION SCREENING FOR SYPHILIS IN ADULTS WITH PRIOR INFECTION What is the initial screening test?Initial screening test is a nontreponemal testInitial screening test is a treponemal testWhat are the nontreponemal screening test results ?ReactiveNonreactivePerform nontreponemal test (Treponemal tests typically remain positive for life in those with a history of syphilis)Was patient treated with an appropriate regimen?No evidence of active syphilis. In patients with a possible recent exposure to syphilis, (eg. condomless sex with unknown/multiple partners in last 6 to 8 weeks), consider repeat testing in 2 to 4 weeks.+Was patient treated with an appropriate regimen?YesNoResults of nontreponemal testing performed following prior treatment are needed to distinguish between new infection, inadequately treated prior infection, and expected serologic findings post-treatment. Are these results available?YesNoNo further testing required Treat for syphilis What are the treponemal screening test results?ReactiveNonreactiveConfirm that patient has no history of prior syphilis.History or prior syphilisNo history of prior syphilisConfirm that patient has no history of prior syphilisHistory or prior syphilisNo history of prior syphilisRefer to alogorithm that describes screening in patients with prior syphilis Confirmatory nontreponemal test is performed (laboratories typically perform this reflexively)ReactiveNonreactiveSecond treponemal test that targets different antigens should be performed (laboratories may perform this reflexively)ReactiveNonreactivePerform confirmatory treponemal testReactiveNonreactiveSerology consistent with syphyilis. Treat accordingly. Did the patient have a possible recent exposure to syphilis (eg. condomless sex with unknown/multiple partners in the last 6 to 8 weeks)?YesNoRepeat treponemal test in approximately 2 to 4 weeks. On rare occastion, a false-negative treponemal test may occur.Repeat test reactiveRepeat test nonreactiveSerology consistent with syphyilis. Treat accordingly. Syphilis unlikely. Nontreponemal test probaby a false positive. Evaluate for causes of false-positive nontreponemal test. No evidence of active syphilis. In patients with a possible exposure to syphilis (eg. condomless sex with unknown/multiple partners in last 6 to 8 weeks), consider repeat testing in 2 to 4 weeks Serology not consistent with syphilis. In patients with a possible recent exposure to syphilis (eg, condomless sex with unknown/multiple partners in last 6 to 8 weeks), conisder repeat testing in 2 to 4 weeks. On rare occasion, a patient who has had a recent exposure may have a false-negative treponemal test Please complete and send this form via fax within 24hrs of reactive results. Fax #: 859.288.7512 Kentucky Reportable Disease Form Please complete and send this form via fax within 24hrs of reactive results. Fax #: 859.288.7512 Kentucky Reportable Disease Form SCREENING FOR SYPHILIS IN PREGNANT WOMEN WITH PRIOR SYPHILIS Perform nontreponemal test (Treponemal tests typically remain positive for life in those with a history of syphilis) What are the nontreponemal screening test results?ReactiveNonreactiveWas patient treated with an appropriate regimen?YesNoResults of nontreponemal testing performed following prior treatment are needed to distinguish between new infection, inadequately treated prior infection, and expected serologic findings post-treatment. Are these results available?YesNoManagement depends upon: • Initial pretreatment titer • Most recent post-treatment titer • Duration of time since treatment • Current nontreponemal titer • Risk of recent exposure No evidence of active syphilis. In patients with a possible recent exposure to syphilis, (eg. condomless sex with unknown/multiple partners in last 6 to 8 weeks), consider repeat testing in 2 to 4 weeks. Management options include empiric treatment or additional monitoring. TREAT FOR SYPHILIS SCREENING AND DIAGNOSIS OF SYPHILIS IN PREGNANT WOMEN WITHOUT PRIOR SYPHILIS Screen all pregnant people at first prenatal visit. What are the screening test results?Screening test reactiveScreening test nonreactive1. Rescreen patient in the third trimester 2. Rescreen patient at delivery Is the confirmatory test reactive?YesNoSerology consistent with syphilisYesNoTreat Results maybe likely consistent with early infection or a false-positive screening test. What kind of test was used as the initial screening test?Non treponemalTreponemalNon TreponemalYesNo1. Repeat confirmatory treponemal test in 2 to 4 weeks 2. Reactive treponemal test 3. Serology consistent with syphilis 4. Treat 1. Initial nontreponemal test likely a false positive 2.Nonreactive treponemal test 3. • Rescreen in the third trimester • Rescreen again at delivery No further testing required Perform second treponemal test that targets different antigensReactive treponemal testNonreactive treponemal test3. Serology consistent with syphilis 4. Treat 1. Initial nontreponemal test likely a false positive 2.Nonreactive treponemal test 3. • Rescreen in the third trimester • Rescreen again at delivery Please complete and send this form via fax within 24hrs of reactive results. Fax #: 859.288.7512 Kentucky Reportable Disease Form Submit If you have question call, 859-899-5222 or email us at epidemology@LFCHD.com Additional Resources Providers Only (lfchd.org)