STI Clinical Program Update: Mpox letter and Bicillin shortage
STI Clinical Program Updates: Mpox letter and Bicillin shortage
The California Department of Public Health (CDPH) STD Control Branch has released two new important communications on: (1) Preventing a Resurgence of Mpox Cases in California and (2) Addressing an ongoing Bicillin® L-A shortage.
CDPH is aware that – while the rate of California (CA) mpox cases has declined precipitously since its peak in August 2022 – mpox transmission has continued in CA, and other states have recently reported a resurgence of mpox cases. Accordingly, CDPH has released a new Dear Colleague Letter intended as a call to action to Californian health care providers to remain vigilant in mpox prevention, recognition, and testing. This is especially important during the upcoming 2023 spring and summer season as people gather for festivals and events, including LGBTQ Pride Month in June. Information on how to diagnose, test for, and vaccinate against mpox is included.
(2) Health Advisory: Bicillin® L-A (Benzathine Penicillin G) Shortage
The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) have announced a shortage of long-acting penicillin G benzathine injectable suspension products (Bicillin® L-A), with an estimated recovery timeframe not until Q4 of 2023. This is of considerable concern in CA, as the state continues to see significant increases in syphilis — including syphilis in pregnant persons and congenital syphilis in infants. CDPH has thus issued a Health Advisory addressing the Bicillin® L-A shortage, providing a framework for prioritization of limited Bicillin® L-A supplies when necessary, and recommending doxycycline as an alternative to Bicillin® L-A in appropriate clinical scenarios.
Sincerely,
California Prevention Training Center
Syphilis Treatment Intervals in Non-Pregnant Patients: A Clinical Resource for Providers
What are appropriate treatment intervals for late latent syphilis or syphilis of unknown duration in non-pregnant people?
Prepared by the STD Control Branch, California Department of Public Health and California Prevention Training Center. Revised February 2023.
STI Clinical Update Webinar: Syndromic Management of STIs – Part 2
Tuesday, December 6, 2022 from 12:00PM-1:15PM (PST)
Presented by Drs. Kathleen Jacobson and Kelly Johnson
A case-based approach to recognizing sexually transmitted infections, with a focus on those that disseminate outside the genital tract.
Learning Objectives
Identify various presentations of STI ulcerative disease
Understand that certain sexually transmitted infections (STIs) can disseminate outside the genital tract, sometimes causing severe disease
Recognize the varied clinical manifestations of disseminated STIs (including disseminated gonococcal infections, secondary syphilis, and mpox)
Understand how to diagnose and manage disseminated STIs
Syndromic Management of STIs-Part 1
October 18, 2022
Presented by Drs. Rosalyn Plotzker, Akanksha Vaidya, and Eric Tang
The California Department of Public Health (CDPH) continues to see statewide increases in all reportable sexually transmitted infections (STIs), including syphilis, gonorrhea and chlamydia.
For many patients, these STIs manifest as a complex syndrome that involves local and systemic symptoms. This webinar is the first of a two-part series, featuring Drs. Rosalyn Plotzker,
Akanksha Vaidya, and Eric Tang of the CDPH Sexually Transmitted Diseases Control Branch who will lead a case-based discussion on the presentation, diagnosis and syndromic management of STIs.
Learning Objectives
Describe the differential diagnosis and management of patients with vaginal discharge and pelvic pain
Discuss the exam findings and treatment of patients with penile discharge and testicular pain
Explain the management of patients with anorectal pain in the setting of a known STI exposure
Clinical Interpretation of Syphilis Screening Algorithms
Clinical Interpretation of Syphilis Screening Algorithms
Providing guidance on the traditional screening algorithm and reverse screening algorithm.
Clinical Practice Alert: Syphilis Screening, Diagnosis, and Treatment
Clinical Practice Alert: Syphilis Screening, Diagnosis, and Treatment
Rates of syphilis have been rising in the US, including in California, which has resulted in a corresponding rise in the rates of congenital syphilis (CS). Fifteen percent of women of childbearing age diagnosed with syphilis are pregnant.
These trends mirror a sharp increase in all stages of syphilis among females, which increased more than 500 percent during the same period. Download the PDF to learn more.
This Clinical Practice Alert includes management of primary, secondary, and latent syphilis. It does not include screening and management of syphilis in people who are pregnant or the diagnosis and treatment of tertiary syphilis.
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Training STI Clinical Update Webinar – Neurosyphilis
STI Clinical Update Webinar – Neurosyphilis
Thursday, July 21, 2022, 11:30 AM – 1:00 PM (PDT)
The California Department of Public Health (CDPH) continues to see dramatic statewide increases in syphilis. Neurosyphilis, a syphilitic infection of the nervous system, poses a complex diagnostic and management challenge for providers caring for patients with syphilis. This webinar features Drs. Kathleen Jacobson, Chief of the CDPH Sexually Transmitted Diseases Control Branch and Sue Tuddenham, Assistant Professor of Medicine at the Johns Hopkins University School of Medicine, who will discuss the epidemiology, diagnosis and management of neurosyphilis.
Learning Objectives:
Review California and national epidemiology of neurosyphilis
Describe the pathophysiology of neurosyphilis
Delineate clinical diagnosis and management of patients with neurosyphilis
Opt-Out ED Screening for HIV, HCV, and Syphilis—Dear Colleague Letter from CDPH
Opt-Out ED Screening for HIV, HCV, and Syphilis—Dear Colleague Letter from CDPH
March 28, 2022: Emergency departments (EDs) are uniquely positioned to identify people with syphilis, HIV, and hepatitis C who otherwise might remain undiagnosed. The California Department of Public Health (CDPH) recommends that EDs consider implementing routine opt-out testing for syphilis, HIV, and hepatitis C.
Identification and immediate treatment through the ED may have the added benefit of furthering health equity for those disproportionately affected by these infections
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Training STI Clinical Update Webinar: Congenital Syphilis Update for California Emergency Department Clinicians
STI Clinical Update Webinar: Congenital Syphilis Update for California Emergency Department Clinicians
December 14, 2021 Presented by Drs. Rosalyn Plotzker and Kristopher Lyon
The California Department of Public Health (CDPH) continues to see dramatic statewide increases in congenital syphilis (CS), a severe yet preventable condition when syphilis is passed from mother to fetus. In California, many infants with CS are born to parents who received care in an emergency department (ED) during pregnancy, suggesting syphilis screening in EDs may offer an important opportunity to detect syphilis in pregnancy and prevent CS.
This webinar features Dr. Rosalyn Plotzker, CDPH public health medical officer and co-author of the CDPH Expanded Syphilis Screening Recommendations for the Prevention of Congenital Syphilis. She will provide a clinical overview of CS prevention and discuss the recommendation to confirm syphilis status for pregnant patients in the ED. In addition, Dr. Kristopher Lyon, Public Health Officer and EMS medical director in Kern County, California and emergency department associate medical director, will present on syphilis screening in EDs from an on-the-ground perspective.
Discuss the pathophysiology and management of syphilis, including among pregnant patients
Explain and apply the CDPH recommendation to confirm syphilis status among pregnant patients receiving care in emergency departments
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