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.

3d illustration of a syphilis pathogen

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

Providing guidance on the traditional screening algorithm and reverse screening algorithm.

various microscopic images of pathogens

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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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

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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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.

Learning Objectives

  1. Describe California’s congenital syphilis epidemiology
  2. Discuss the pathophysiology and management of syphilis, including among pregnant patients
  3. Explain and apply the CDPH recommendation to confirm syphilis status among pregnant patients receiving care in emergency departments

Perinatal HIV and Congenital Syphilis—Dear Colleague Letter from CDPH

November 16, 2021: CDPH is asking for assistance in responding to concerning increases in congenital syphilis and perinatal HIV in California. Perinatal HIV transmission and congenital syphilis can be prevented with timely testing and treatment. A common risk factor, however, is receiving late or no prenatal care.

CDPH requests your assistance to implement the following policies and best practices to Screen, Treat and Prevent, and Prepare for perinatal transmissions

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STI Clinical Update Webinar: San Francisco Department of Public Health, San Francisco City Clinic

November 4, 2021

The San Francisco Department of Public Health continues to see concerning rises in sexually transmitted infections (STIs).

This half-day, virtual event provides important updates in the field of sexual health to help providers strengthen the delivery of STI prevention and care. Hear from local experts on STI epidemiology in San Francisco, important recommendations to prevent congenital syphilis, updates from the 2021 CDC STI Treatment Guidelines, and a lively case panel.

Learning Objectives

  1. Summarize current STI trends in San Francisco
  2. Identify and screen those most at risk for syphilis in San Francisco
  3. Describe updated treatment recommendations for chlamydia, gonorrhea, Mycoplasma genitalium, NGU, and trichomonas