Expanded Syphilis Screening Recommendations for the Prevention of Congenital Syphilis—2020

This document was created to enhance syphilis detection among people who are or could become pregnant (e.g. pregnant women and females of childbearing age) to prevent congenital syphilis (CS). Evidence-based recommendations in this document support policies and best practices intended to strengthen the response to the recent dramatic rise in CS incidence across California.

Please also see the associated Dear Colleage letter

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Home Training Clinical Practice Alert: Chlamydia and Gonorrhea Screening and Treatment

Clinical Practice Alert: Chlamydia and Gonorrhea Screening and Treatment

June 20, 2019

Rates of sexually-transmitted diseases (STDs) such as chlamydia trachomatis (CT) and gonorrhea (GC) have reached an all-time high. In the U.S., California leads the nation in reported cases of these STDs. Because persons with CT and GC are often asymptomatic, screening is essential for the early detection and treatment that can prevent reproductive complications including pelvic inflammatory disease (PID), tubal infertility, ectopic pregnancy, and chronic pelvic pain in females and epididymitis in males.

This webinar covers current clinical guidelines for routine and targeted screening, treatment, follow-up, and prevention of CT and GC.

Learning objectives:

Understand current guidelines for screening for CT and GC among sexually active women and men
List the indications for anorectal and oropharyngeal CT/GC screening
Explain when test-of-cure is indicated
Identify the proper ICD-10 codes for lab requests and billing information

Presenters:

Resources:

Extragenital Screening

Home Resources Extragenital Screening

Extragenital Screening

Don’t forget to swab! Among men who have sex with men, 84% of gonorrhea and chlamydia infections would be missed with urine-only screening1. Make sure your clients are screened for gonorrhea and chlamydia of the throat and rectum.

What:	Extragenital Screening for Gonorrhea and Chlamydia
Where:	Rectum and throat
Who:	Men who have sex with men (MSM), transgender women, people living with HIV, and people on PrEP who report having receptive anal and/or oral sex
When:	At least annually, or every 3 to 6 months as needed based on exposure
Why:	When urine-only screening is performed, up to 90% of rectal gonorrhea and 77% of rectal chlamydia infections remain untreated¹. HIV-negative men diagnosed with rectal infections are excellent candidates for PrEP, because they have a high risk of HIV infection
How:	Swab specimen (self or clinician-collected swab)

The California Prevention Training Center supports clinics and providers in implementing rectal and pharyngeal STI screening.

For more information, contact us.

Resources for Providers

FDA clears first diagnostic tests for extragenital testing for chlamydia and gonorrhea, FDA New Release
May 23, 2019

Extragenital Chlamydia and Gonorrhea Among Community Venue–Attending MSM, CDC MMWR
April 11, 2019

CA Department of Public Health, Dear Colleague Letter
February 20, 2019

HIV incidence among men with and those without sexually transmitted rectal infections, Clinical Infectious Diseases
October 15, 2013

National Coalition of STD Directors – Extragenital Testing

NYC Department of Health and Mental Hygiene – STI’s Among MSM Protocol Card

Resources for Clinics

Self Swab Instructional Posters:

Rectal, Throat, and Vaginal Self-Swab

Rectal Self-Swab

Throat Self-Swab

Vaginal Self-Swab

CDC Recommendations for Laboratory-Based Detection of Gonorrhea and Chlamydia, March 14, 2014

Verification of Patient Self-Collected Extragenital Nucleic Acid Amplification Tests

Resources for Patients

CDC Just Diagnosed – Gonorrhea and Chlamydia

CDC PrEP Resources

Please PrEP Me – Provider Locator

Building Healthy Online Communities – Sexual Health Information

Marcus JL, Bernstein KT, Kohn RP, Liska S, Philip SS. Infections missed by urethral-only screening for chlamydia or gonorrhea detection among men who have sex with men. Sexually transmitted diseases. 2011 Oct 1;38(10):922-4.

Congenital Syphilis Algorithm

Video example of a disease intervention interview linking a person co-infected with syphilis and HIV to care, and providing partner services.

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Extragenital Screening Resources

Extragenital (rectum and throat) gonorrhea and chlamydia screening resources for providers, clinics, and patients.

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Secondary Syphilis Patient Evaluation Algorithm

Algorithm to evaluate patients for secondary syphilis. Includes sexual history taking and physical exam, diagnostic work-up, treatment and follow-up, and reporting and partner management.

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Primary Syphilis Patient Evaluation Algorithm

Algorithm to assist in evaluating patients for primary syphilis.

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Syphilis Treatment Recommendations

Providing an overview of syphilis treatment recommendations.

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Syphilis Staging

Providing an overview of syphilis staging.

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Traditional Syphilis Serologic Screening Algorithm

Providing an overview of traditional and reverse sequence syphilis screening algorithms.

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