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Syphilis incidence is increasing locally since 2010. In 2016,there were 44 cases of early syphilis reported to the Monterey County Health Department, compared to 1 to 2 cases per year from 2006 to 2009. Gay, bisexual, and other men who have sex with men are at particularly high risk of acquiring syphilis. In 2015, Monterey County reported its first congenital syphilis case in over 10 years.
Recommendations for Healthcare Providers
- Test for syphilis. Syphilis serology testing should include a rapid plasma regain (RPR) with titer that reflexes to a treponemal test if the RPR is reactive.
- Pregnant women should be screened for syphilis at their first prenatal care visit. Testing should be repeated during the third trimester and at delivery for women who are at high risk for syphilis.
- Sexually active gay, bisexual, and other men who have sex with men should be screened annually or sooner following disclosure of high risk sexual activity.
- An algorithm from the Health Department is available to assist with interpreting screening results.
- Follow the Centers for Disease Control and Prevention’s (CDC’s) guidelines for treatment.
- All providers are encouraged to treat patients and their partners in their practice. Family PACT, Medi-Cal, and private insurances normally cover testing and treatment for syphilis.
- All patients with syphilis should be tested for HIV if not already known to be HIV-infected. From 2013 to 2015, 42% of all reported early syphilis cases in Monterey County were also HIV positive.
- Promptly report all suspected syphilis cases to the Health Department’s Communicable Disease Unit (phone: 831-755-4521; fax: 831-754-6682).
For additional information about syphilis, please contact the Communicable Disease Unit at 831‑755‑4521 or visit the CDC’s provider website. For consultation regarding clinical management of syphilis, contact the California Department of Public Health STD Control Branch provider warm-line at (510) 620-3400 or by email at email@example.com 8 a.m. to 5 p.m. Monday through Friday.