SYPHILIS
(Treponema pallidum)

Clinical Criteria
- Primary syphilis
Any person with one or several (usually painless) chancres in the genital, perineal, anal area
or mouth or pharyngeal mucosa or elsewhere extragenitally

- Secondary syphilis
Any person with at least one of the following three:
- Diffuse maculo-papular rash often involving palms and soles
- Generalized lymphadenopathy
- Condyloma lata
- Enanthema
- Allopetia diffusa

- Early latent syphilis (< 1 year)
A history of symptoms compatible with those of the earlier stages of syphilis within the
previous 12 months

- Late latent syphilis (> 1 year)
Any person meeting laboratory criteria (specific serological tests)

Laboratory Criteria
At least one of the following four laboratory tests:
- Demonstration of Treponema pallidum in lesion exudates or tissues by dark-field
microscopic examination
- Demonstration of Treponema pallidum in lesion exudates or tissues by DFA test
- Demonstration of Treponema in lesion exudates or tissues by PCR
- Detection of Treponema pallidum antibodies by screening test (TPHA, TPPA or EIA)
AND additionally detection of Tp-IgM antibodies (by IgM-ELISA, IgM immunoblot or
19S-IgM-FTA-abs) - confirmed by a second IgM assay

Epidemiological Criteria
- Primary/secondary syphilis
An epidemiological link by human to human (sexual contact)
- Early latent syphilis (< 1 year)
An epidemiological link by human to human (sexual contact) within the 12 previous months

Case Classification
A. Possible case    NA
B. Probable case
Any person meeting the clinical criteria and with an epidemiological link
C. Confirmed case
Any person meeting the laboratory criteria for case confirmation