SYPHILIS, CONGENITAL and NEONATAL
(Treponema pallidum)

Clinical Criteria
Any infant < 2 years of age with at least one of the following ten:
– Hepatospenomegaly
– Mucocutaneous lesions
– Condyloma lata
– Persistent rhinitis
– Jaundice
– Pseudoparalysis (due to periostitis and osteochondritis)
– Central nervous involvement
– Anaemia
– Nephrotic syndrome
– Malnutrition

Laboratory Criteria
- Laboratory criteria for case confirmation

At least one of the following three:
– Demonstration of Treponema pallidum by dark field microscopy in the umbilical cord, the
placenta, a nasal discharge or skin lesion material
– Demonstration of Treponema pallidum by DFA-TP in the umbilical cord, the placenta, a
nasal discharge or skin lesion material
– Detection of Treponema pallidum - specific IgM (FTA-abs, EIA)
AND a reactive non treponemal test (VDRL, RPR) in the child’s serum

- Laboratory criteria for a probable case

At least one of the following three:
– Reactive VDRL-CSF test result
– Reactive non treponemal and treponemal serologic tests in the mother’s serum
– Infant’s non treponemal antibody titre is fourfold or greater than the antibody titre in the
mother’s serum

Epidemiological Criteria
Any infant with an epidemiological link by human to human transmission (vertical
transmission)

Case Classification
A. Possible case    NA
B. Probable case
Any infant or child meeting the clinical criteria and with at least one of the following two:
– An epidemiological link
– Meeting the laboratory criteria for a probable case
C. Confirmed case
Any infant meeting the laboratory criteria for case confirmation