June 27, 2016<\/p>\n
Dear Colleague:<\/p>\n
I am writing today to make you aware of significant increases in reported syphilis cases in Virginia and nationally and to assure you have the necessary information on testing, treatment and related resources.<\/p>\n
Key Observations\/Recommendations<\/strong><\/p>\n Syphilis Cases<\/strong> HIV and syphilis co-infection raises concerns for further syndemic transmission.\u00a0 In addition, patients co-infected with syphilis and HIV may be at increased risk for neurologic complications and serologic treatment failure.<\/p>\n Due to increases in ocular syphilis, the Centers for Disease Control and Prevention (CDC) recently released an updated advisory<\/a>.\u00a0 This clinical manifestation can occur at any stage of syphilis and may result in significant sequelae, including blindness.\u00a0 The Virginia Department of Health (VDH) received reports of five cases in 2015 and three cases in 2016.<\/p>\n Testing<\/strong><\/p>\n Timely identification of STDs<\/a> is the foundation for effective prevention efforts.\u00a0 The U.S. Preventive Services Task Force\u00a0now recommends syphilis screening<\/a> for at-risk asymptomatic adolescents and adults.\u00a0 In addition:<\/p>\n Treatment<\/strong><\/p>\n The CDC\u2019s 2015 STD Treatment Guidelines<\/a> indicate that a one-time dose of penicillin G benzathine (Bicillin-LA\u00ae) 2.4 million units IM is recommended for primary, secondary and early latent syphilis.\u00a0 Additional doses to treat early syphilis do not enhance efficacy, including in patients living with HIV infection.\u00a0 Treat sexual partners of a person who receives a diagnosis of primary, secondary, or early latent syphilis within 90 days preceding the diagnosis presumptively for early syphilis, even if serologic test results are negative.\u00a0 Although the CDC announced a national shortage of Bicillin-LA\u00ae<\/a> in May 2016, more recently CDC indicates there is currently a sufficient supply to adequately treat syphilis cases.\u00a0 If providers\u2019 supply levels of Bicillin-LA\u00ae reach three weeks or less, notify the Pfizer Supply Continuity Team at 844-804-4677 for assistance.\u00a0 Treat ocular syphilis with aqueous crystalline penicillin G IV or procaine penicillin IM with Probenecid for 10-14 days.<\/p>\n In closing, I appreciate your efforts to ensure identification and reporting of syphilis cases.\u00a0 This will aid our collective efforts to effectively address this increase.\u00a0 Please report syphilis<\/a> to your local health department via a morbidity report form<\/a>.\u00a0 Report primary and secondary syphilis immediately by the most rapid means available.\u00a0 Clinical consultation on syphilis management is available on-line at National Network of STD Clinical Prevention Training Centers (NNPTC) STD Clinical Consultation Network<\/a>.\u00a0 For additional information, contact Ashley Carter at ashley.carter@vdh.virginia.gov<\/a> or 8048648042 or visit the VDH-STD program<\/a> or CDC-Division of STD Prevention<\/a> websites.<\/p>\n Thank you for your continued efforts to improve and maintain the health of the people in Virginia.<\/p>\n Sincerely,<\/p>\n Marissa J. Levine, MD, MPH, FAAFP<\/p>\n State Health Commissioner<\/p>\n","protected":false},"excerpt":{"rendered":" June 27, 2016 Dear Colleague: I am writing today to make you aware of significant increases in reported syphilis cases in Virginia and nationally and to assure you have the necessary information on testing, treatment and related resources. Key Observations\/Recommendations Most syphilis is reported among men who have sex with other men (MSM); however, cases […]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-142","page","type-page","status-publish","hentry"],"yoast_head":"\n\n
\nVirginia rates of TES diagnoses, (which includes primary, secondary and early latent syphilis) increased by 40.5% in 2015 when compared to the 2011-2014 average annual rate.\u00a0 The majority of TES cases were male (90%); of these, 75% were MSM.\u00a0 The rate of TES among women increased 47% for the same period.\u00a0 National rates of congenital syphilis increased 38% from 2012-2014.\u00a0 Virginia had eight congenital syphilis diagnoses from 2013-2015 as compared to two cases diagnosed in 2010-2012 (Annual STD Surveillance Report-Total Early Syphilis<\/a>).<\/p>\n\n