Caused by the bacteria Treponema pallidum, Syphilis transmission is primarily person to person via direct contact with infectious lesions or through transplacental spread during pregnancy leading to congenital infection.
The HPSC reported 611 notifications of early infectious syphilis in Ireland in 2020. As asymptomatic infection is common, screening and treatment in at risk groups is important to reduce onward transmission.
There are several stages of syphilis infection: early infection which is divided into primary infection, secondary infection, and early latent infection and late syphilis which includes latent, cardiovascular and gummatous syphilis. The average incubation period is 21 days but can range from 10-90 days.
Primary syphilis: The classic lesion of primary syphilis is a single, painless and indurated ulcer with a clean base. This is called a chancre. However, there is significant variability in morphological presentation and can therefore be unreliable.
Secondary syphilis: There may not be a sharp demarcation between primary and secondary stage syphilis. The chancre may also still be present. Secondary syphilis is often a subtle disease as skin lesions may be easily overlooked or mistaken for other dermatologic diseases.
Latent (early & late) syphilis: The latent or asymptomatic stage of syphilis is defined as the disappearance of the secondary manifestations until therapeutic cure or tertiary manifestations develop. This stage is arbitrarily divided into early and late latent syphilis based on the spontaneous infectious relapse of untreated patients. Approximately 90% of relapses occur within 1 year, these cases are known as early latent syphilis. 94% of relapses occur within 2 years and the rest occur over 4 years. Relapses occurring after 1 year are defined as late latent syphilis.
Tertiary syphilis: This stage presents at the end stage of infection, 10-30 years after initial infection. Tertiary syphilis has many different clinical presentations. i) Cardiovascular syphilis, ii) Neurosyphilis and iii) Late benign disease. Tertiary syphilis can occur 10-30 years after initial infection.
The diagnosis of Syphilis depends on clinical findings, examination of lesion materials and/or serologic tests for syphilis.
5mL venous serum or plasma OR 0.8mL capillary serum.
Enfer Medical offers the Syphilis TP assay to detect IgM and IgG antibodies to T. pallidum. This test is CE-IVD certified.
For clients using the Enfer Medical Client Portal, the Enfer Medical Patient Request Form (PRF) will be generated when you have completed your “Test Request” within the portal linked below.
Please note that samples suspected of containing high risk pathogens such as Mycobacterium tuberculosis should be clearly identified on the form and packed separately from other samples.
Results are available next working day.
This assay is available seven days a week.
The packaging/preparation of samples for delivery to the laboratory are required to be in adherence to all national regulations for the safe transport of biological materials. HSE guidance can be reviewed HERE.
There are specific packaging instructions and labelling requirements requiring triple packaging including:
Further information on the packaging/preparation of samples for delivery to the laboratory is contained within the Enfer Medical Laboratory User Manual which clients are provided with.
Venous blood samples must be tested within 72 of collection hours if stored at room temperature. Venous blood samples must be tested within 7 days of collection if stored at 2-8°C. Capillary blood samples must be tested within 7 days of collection.
In addition to the packaging of samples, the transport/delivery of clinical samples to the laboratory is required to be in adherence to all national regulations for the safe transport of biological materials. Enfer Medical provides a fully compliant logistics service, aligned with clients’ testing requirements.
Prompt transport of specimens:
To ensure prompt testing of samples and release of results within the published test turnaround times, samples should arrive to the laboratory by 18:00. Test turnaround time is measured from receipt of the sample at the laboratory until the time the authorised results are reported to users.
In rare cases specimens may not be suitable for testing on arrival to the laboratory. In that case the sample will be rejected at the receipt stage and the service user will be notified immediately and an explanation as to why the sample could not be processed will be provided. Reasons why samples cannot be processed include but are not limited to:
Please refer to the Health Protection Surveillance Centre for the Case Definitions for Notifiable Diseases:
Following receipt at the Laboratory, results should be available on the next working day and will be reported to the referring clinician via the Enfer Medical Client Portal or in a format agreed with clients.
Established clients can login to the portal using the link above.
