Reporting Criteria for Syphilis(1) Definition
Sexually transmitted disease caused by Treponema pallidum belonging to thegenus Spirochaeta.
(2) Clinical manifestations
Primary symptomatic syphilis is characterized by early induration or hard chancre
in the infected site and/or painless enlargement of inguinal lymph node, which appear
after a latency period of 3~6 weeks post-infection.
Secondary symptomatic syphilis is characterized by syphilitic roseola, papularsyphilid or condyloma latum on the skin or mucous membrane ~3 months afterinfection.
Late symptomatic syphilis is characterized by gumma, cardio-vascular, neurologicaland/or ocular symptoms that appear in some patients 3 years or more after infection.
Some patients may remain asymptomatic, however.
Congenital syphilis appears in infants born to syphilis-infected mothers. There arethree types: (1) cases with laboratory findings indicating in utero infection, (ii) cases
manifesting the signs of early congenital syphilis, such as secondary symptomatic
syphilitic roseola and osteochondritis, and (iii) cases that manifest the signs of latecongenital syphilis, such as Hutchinson’s triad (parenchymatous keratitis, inner ear
deafness and Hutchinson teeth) during childhood, without manifesting any signs orsymptoms during infancy.
(3) Reporting criteriaa) “Patients (confirmed cases)”
In compliance with Article 12 paragraph 1 of the Infectious Diseases Control Law, if
a physician examines a patient with clinical findings as described in (2), suspects
syphilis, and makes a diagnosis of syphilis based on the results obtained by thelaboratory methods and specimens as described below, the physician must notify
the case within 7 days.
Specimens used (listed in the right side box) must match the diagnostic methods
employed (listed in the left side box).
b) “Asymptomatic carriers”
In compliance with Article 12 paragraph 1 of the Infectious Diseases Control Law, if
a physician examines an individual who had no clinical signs or symptoms as
described in (2) but was antibody-positive in the test listed in the lower left box in
the table below, and if the physician has diagnosed that the individual was anasymptomatic carrier, the physician must notify the case within ７days. Sera withtiter x16 or above in the rapid plasma regain (RPR) card test, the agglutination testor the slide precipitation test or sera with titer 16.0 R.U., 16.0 U, or 16.0 SU/ml orabove in the automated tests, all using cardiolipin as the antigen, are consideredantibody-positive.
c) “Deceased”
In compliance with Article 12 paragraph 1 of the Infectious Diseases Control Law, if
a physician examines a dead body with clinical signs and symptoms as described in(2), and diagnoses that the death was due to syphilis based on the results obtainedby the laboratory methods and specimens as described below, the physician must
notify the case within 7 days.
Specimens used (listed in the right side box) must match the diagnostic methods
employed (listed in the left side box).
Laboratory methods

Specimen

Detection of the pathogen by India ink or

Eruption (early induration, hard

Giemsa staining methodchancre, condyloma latum,
mucosal eruption)

Positive in both tests (1) and (2) listed below(1) Positive in the tests below using
cardiolipin as the antigen--RPR card test; agglutination test; slide
precipitation test; automated test

Serum(2) Positive in either of the tests below thatuse T. pallidum as the antigen--TPHA test; FTA-ABS method
Cases satisfying either of the following criteria are considered congenital syphilis:a.

Antibody level is far higher than that of the mother.

b.

Persisting antibody titer whose level is far higher than the titer expected fromthe maternal antibody.

c.

IgM antibody against T. pallidum derived from the infant is positive.

d.

Positive for signs or symptoms of early congenital syphilis.

e.

Positive for signs or symptoms of late congenital syphilis.