Blood (paediatric/*neonatal (see collection note))
2x SST with gel 600 uL Paed (Red or Yellow top)
Black top tubes (kit contains 3 tubes; sterile)
1. Syphilis Serology - Serum (EIA/RPR/TPPA) Serum is the preferred specimen but plasma samples (lithium heparin or EDTA) can be used.
2. *Neonatal Syphilis Serology - for assessment of neonates for congenital Syphilis where maternal serology is known to be reactive; request RPR and Syphilis IgM on neonatal sample. Blood sample requirements - see under paediatric / neonatal above. Preferred volume is 1ml of blood; minimum 600 ul.
3. Neurosyphilis - CSF (VDRL) (Test code: VDRLX) Only VDRL is validated as a serolgical test for Syphilis on CSF. Both VDRL and MSC should be requested to exclude neurosyphilis.
SEROLOGICAL TESTS FOR SYPHILIS
1. An EIA Screening Test is performed and if positive a TPPA (Treponema pallidum particle agglutination) and RPR (Rapid Plasma Reagin) are performed.
2. The Syphilis EIA and TPPA detect specific Treponema pallidum antibodies and become positive within 1-4 weeks of exposure and remain positive for life.
3. The RPR detects non-specific antibodies related to the tissue damage the infection causes and appears later than the EIA/TPPA antibodies. The RPR titre will decrease or revert to non-reactive with both time and treatment and is a measure of activity. An RPR titre of >16 is suggestive of active disease.
4. If the EIA screen is the only test positive, serum is sent to a reference laboratory for an FTA-ABs (Fluorescent treponemal antibody-absorbed) test to determine if the EIA is a false positive reaction or not.
5. If neurosyphilis is suspected, a lumbar puncture is indicated and the diagnosis made on the basis of a raised CSF cell count and protein and the presence of a positive VDRL (Venereal Diseases Research Laboratory) test.