Lab Matters Spring 2018 - Page 32

infectious diseases Syphilis Rising: APHL’s Efforts to Address Another Historic Foe by Anne M. Gaynor, PhD, manager, HIV, Hepatitis, STDs evaluate new assays. The North Carolina State Public Health Laboratory conducted an evaluation of the FDA-cleared rapid syphilis test, examining its performance in the state laboratory and two county STD clinics. APHL, CDC and North Carolina have been working to get this data published in a peer- reviewed journal, while APHL continues to work with CDC to identify new syphilis diagnostics tests that can or should be evaluated in partnership with member laboratories. Treponema pallidum spirochetes highlighted using a modified Steiner silver stain. Photo: CDC Public Health Image Library 2018 has provided a useful reminder of the importance of not only remembering our past but learning from it as well. While we commemorate the 100th anniversary of the 1918 influenza pandemic, let us not forget about some of our other microbial foes. Syphilis, a sexually transmitted infection caused by the Treponema pallidum bacteria, is 100% preventable and curable. Even so it has caused illness and death for hundreds of years. Unlike our constantly changing influenza viruses, Treponema pallidum has not changed since we named it. The current treatmentβ€”used since the 1940sβ€”is penicillin, and while new tests have been developed to detect the pathogen, we still rely heavily on those created in the 1950s. With such a history, it may be hard to believe that syphilis is not a disease of a bygone era but a very real issue facing us today. Rates of syphilis are the highest in 30 LAB MATTERS Spring 2018 more than 20 years, with a 67% increase between 2011 and 2015 and increased cases of transmission from mother to child during pregnancy resulting in severe morbidity and mortality. In April 2017, the US Centers for Disease Control and Prevention (CDC) published their syphilis call to action and outlined steps that various sectors can take to meet their collective goals. The first is to create new tools to detect and treat syphilis, a goal that APHL and its members have pursued even before this official call. Since 2013, 14 APHL member laboratories have submitted over 600 residual syphilis positive specimens to CDC for inclusion in their specimen repository. APHL will once again request samples in 2018. Additionally, APHL has worked with CDC to make these sample ́…Ω…₯±…‰±”°Ρ‘ɽ՝ )…Έ½Ή±₯Ή”Ι•ΕΥ•ΝЁѼ  °ΡΌ‘₯…Ή½ΝΡ₯Œ)΅…ΉΥ™…ΡΥΙ•Ίё…ЁΉ••Ν…΅Α±•ΜΡΌ)A!0‘…́‰••Έ‘•±Α₯ΉœΡΌ‘•Ω•±½ΐ)±…‰½Ι…Ρ½Ι䁝Υ₯‘•±₯Ή•Μ™½Θ‘₯…Ή½Ν₯́½˜)QΙ•Α½Ή•΅„Α…±±₯‘Υ΄™½Θ΅…Ήδε•…ΙΜΈ%Έ(Θΐΐ䰁A!0‘½ΝΡ•„΅••Ρ₯ΉœΡΌΙ•Ω₯•ά)Ρ‘”±₯Ρ•Ι…ΡΥΙ”…Ёё…ЁΡ₯΅”€‘₯Έ½Ή©ΥΉΡ₯½Έ)έ₯Ρ Ρ‘”΅••Ρ₯ΉœΡΌ‘•Ω•±½ΐΡ‘”9•₯ΝΝ•Ι₯„)½Ή½ΙΙ‘•„…Ή ‘±…΅ε‘₯„ΡΙ…‘½΅…Ρ₯Μ)±…‰½Ι…Ρ½Ι䁝Υ₯‘•±₯Ή•Μ€ΈUΉ™½ΙΡΥΉ…Ρ•±δ°Ρ‘”)΅••Ρ₯Ήœ‘₯Ή½ΠΙ•ΝձЁ₯ΈΡ‘”‘•Ω•±½Α΅•ΉΠ)½˜±…‰½Ι…Ρ½Ι䁝Υ₯‘•±₯Ή•ΜΈ9½Ρ₯ΉœΡ‘”±…¬)½˜™½Ι΅…°Ι•½΅΅•Ή‘…Ρ₯½ΉΜ…ΉΡ‘”)Ή••™½Θ₯΅ΑΙ½Ω•ΥΉ‘•ΙΝΡ…Ή‘₯Ήœ…Ή)Υ₯‘…Ή”°Ρ‘”A!0MQMΥ‰½΅΅₯ΡΡ•”)½ΠΡΌέ½Ι¬Έ%Έ€ΘΐΔΤ΄ΘΐΔ؁ё•δ‘•Ω•±½Α•)Ρ‘Ι•”½Ή±₯Ή”ΡΙ…₯Ή₯Ήœ΅½‘Υ±•Μ™½ΘΝεΑ‘₯±₯Μ)Ν•Ι½±½δΡ•ΝΡ₯Ήœ…Ή‘•Ω•±½Α•Ρ‘”)ΑΥ‰±₯…Ρ₯½Έ°M՝•ΝΡ•I•Α½ΙΡ₯Ήœ1…ΉΥ…”)™½ΘMεΑ‘₯±₯́M•Ι½±½δQ•ΝΡ₯ΉœΈ%Έ•…Ι±δ€ΘΐΔά°)A!0Α…ΙΡΉ•Ι•έ₯Ρ  Šé₯Ω₯Ν₯½Έ½˜)M•αΥ…±±δQΙ…ΉΝ΅₯ΡΡ•₯Ν•…Ν”AΙ•Ω•ΉΡ₯½Έ)ΡΌ•Ω…±Υ…Ρ”Ρ‘”±₯Ρ•Ι…ΡΥΙ”…Ή₯‘•ΉΡ₯™δ)‰•ΝЁΑΙ…Ρ₯•Μ™½Θ±…‰½Ι…Ρ½Ι䁑₯…Ή½Ν₯Μ)½˜ΝεΑ‘₯±₯́₯ΈΡ‘”ULΈΝΡΙՍΡΥΙ•)•αΡ•ΙΉ…°Ι•Ω₯•άΑΙ½•Ν́݅́•ΝΡ…‰±₯Ν‘•)Υ±΅₯Ή…Ρ₯Ήœ₯Έ„ΡέΌ΅‘…䁍½ΉΝΥ±Ρ…Ρ₯½Έ)9½Ω•΅‰•Θ€Θΰ΄Θδ°€ΘΐΔάΈA!0₯́₯ΈΡ‘”)ΑΙ½•Ν́½˜™₯Ή…±₯ι₯ΉœΡ‘”‘Ι…™Π΅••Ρ₯Ήœ)Ι•Α½ΙЁ™Ι½΄Ρ‘”½ΉΝΥ±Ρ…Ρ₯½Έ°έ‘₯ έ₯±°)‰”ΑΥ‰±₯Ν‘•½Έ…Α‘°Ή½ΙœΈΈ)AΥ‰±₯!•…±Ρ‘1…‰Μ)A!0)A!0Ή½Ιœ