Table 1. Clinical Syphilis Case Definitions.

Primary syphilis – primary chancre with reactive syphilis serology and/or PCR and/or dark ground positive test(s)

Secondary syphilis – systemic symptoms typical of syphilis with reactive syphilis serology, plus mucocutaneous lesions (which may be dark field microscopy and/or PCR positive)

Early latent syphilis – asymptomatic with reactive syphilis serology (on two occasions) and non-reactive serology results within the last 2 years or, if not previously tested, likely time of infection in the last 2 years

Late or unknown duration latent syphilis – asymptomatic with reactive syphilis serology and no prior testing or prior testing >2 years since the last test

Past treated syphilis – documented adequate treatment for syphilis and has achieved adequate serological and clinical response on follow up

Positive syphilis serology – either reactive immunoassay ± reactive RPR (need two sets of positive results to confirm if asymptomatic if no prior history of syphilis or reactive RPR with a fourfold titre increase if past treated syphilis).