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Access tools and guidance for conducting case-based STD surveillance.
Syphilis Surveillance Tools
Syphilis is an STI that follows a progression of stages. However, identifying the stage of syphilis in adults can be challenging. See the following resources for guidance on staging syphilis in adults for surveillance purposes.
The Council of State and Territorial Epidemiologists (CSTE) Syphilis Case Definition provides clinical, laboratory, and epidemiological criteria used to stage syphilis.
See the CSTE Syphilis Case Definition
CDC’s Adult Syphilis Staging and Clinical Manifestations Classification Algorithms are useful tools for surveillance staging of adult syphilis and classification of clinical manifestations among adult syphilis cases. These algorithms do not supersede the CSTE syphilis case definition.
Download the Syphilis Algorithms
The CSTE syphilis case definition and CDC’s staging algorithm should not be used for determining staging for clinical care. For more information on clinical staging and treatment recommendations for syphilis, see CDC’s STI Treatment Guidelines.
The Council of State and Territorial Epidemiologists (CSTE) offers a free “Case-based Surveillance for Syphilis” course. The course is divided into multiple lessons and discusses both adult and congenital syphilis surveillance.
Automated Record Search and Review Algorithm for Syphilis
Public health agencies prioritize investigations of syphilis cases using:
- Lab results (i.e., nontreponemal test titer)
- Age and sex at birth
- Prior syphilis history
However, these traditional methods miss potential cases. They also require many resources. CDC with the Florida Department of Health and New York City Department of Health and Mental Hygiene developed a new algorithm for prioritizing case investigations. The new algorithm automates the traditional process.
Get the algorithm on GitHub (Instructions included)
Interested in learning more about the record search and review algorithm for syphilis?
View the webinar from the National Coalition of STD Directors:
Should your jurisdiction automate a syphilis record search process? Yes!
Reporting Guidance for the National Electronic Telecommunication System for Surveillance and the National Electronic Disease Surveillance System
The National Electronic Telecommunication System for Surveillance (NETSS) and the National Electronic Disease Surveillance System (NEDSS) are data transfer and information technology architectural standards. NETSS and NEDSS are used by public health agencies to report STD surveillance information including:
- Numbers of new STDs
- Results from laboratory tests
- Information on STD treatment
Resources
- NETSS Implementation Plan (Effective January 2018): NETSS guidance on procedures and record layouts health departments must use to electronically report cases of nationally notifiable STDs to CDC.
- Summary of Revisions to the NETSS Implementation Plan: Latest changes to the NETSS Implementation.
- Reporting Case Classification Status for STD Case Notifications (Updated April 2023): Background and guidance on reporting case classification status for STD cases sent to CDC.
- Guidance for Reporting Lymphogranuloma venereum (LGV) Cases as Chlamydia to CDC (Updated April 2022): Background and guidance on how LGV cases should be reported to CDC.
- Guidance on Classifying STD Case Reports into MMWR Week (Updated February 2021): Background and guidance on how jurisdictions should assign the MMWR week data element for STD case reports.
- Deduplication Standards for Chlamydia and Gonorrhea Case Reports Based on Laboratory Test Results (Updated January 2023): Background and information on the national standards for deduplicating chlamydia and gonorrhea case reports based on laboratory test results.
- Including Information on Disseminated Gonococcal Infection (DGI) in Gonorrhea Case Notifications Provided to CDC [PDF – 278 KB] (Updated July 2023): Background and guidance on how to indicate DGI in gonorrhea case notifications sent to CDC.
STD Surveillance Tips
Tips on select STD surveillance topics address frequently asked questions from STD program staff working in state, local, and territorial public health agencies.
Note: Previous versions of the STD Surveillance Tips were e-mailed to STD programs via the monthly STD Surveillance and Data Science Updates from CDC’s Division of STD Prevention (DSTDP). The content on this website includes minor edits to the original content.