Syphilis is usually diagnosed using a blood test or having a swab taken of your sore(s).
Syphilis is commonly diagnosed through a series of blood tests that detect antibodies to proteins that occur in syphilis cases. Commonly used blood tests include a) treponemal enzyme immunoassay (EIA) and b) rapid plasma reagin (RPR).
These tests may not work in people who are very early in the infection. If a negative diagnosis is suspected to be positive, the Public Health Agency of Canada recommends that the test is repeated weeks later as this leaves times for the the body to make antibodies necessary for diagnosis.
Syphilis can also be diagnosed by swabbing an infectious chancre and examining it.
Syphilis diagnostic testing requires careful interpretation by expert clinicians as there is no one single diagnostic test. Instead, there are several algorithms used by diagnostics laboratories based upon the clinical suspicion and results of various tests, including those listed above. Certain tests like an EIA are likely to stay positive for life after your first syphilis infection, meaning more tests and careful interpretation is always required.
The swab of a possible syphilis sore is very helpful when positive as it is highly specific and might be helpful before the body makes antibodies detected by the blood tests. Unfortunately, a negative result is not always truly negative as it is dependent on making sure some bacterial DNA is collected and present when the test is run.
The blood test for syphilis is available through all standard laboratories but does require collection and transportation to a testing center. The swab is usually only available in hospitals and specialty, sexual health clinics as it requires special storage and the trained eye of a clinician who knows exactly what sore to sample. It can also be falsely negative is therefore should always be performed with a blood test.
Syphilis tests can be delivered by doctors and nurses. Usually, you can get tested at a lab with a referral from your provider, at the STI clinic, and specific outreach locations. For a better understanding about testing sites in your area, contact your local STI clinic or health line.
Syphilis testing can be accessed for free by any Canadians with a valid healthcare card.
There is a cost associated with syphilis testing for those applying to immigrate to Canada. In the context of Canadian Immigration Medical Examination (IME), test costs vary depending on your location.
Positive test results for syphilis (as well as chlamydia, gonorrhea, hepatitis B, hepatitis C, and HIV) are reported to your local public health department. Your personal information stays within the health department - the only people who will know about your results are yourself, your healthcare provider, and the public health nurse.
The reason why syphilis (and other STIs) are considered ‘notifiable’ infections is that they must be able to notify others who may have potentially been exposed to the infection so they can also get tested and treated. Notification of partners is performed by professionals in an anonymous and confidential fashion, or as close to it as possible.
From the time you are exposed to the infection, it can take up to 12 weeks for blood tests to detect a syphilis infection. When a test is positive, usually confirmatory tests will be required to verify the results. From the moment you’ve done your test, it can take 5-10 business days for them to be processed and for a result to be reached. Timelines can vary depending on where you’re located, where you got tested, and your results.
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