Syphilis Toolkit for Healthcare Providers
Bicillin L-A® Shortage
The only medication available to treat pregnant people with syphilis and babies with congenital syphilis is in short supply. Healthcare providers are encouraged to prioritize Bicillin L-A® for these populations. Pfizer anticipates this shortage until early- to mid-2024. The Food and Drug Administration is now allowing the temporary importation of Extencilline (benzathine benzylpenicillin) which is an equivalent injectable medication until supplies of Bicillin are replenished. It is only available by prescription in the United States.
You may already be aware that syphilis rates have been increasing since 2001, and that the Centers for Disease Control and Prevention (CDC) is concerned about these and other increasing sexually transmitted diseases (STD) or sexually transmitted infections (STI) rates.
In the past ten years, primary and secondary syphilis cases have more than doubled, from 91 in 2011 to 277 in 2021. From 2019 to 2021, primary and secondary syphilis cases increased 60%. Like you, we are concerned.
We need your help.
Health care providers can play a critically important role in helping to reduce syphilis in suburban Cook County by taking the following actions:
Report. It’s the law.
Report syphilis to the health department as soon as possible but within 7 days so we can help you, your patients and their partners.
Fax completed Morbidity Report Form to: (708) 836-5450.
Click here for the Morbidity Report Form from the Illinois Department of Public Health (IDPH). View video at right for instructions on how to complete the Morbidity Report Form.
Test And Diagnose. Stage And Treat
Syphilis is called ‘the great imitator’ because it can mimic so many other conditions. For this reason, and because talking about sex can sometimes be difficult, we know the process of testing, diagnosing, staging and treating syphilis can be challenging.
The enclosed staging and treatment algorithms from IDPH can help. IDPH has also prepared a staging and treatment document. Click here to view. The University of Washington STD Prevention Training Center recorded a podcast on Monitoring and Interpretation of Syphilis Serological Tests .
Always follow CDC’s Treatment Guidelines . The 2021 STD Treatment Guidelines app is available for download on iPhone and Android devices.
Prevent
Encourage frequent syphilis/STI testing in any patients who may be at high risk, including:
- Gay, bisexual or other men who have sex with men (MSM)
- Pregnant women – By law , pregnant women must be tested at first visit and at 28 weeks of pregnancy
- Patients who use ‘dating’ or ‘hookup’ apps like Jack’d, Grindr, Adam4Adam, etc. for sex may be at higher risk for STIs
Remember, anyone who is sexually active can get syphilis. Promote safer sex by encouraging your sexually active patients to use condoms consistently and correctly every time they have sex.
Contact Us
We want to hear from you. If you have questions about syphilis, reporting, staging, or treatment, we can help. If you think there’s something we can do better or if you have ideas about how to reduce syphilis in our area, let us know: (708) 836-8637.
Demian Christiansen, DSc, MPH
- Unit Director Communicable Disease Control and Prevention Cook County Department of Public Health
-
Rachel Rubin, MD, MPH, FAAP
- Senior Public Health Officer Cook County Department of Public Health
Updated January 30, 2025, 5:14 PM