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
What healthcare providers can do
Think syphilis
Ask whether your patients are sexually active and offer testing for syphilis, as well as HIV and other STIs when appropriate.
Know how to stage and treat syphilis
Ordering the right tests (e.g., BOTH RPR and FTA) and staging and treating syphilis can seem complex, especially if you are a provider who doesn’t see syphilis often. See IDPH’s staging and treatment algorithm for more information. Download CDC’s smartphone app for treating syphilis and other STIs by clicking Android or iOS .
Give patients test results ASAP
The longer a patient with a syphilis infection waits for test results and treatment, the greater the chances are for the infection to spread.
Listen to an interpreting syphilis podcast
Listen to Dr. Kahlil Ghanem, a Johns Hopkins University Professor of Medicine and a syphilis expert, reviews how to monitor and interpret syphilis serological tests in an interview with Dr. David Spach, the National STD Curriculum Editor-in-Chief. Listen to the podcast here .
Use our online toolkit
Health care providers can play a critically important role in helping to reduce syphilis in suburban Cook County. Review our Syphilis Toolkit for Healthcare Providers for reporting requirements and Morbidity Report Form, staging and treatment algorithms, and information to share with patients.
What CCDPH is doing to help reduce syphilis cases
- Serving as a technical consultant for test ordering, staging, and current treatment guidelines
- Talking with cases, help them to notify partners, and help individuals reduce risk
- Providing condoms
- Educating the public, providers and ourselves
- Monitoring trends and intervene where we can
- Helping folks get into primary care
Updated July 3, 2025, 12:26 PM