Syphilis Testing

Syphilis is a complex, sexually transmitted disease (STD) that is caused by bacteria. Syphilis can also be passed from an untreated, infected mother to her baby before birth (congenital syphilis). The bacterium that causes syphilis is a spirochete called Treponema pallidum. When a person becomes infected with T. pallidum, the body's defense mechanism is stimulated to produce different antibodies. One response produces non-treponemal antibodies to the cardiolipin associated with the cellular surface of the treponeme (T. pallidum) or with host tissue damage caused by the treponeme. These non-treponemal antibodies are also referred to as reagin antibodies. A second response produces treponemal antibodies specific to the treponeme. Symptoms of syphilis usually develop 10-90 days after infection.

www.cdc.gov/std/syphilis
www.dhss.mo.gov/CommunicableDisease/Reports

At the State Public Health Laboratory the Rapid Plasma Reagin (RPR) non-treponemal test for reagin and the Treponema Pallidum-Particle Agglutination (TP-PA) test are performed on serum. RPR testing is performed daily (Monday through Friday). The normal turn-around time from receipt of the specimen in the laboratory is same day for both non-reactive and reactive specimens. Allowance should be considered for transit of the specimen to the laboratory and the mailing of the report back to the submitter.  Specimens producing a reactive RPR will be tested quantitatively (titered) and also tested with the TP-PA.

The VDRL (Venereal Disease Research Laboratory) is a test for syphilis performed on spinal fluid specimens only. The CSF-VDRL procedure is performed on Tuesday and Friday at the State Public Health Laboratory. A treponemal test procedure on spinal fluid is not available.

Special instructions for submission of specimens:

Vacutainer tubes (supplied with the State Public Health Laboratory mailers) should be used to collect specimens. Single or multiple mailers are available from the State Public Health Laboratory upon request. There is presently a ten dollar handling fee on specimens received from private sources.

For the RPR and TP-PA tests, whole blood or serum specimens are acceptable. Not less than 2 ml of whole blood or 1 ml of serum should be submitted. Specimens should not be drawn for at least one hour following a meal in order to avoid chylous serum which cannot be tested. Please do not submit blood specimens with anticoagulant added; plasma is not a reliable specimen for testing.

For the VDRL test, spinal fluid is the acceptable specimen. Spinal fluid specimens containing blood (or serum) are not satisfactory for testing as the results may be misleading to the diagnostician.

When possible, specimens should be shipped on the day they are drawn. If it is necessary to hold the specimen(s), keep them refrigerated.

Submission of Specimens
Shipping containers are available from the SPHL upon request

SPECIMENS MUST BE SUBMITTED IN THE PROPER MAILING KIT SUPPLIED BY THE STATE PUBLIC HEALTH LABORATORY.