Classification of Latent Syphilis: Is It Time to Change the Case Definition?
The accompanying paper from the Centers for Disease Control and Prevention (CDC) (Peterman et al. pp. 144–149) points out that the staging of syphilis from 6 different jurisdictions within the United States was in excellent agreement with the CDC case definitions for “primary,” “secondary,” and “late latent” syphilis, but there was only about 50% agreement with the CDC’s definitions of “early latent” and “unknown duration.” These misclassifications have important implications in terms of treatment of cases and contract tracing. A suggestion is being made that the case definitions should be modified in response to the inaccurate staging that is coming from the field. That, of course, has implications for surveillance as temporal changes can only be monitored in the context of consistent case definitions. This is an important issue and deserves careful consideration. We would welcome readers’ reactions, comments, and suggestions to the perceived problems and the suggested changes. We will publish those in the journal or make them available at our website, depending upon the volume of responses. Write to us via e-mail at [email protected].© Copyright 2005 American Sexually Transmitted Diseases Association