Frequently Asked Questions (FAQ): 2013 Syphilis Technical Instructions

What are the Syphilis Technical Instructions?

HHS/CDC regulations require that all immigrants and refugees coming to the United States be screened for syphilis. CDC’s Division of Global Migration and Quarantine (DGMQ) develops guidelines, called Technical Instructions, for the physicians who test and treat immigrants and refugees for syphilis.

What was updated in the 2013 Syphilis Technical Instructions?

The Syphilis Technical Instructions were updated in 2013 for both panel physicians and civil surgeons.

The CDC Syphilis Technical Instructions, effective January 1, 2013, updated the requirements for testing, treatment, and classification to bring them in line with current medical standards.

• Treatment requirements now reflect the CDC’s 2010 Sexually Transmitted Diseases (STD) Treatment Guidelines.
• Testing information was updated to reflect current medical practice and CDC recommendations, including obtaining blood tests for those applicants confirmed to have syphilis when examined in the United States by civil surgeons.
• The Technical Instructions now clarify that syphilis tests must be performed at the time of the screening medical examination and at the laboratory designated as the testing laboratory for the panel physician or civil surgeon. Syphilis tests performed at other laboratories or before the panel physician or civil surgeon examines the applicant are not acceptable.
• Applicants who are treated by a panel physician or civil surgeon for syphilis should now be given a Class B designation. Previously, applicants would be considered Class B only if they had a residual neurologic deficit.

How has this revision affected the validity period for syphilis tests?

The expiration date for the syphilis test will be the same as the expiration date for the tuberculosis (TB) evaluation in the country of examination. If, for example, the expiration period for an applicant’s TB evaluation is 6 months, the syphilis test will expire at the same time, and the applicant will need to be re-tested for syphilis when s/he has a repeat medical examination to update the tuberculosis evaluation. This change will align validity periods for the medical examination as much as possible and help avoid confusion.