Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (notified under document C(2012) 5538) (Text with EEA relevance) (2012/506/EU)

2.42. SYPHILIS, CONGENITAL AND NEONATAL (Treponema pallidum)

Clinical Criteria

Any infant < 2 years of age with at least one of the following 10:

• Hepatospenomegaly

• Mucocutaneous lesions

• Condyloma lata

• Persistent rhinitis

• Jaundice

• Pseudoparalysis (due to periostitis and osteochondritis)

• Central nervous involvement

• Anaemia

• Nephrotic syndrome

• Malnutrition

Laboratory Criteria

• Laboratory criteria for case confirmation

  At least one of the following three:

  • Demonstration of Treponema pallidum by dark field microscopy in the umbilical cord, the placenta, a nasal discharge or skin lesion material

  • Demonstration of Treponema pallidum by DFA-TP in the umbilical cord, the placenta, a nasal discharge or skin lesion material

  • Detection of Treponema pallidum — specific IgM (FTA-abs, EIA)

  AND a reactive non-treponemal test (VDRL, RPR) in the child’s serum

• Laboratory criteria for a probable case

  At least one of the following three:

  • Reactive VDRL-CSF test result

  • Reactive non-treponemal and treponemal serologic tests in the mother’s serum

  • Infant’s non-treponemal antibody titre is four-fold or greater than the antibody titre in the mother’s serum

Epidemiological Criteria

Any infant with an epidemiological link by human to human transmission (vertical transmission)

Case Classification

A. Possible case NA

B. Probable case

Any infant or child meeting the clinical criteria and with at least one of the following two:

• An epidemiological link

• Meeting the laboratory criteria for a probable case

C. Confirmed case

Any infant meeting the laboratory criteria for case confirmation