{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:15:02Z","timestamp":1778087702431,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Syphilis has re\u2010emerged as a significant public health concern in Australia, with rising notification rates among both traditional and non\u2010traditional risk groups. Declared a Communicable Disease Incident of National Significance, syphilis continues to pose a diagnostic challenge due to its myriad of different presentations and ability to mimic other diseases. The recent rise in cases of congenital syphilis is particularly concerning and highlights the urgent need for improvement in syphilis testing in antenatal care. This clinical perspective provides a contemporary and relevant summary of the evolving epidemiology, staging of syphilis infections, interpretation of serological tests, as well as management approaches including partner notification and follow\u2010up testing. We also outline advances in syphilis diagnostics\u2014including nucleic acid amplification tests and point\u2010of\u2010care tests\u2014which have made it much easier to detect syphilis infections early. The recent availability of doxycycline as post\u2010exposure prophylaxis is also discussed, which offers a promising tool to prevent infections and re\u2010infections in at\u2010risk populations, namely men who have sex with men and transgender women. Treatment for syphilis continues to rely primarily on long\u2010acting injectable benzathine benzylpenicillin, with alternative regimens being used increasingly amid a continual global shortage of this formulation of penicillin. Encouragingly, there are early signs that suggest notification rates for syphilis are finally decreasing in some jurisdictions, likely in response to the multitude of interventions implemented as part of the national syphilis response. Physicians in all specialties should remain aware and confident in testing and managing syphilis in order to continue cementing this downward trend.<\/jats:p>","DOI":"10.1111\/imj.70358","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:02:29Z","timestamp":1772967749000},"page":"544-551","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Syphilis in adults: updates on testing, prevention and treatment"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4043-1895","authenticated-orcid":false,"given":"Arthur","family":"Wong","sequence":"first","affiliation":[{"name":"Sexual Health &amp; Bloodborne Viruses Services Population and Community Health, South Eastern Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Kirby Institute UNSW  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen Li","family":"Lim","sequence":"additional","affiliation":[{"name":"Sexual Health &amp; Bloodborne Viruses Services Population and Community Health, South Eastern Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5422-3777","authenticated-orcid":false,"given":"Phillip","family":"Read","sequence":"additional","affiliation":[{"name":"Sexual Health &amp; Bloodborne Viruses Services Population and Community Health, South Eastern Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Kirby Institute UNSW  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_2_15_2_1","unstructured":"Department of Health DaA.Chief Medical Officer's statement declaring syphilis a Communicable Disease Incident of National Significance. In: Australian Government editor.2025."},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.1903"},{"key":"e_1_2_15_4_1","volume-title":"HIV, Viral Hepatitis and Sexually Transmissible Infections in Australia: Annual Surveillance Report 2024","author":"King JKJM","year":"2024"},{"key":"e_1_2_15_5_1","unstructured":"Interim Australian Centre for Disease Control.National Syphilis Response Plan 2023\u20132030 In: Australian Government Department of Health DaA editor.2025."},{"key":"e_1_2_15_6_1","volume-title":"Modelling of the Infectious Syphilis Outbreak in Indigenous Australians\u2014Update","author":"Hui BR","year":"2019"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51864"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52388"},{"key":"e_1_2_15_9_1","unstructured":"NSW Government.NSW Sexually Transmissible Infection Data Report\u2014January to December 2024. In: NSW Health editor. New South Wales2025."},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/09564624241280406"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052219"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2007.007258"},{"key":"e_1_2_15_13_1","volume-title":"UpToDate","author":"Hicks CBM","year":"2023"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad437"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad582"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2021-055370"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30838-0"},{"key":"e_1_2_15_18_1","unstructured":"Public Health Laboratory NetworkSyphilis\u2014Laboratory case definition. Australia 2012"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7301a1"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001498"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1071\/MA24036"},{"key":"e_1_2_15_22_1","unstructured":"Australasian Society for HIV VHaSHM.Australian STI Management Guidelines for use in primary care2021https:\/\/sti.guidelines.org.au\/sexually-transmissible-infections\/gonorrhoea\/."},{"key":"e_1_2_15_23_1","unstructured":"Australian Centre for Disease ControlSyphilis\u2014CDNA National Guidelines for Public Health Units2024"},{"key":"e_1_2_15_24_1","unstructured":"Northern Territory Government Department of HealthCongenital syphilis guidelines for the Northern Territory In: Health Do editor. Northern Territory2015"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2024-056208"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06458-8"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52258"},{"key":"e_1_2_15_28_1","volume-title":"Therapeutic Guidelines","author":"Therapeutic Guidelines","year":"2025"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihad087"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01092-16"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02977-22"},{"key":"e_1_2_15_32_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00301-14"},{"key":"e_1_2_15_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200103000-00007"},{"key":"e_1_2_15_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13881"},{"key":"e_1_2_15_35_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/3958406"},{"key":"e_1_2_15_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2024-260588"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70358","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.70358","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70358","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T16:52:47Z","timestamp":1778086367000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/imj.70358"],"URL":"https:\/\/doi.org\/10.1111\/imj.70358","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,2]]},"assertion":[{"value":"2025-10-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}