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Volume 29, Number 10—October 2023
Policy Review

Managing Risk for Congenital Syphilis, Perth, Western Australia, Australia

Hannah MacKenzie, Suzanne P. McEvoyComments to Author , and Timothy J. Ford
Author affiliations: Western Australia Department of Health, Perth, Western Australia, Australia (H. MacKenzie, S.P. McEvoy); Metropolitan Communicable Disease Control, Perth (S.P. McEvoy); Perth Children’s Hospital, Perth (T.J. Ford); University of Western Australia, Perth (T.J. Ford)

Main Article

Table

Local initiatives implemented to tackle the syphilis outbreak in Perth, Western Australia, Australia*

Priority area of the Metropolitan Action Plan (28) Descriptions of initiatives
Prevention, education, and community engagement Syphilis outbreak campaigns to increase awareness among health professionals and the community, including accessible educational resources that reduce stigma and are guided by cultural considerations
Education of community organizations and community members (e.g., Indigenous, homeless and CALD persons)
Education of cases and contacts by MCDC public health nurses, Indigenous health professionals and midwife
Indigenous health team engagement and outreach with community members and persons experiencing homelessness
Indigenous health team outreach service collaborates with other agencies (e.g., Indigenous community health and health services for persons experiencing homelessness)
Workforce development Establishment of MSORT, a multiagency team to lead a coordinated outbreak response
Diversification of MCDC workforce to address population and workforce needs, with a focus on priority populations, including establishment of Indigenous health, clinical midwifery, and general practitioner roles
Project officer employed to facilitate the development of contextualized models of care and health promotion materials guided by stakeholder engagement for priority groups, including CALD persons
Epidemiologist employed to help facilitate enhanced surveillance and reporting
Public health staff engaging with and delivering education to a wide range of health professionals and services, focusing on specialty services that see high priority and/or atypical cases
General practitioner delivering education to primary healthcare doctors and nurses
MCDC midwife providing education to health professionals in maternity services
Development of educational resources and clinician alerts to inform health professionals
Establishment of regular multiagency SIP and SAPH case management meetings to oversee management of these priority groups
Testing, treatment and contact tracing Template letter about syphilis treatment, partner notification and repeat testing sent to the test requesting health professional
Evidence from the congenital syphilis case reviews informed adoption of 3-test routine screening of all pregnant women
Frontline services engaged in case management and supporting contact tracing
Engagement with laboratories to improve timeliness of results, particularly for antenatal requests, and changes to reporting algorithms to prevent missed notifications and diagnoses
Improved processes for ordering parallel testing when monitoring RPRs in pregnant women
Systematic approach to obtaining maternal and infant syphilis results through a reporting protocol to the MCDC SIP team from hospital obstetric services
Surveillance and reporting Electronic syphilis public health management register developed to meet the needs of a syphilis outbreak, which has enabled better monitoring and identification of priority populations, including testing, treatment, and contact tracing efforts
The register is used to generate automated reports (e.g., quarterly reports, individual summaries for case management meetings, and synoptic reports [neonatal management plans])
Automated alerts remind MCDC staff to confirm receipt of treatment or repeat testing for priority cases
Antenatal and postnatal care Local STI, antenatal and obstetric guidelines changed to recommend syphilis screening for all pregnant women at initial visit, 28 weeks, and 36 weeks of gestation (or birth if earlier)
Proactive public health management of pregnant women with syphilis and their sexual contacts
Monthly multiagency meetings to ensure appropriate care and follow-up of pregnant women with syphilis
Routine synoptic reporting (neonatal management plans) to guide syphilis testing and management of neonates and their mothers at delivery
Interagency congenital syphilis case reviews to identify gaps in service delivery and inform service improvement

*CALD, culturally and linguistically diverse; MCDC, Metropolitan Communicable Disease Control; MSORT, Metropolitan Syphilis Outbreak Response Team; RPR, rapid plasma reagin; SAPH, Syphilis Among People Experiencing Homelessness; SIP, Syphilis In Pregnancy; STI, sexually transmitted infection.

Main Article

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Page created: August 03, 2023
Page updated: September 20, 2023
Page reviewed: September 20, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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