The California Department of Public Health (CDPH) has updated syphilis serologic screening recommendations in response to rising syphilis and congenital syphilis rates in the state. These recommendations are applicable statewide, regardless of local case rates. The new recommendations include:

1. All sexually active persons 15-44 years old should be screened for syphilis at least once in their lifetime. Following the initial screen, CDPH recommends that syphilis screening be offered annually.
2. Syphilis testing should be included whenever a person of any age is tested for HIV or other sexually transmitted infections, including mpox.
3. All pregnant persons should now be screened for syphilis three times: (1) at confirmation of pregnancy or first prenatal encounter, (2) early in the third trimester, and (3) at delivery.
4. All persons 15-44 years old who enter a correctional facility should ideally be screened for syphilis, preferably at intake.
5. Emergency departments and hospital-affiliated urgent care clinics should screen all pregnant persons for syphilis prior to discharge if syphilis test results are not available for the current pregnancy.

CDPH also encourages health care providers to empirically treat for syphilis while awaiting confirmatory testing, if clinically indicated, among persons who have preliminary positive treponemal or non-treponemal test results –particularly if the likelihood of successful patient follow-up is uncertain.  

For more information, including a crosswalk comparing prior and updated CDPH syphilis scre​ening recommendations the full Health Alert: CDPH Updates Syphilis Screening Recommendations.