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Immigrant and Refugee Health
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Syphilis Screening using the Reverse Algorithm for All
Applicants Aged 18 Years to Those Aged less than 45
Years
*And Any Applicant Aged less than 18 Years or 45 Years or greater Suspected of having Syphilis Infection
Text Description:
Top of chart begins: “Treponemal Serologic Test”
1. If “Nonreactive treponemal Serologic Test” then “No class”
2. If “Reactive Treponemal Serologic Test” then “Nontreponemal Serologic Test”
a. If “Reactive Nontreponemal Serologic Test with Titers”, then “Class A Syphilis”
b. If “Nonreactive Nontreponemal Serologic Test” then “Second Treponemal Serologic Test (preferably based on
different antigens)”
i. If “Nonreactive Second Treponemal Serologic Test” then “No class”
ii. If “Reactive Second Treponemal Serologic Test” and
1. “No or unknown history of prior syphilis treatment” then “Class A Syphilis”
2. “Documented prior syphilis treatment and no concern for re-infection” then “No class”
*And any applicant aged <18 or >44 years of age suspected of having syphilis infection.
Last Reviewed: January 9, 2023