This article doesnt mention the test by name. Most labs perform a screening test RPR(rapid plasma reagin). If that is positive a confirmatory test FTA which is more specific for syphilis is performed.

Can you imagine the poor honest husbands getting blamed for giving their pregnant wife syphilis ( syphilis tests are part of routine pregnancy care) Wonder how many divorces this caused?

• Venereal disease research laboratory (VDRL) test. The VDRL test checks for an antibody that can be produced in people who have syphilis. This antibody is not produced as a reaction to the syphilis bacteria specifically, so this test is sometimes not accurate. The VDRL test may be done on a sample of blood or spinal fluid. The VDRL test is not very useful for detecting syphilis in very early or advanced stages.
• Rapid plasma reagin (RPR) test. The RPR test also detects syphilis antibodies.
• Enzyme immunoassay (EIA) test. This is a newer blood test that checks for antibodies to the bacteria that cause syphilis. A positive EIA test should be confirmed with either the VDRL or RPR tests.

Tests used to diagnose syphilis include:

• Fluorescent treponemal antibody absorption (FTA-ABS) test. The FTA-ABS test checks for antibodies to the bacteria that cause syphilis and can be used to detect syphilis except during the first 3 to 4 weeks after exposure to syphilis bacteria. It is more difficult to do and may be used to confirm a syphilis infection after another method tests positive for the syphilis bacteria. The test can be done on a sample of blood or spinal fluid.
• Treponema pallidum particle agglutination assay (TPPA). The TPPA test is used to confirm a syphilis infection after another method tests positive for the syphilis bacteria. This test detects antibodies to the bacteria that cause syphilis and can be used to detect syphilis in all stages, except during the first 3 to 4 weeks. This test is not done on spinal fluid.
• Darkfield microscopy. This test uses a special microscope to examine a sample of fluid or tissue from an open sore (chancre) for the syphilis bacteria. If syphilis is present, it can be seen as corkscrew-shaped objects on the microscope slide. This test is used mainly to diagnose syphilis in an early stage.
• Microhemagglutination assay (MHA-TP). The MHA-TP is used to confirm a syphilis infection after another method tests positive for the syphilis bacteria. The MHA-TP test detects antibodies to the bacteria that cause syphilis and can be used to detect syphilis in all stages, except during the first 3 to 4 weeks. This test is not done on spinal fluid. The MHA-TP test is rarely used any more

i'd say they would do additional tests to confirm. actually, i'm quite certain about that. rpr is used as routine screen in psych along with tsh, to rule out organic reasons for psychosis.

I'd rather have a false positive than a false negative! I had Lyme in the chronic stages. Lyme testing is not very accurate. I'd tell a Dr. I had Lyme (was seeing one just for Lyme) and they would test me for syphilis every time.

It would have been helpful if the author of this article named the tests under discussion. The generalities used are not helpful to anyone's rational understanding of the problem. The headline title of the article is attention getting and fuels fear and distrust of the testing systems. This need no be.

How much do these writers get paid? Another poorly written article. I know high school kids that research and write papers than these clowns.

Maybe you should take lessons from them. The word "better" might be appropriate in there somewhere!

Bad headline!!

Test gets almost 1 in 5 syphilis cases wrong

That means 1 of 5 people TESTED get wrong results - a false positive rate means 1 in 5 who got a positive result are wrong.

Say 100,000 women took the test, and 1000 were told they were infected. On average, 180 of those 1000 were not actually infected. The headline reads as though 18% of those who took the test.

Anyone can Google the standard tests for syphilis. Both the RPR and VDRL have been used for decades. As stated above, an FTA for confirmation. Why didn't this author take a minute to research what they were talking about and tell the readers which one was in question. I have never heard of a screening test being taken as a "case" as the author states, without follow up confirmation. The whole story is pretty suspect and weak. Typical MSNBC article.

Rapid Plasma Reagin (RPR) refers to a type of test that looks for non-specific antibodies in the blood of the patient that may indicate that the organism (Treponema pallidum) that causes syphilis is present. The term "reagin" means that this test does not look for antibodies against the actual bacterium, but rather for antibodies against substances released by cells when they are damaged by T. pallidum.

In addition to screening for syphilis, an RPR level (also called a "titer") can be used to track the progress of the disease over time and its response to therapy.

Accuracy

The RPR test is an effective screening test, as it is very good at detecting people without symptoms who are affected by syphilis. However the test may suggest that people have syphilis who in reality do not (i.e., it may produce false positives). False positives can be seen in viral infections (Epstein-Barr, hepatitis, varicella, measles), lymphoma, tuberculosis, malaria, endocarditis, connective tissue disease, pregnancy, autoimmune diseases, intravenous drug abuse, or contamination. It can also occur naturally in the elderly. ^[1] As a result, these two screening tests should always be followed up by a more specific treponemal test. Tests based on monoclonal antibodies and immunofluorescence, including Treponema pallidum hemagglutination assay (TPHA) and Fluorescent Treponemal Antibody Absorption (FTA-ABS) are more specific and more expensive. Unfortunately, false positives can still occur in related treponomal infections such as yaws and pinta. Tests based on enzyme-linked immunoassays are also used to confirm the results of simpler screening tests for syphilis.

Another test often used to screen for syphilis is the Venereal Disease Research Laboratory VDRL slide test. However, the RPR test is generally preferred due to its ease of use.

Other types of tests are currently being evaluated as possible alternatives to, or as replacements for, the rapid plasma reagin test. One of these alternatives is an immunochromatographic strip test. A study published in February 2006 found that this test outperformed the RPR test in values of sensitivity and specificity, and it does not require a laboratory to process the results.

Fluorescent Treponemal Antibody Absorption Test is the most specific test for syphilis. If this is positive it confirms the diagnosis.

Article "author," MIKE STOBBE of The Associated Press, just couldn't be bothered to provide useful information .... like the the name of the screwed-up test, the one he said had 18% false positives!

Q1. Does A.P. still employ editors?

Q2. Does A.P. pay them while they sleep?

Hey mike, does this test have a name? How about the RPR or the VDRL? Or is it the FTA? Patronizing us, thinking we don't need to know, or just not caring, is not acceptable reporting.

The EIA assay is the one with false-positives, which are then retested using the TPPA method to confirm.

"Among the 140,176 specimens screened with an EIA/CIA, 4,834 (3.4%) had a reactive test result (Table). Among these 4,834 EIA/CIA-reactive sera, 2,743 (56.7%) were RPR-nonreactive, of which 866 (31.6%) were nonreactive by TP-PA or FTA-ABS testing, suggesting that the initial EIA/CIA result was a false-positive."

My first thought was what this could do to a relationship. If I tested positive the only person that could be at fault would be my husband, or soon to be ex-husand.

My first thought was how many relationships this has changed. If I tested positive my husband would soon be my ex-husband.

You can get false positives with many tests, not just syphilis. Most of these tests are just screening tools that doctors use - which means just that - they "screen" for diseases. When a patients sample is positive for these screening tests, then there are other tests that can be performed to confirm a positive. Sometimes, these test do come back as false positives, but the screens are much cheaper than the confirmation tests. That's why these are used first. There are also HIV tests, Hepatitis tests, and the 2 hr. glucose tests that pregnant women take around 28 weeks gestation - just to name a few. If any of these come up positive, samples are sent for confirmation or in the case of the glucose test for pregnant women, they then have to take a 3-5 hour glucose tolerance test. Just my two cents on the subject.

not only the man how about the faithfull man who sees the results of his wife's test & assumes she was the cheating party?

how about the faithfull husband who sees his wife's results & therefore assumes she is the cheating party?

I must add my indignation about the how poorly written this article is; analyzed from all aspects: grammar, content, degree of useful information; especially the fact that the author never mentions the name of the faulty test Shame on MSN... what a disgrace. It's nice to see that those who have commented here use their skills to judge the article, but unfortunately, so many others just accept whatever trash the media dishes out. So lamentable. MSN should review their commitment to responsibility and accountability to the public.

How about people getting their blood samples mixed up. IF YOUR MARRIAGE RIDES ON A TEST RESULT... give a damn enough to get retested and further evaluated. It would be careless to just file for divorce. I was married to a cheater. Had I tested positive for ANYTHING, I would have straight up told my doctor to REDRAW the blood and double check or they would see me on the 10 o clock news for sure!!! At least while waiting for pending "retesed results" I could maybe get use to the fact and possibly contain my anger a little better until I knew FOR SURE FOR SURE that he gave me some jacked up STD! There would probably be a talk though that night after dinner... and Id probably have him tested in the mean time.

Dont be mad at a test. That's just ignorant.

This article was poorly written and the MMWR that this study was in is a must read if you really want to know what this was all about. I was a state disease intervention specialist tasked with syphilis notification and case finding and saw my lion's share of this disease. You would not believe the number of uniformed physicians out there who automatically assume that an RPR means syphilis. IT DOES NOT. It can mean 40 other things and be reactive if you are pregnant, have rheumatoid arthritis, a variety of tropical diseases among others. This is why the health department always did a confirmatory FTA-ABS or TP-PA as well as a physical exam. What the article also failed to mention was that syphilis is a latent disease and is only infectious for a short period of time and may go undetected for years. Very often physicians fail to diagnose actual syphilis when they see it. For example: I had a young man come in whose eyelashes and eyebrows fell out and he had alopcia on his head. He also had a rash. He went to the ER twice and to a dermatologist who blamed it on a car accident where the airbag had gone off. I took one look at him and did an RPR and the titer was 1:512 with classic symptoms of secondary syphilis. Physicians really need to reacquaint themselves with a disease that is on the rise and called "the great imitator" for a reason.

Ironically the study that was cited also stated that when they did the reverse testing with the more reliable automatable treponemal enzyme and chemiluminescence immunoassays (EIA/CIA), more than 50% of RPR's were falsely non-reactive and of those more than 30% had a falsely non-reactive TP-PA or FTA-ABS. Moreover, they found that this was occuring in low prevalence syphilis areas. THAT IS SCARY and this is what the article should have focused on.

Mistakes are possibly all that they are.

But if someone intentionally changed the results of a test to do harm to another person, This should be revealed.

By Appollo's oath beware.

I was one of the statistics. When I was 17 I donated blood. A few weeks later I got a letter in the mail saying that I had syphilis and that I needed to make an appointment with the county health department. I was sexually active, but not promiscuous. I had donated blood several times. Long story short, my boyfriend got tested. He was negative. I got a repeat RPR done at the health department. It was positive again. They did an FTA, as did my personal gynecologist , and both were negative. I have never had another positive test, never had any symptoms, nothing. That was 15 years ago. I was harrassed constantly by the health department. I can never donate blood in my hometown again. It is shameful that there is not an affordable routine test for syphillis that has high specificity. This is a real problem.

An 18% error rate! unbelievable. this test should be pulled from the market and the maker fined large amounts for failure to discover this defect and disclose it on their without the CDC having to find it. The manufacturers do not care who is harmed or who bears additional costs. Jump on them with both feet (in heavy boots!).