(P34) A NEW PARTNERSHIP FOR ENHANCED SURVEILLANCE: EXAMINATION OF A SPECIALTY FACILITY'S RECORDS TO IDENTIFY UNREPORTED NEUROSYPHILIS-RELATED MANIFESTATIONS IN NEW YORK CITY, 2020-2021

Background:
As of 2018, neurologic, otic, and ocular manifestations of syphilis were added to national notifiable case definitions. These manifestations are thought to be rare and rarely reported via routine, case-based surveillance for syphilis. Given the increase in syphilis rates over the past two decades, a novel way to identify unreported manifestations was explored.

Methods:
The New York City (NYC) Health Department partnered with a facility specializing in treating diseases of the eyes, ears, nose, and throat. This facility serves as a referral site and rarely makes initial syphilis diagnoses, nor conducts serologic testing for syphilis, or reports neurosyphilis-related findings to NYC Health Department. They provided 132,733 diagnosis code-level records of patient-visits from 1/2/2020-3/31/2021. We matched their records with syphilis-specific diagnosis codes against the STI surveillance system (Maven) to compare visit information with data collected through routine reporting.

Results:
Of 46,638 visits made by 46,472 unique patients captured in facility records, six patients had a syphilis-specific diagnosis code: four patients diagnosed with secondary syphilis oculopathy and two with late syphilis oculopathy. All six patients were in Maven; four of them were known to have HIV. Three of the six patients had syphilis events prior to their facility visit that fit the case definition and they received appropriate treatment. Two of the three patients already had ocular manifestations documented in Maven, while one patient had syphilis events in 2018 and 2020, and neither event had ocular manifestations documented.

Conclusion:
This retrospective review of facility data suggests under-reporting of neurosyphilis-related symptoms and use of facility data as an important supplement to routine surveillance. Incorporating such facility-level data into existing surveillance systems at health departments should be considered for not only identifying neurosyphilis-related symptoms in real-time, but for monitoring/characterizing these syphilis manifestations that would otherwise be unreported.