Rising cases of congenital syphilis in Quebec

Six cases of congenital syphilis were declared in 2021, and already two cases have been reported in 2022, indicated Quebec’s public health department. Despite a goal of zero cases per year, in 2021 Quebec experienced its highest annual rate of congenital syphilis since the establishment of the reportable disease registry in 1990. Public health described the increase as “worrying,” and with two cases already declared for 2022, there are still others currently under investigation. Read: Activists say Canada's response to HIV, AIDS has stalled, call for more funding Syphilis has been on the rise in Quebec since 2001, particularly affecting men who have sex with other men. But since 2015, a significant increase in cases has been observed among women, too. According to the public health in Quebec, more than 138 cases of syphilis were reported in women in 2021; 92% of them being in women of childbearing age. “This is a significant increase, compared to an average number of 82 cases per year for the past five years,” noted the Ministry of Health. Furthermore, the risk of transmission to the fetus is higher during the early phase of syphilis in the mother, and if the infection occurs during the second and third trimesters of pregnancy. The disease in pregnant women can cause stillbirths or premature deliveries. It can also lead to neurological, hepatic, cardiological, hematological, ocular or bone manifestations in the baby. Recommendations In analyzing these various new cases, Public Health has suggested that screening opportunities have been missed. It has since developed recommendations noting that “[The collaboration of healthcare professionals] is essential to limit the transmission of syphilis and contribute to the elimination of congenital syphilis.” It recommends, among other things, screening for syphilis in women of childbearing age with risk factors, such as having had an "anonymous partner" or more than one partner in the last year, sex workers or women from a region where sexually transmitted and blood-borne infections (STBBIs) are endemic. In addition, health professionals should offer testing for syphilis to any woman of childbearing age who requests it, even if she does not have one of the risk factors listed above. The province’s health department also recommends systematically offering screening for the disease and other STBBIs to pregnant women during the prenatal check-up. Read: Talking to patients about sex In addition, risk factors and new exposures in the pregnant person and their partner should be assessed during pregnancy. During childbirth, a systematic search for STBBI screening results should be carried out. In all cases, newborns or women with syphilis should be treated according to the best practice guideline of the National Institute of Excellence in Health and Social Services and the Canadian Pediatric Association. Read: Poll: Is public health messaging on monkeypox doing a good job in avoiding stigma against gay men? This article has been translated from its original French and originally appeared on our sister site Profession Santé.

Rising cases of congenital syphilis in Quebec

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