Vol. 142 No. 0102 (2012)
Congenital syphilis in Switzerland: gone, forgotten, on the return
- Sauteur Meyer
- J Trück
- PP Bosshard
- M Tomaske
- Cadenas Morán
- S Lautenschlager
- P Goetschel
INTRODUCTION:Acquired syphilis has re-emerged in many Western European countries. In contrast to international guidelines, screening for syphilis in pregnancy is not generally recommended in Switzerland. There has been an increase in the incidence of laboratory syphilis notifications in recent years, regardless of gender and age.
METHODS: We conducted a retrospective study, evaluating the total numbers of pregnant women with positive syphilis serology (Treponema pallidum Particle Agglutination assay, TPPA) from 2000 to 2009, and evaluated the clinical management and outcome of their offspring. In addition, we sought to determine cases of infectious syphilis (primary, secondary, and early latent syphilis) reported to the Swiss Federal Office of Public Health in women of childbearing age, which has previously been shown to precede changes in the incidence of congenital syphilis within a population.
RESULTS: Out of 13,833 women who gave birth at our institution, positive syphilis serology was found in 9 pregnant women during the 10 years studied. A total of 6 pregnant women were diagnosed having syphilis infection during pregnancy. Regarding their offspring, 8 of the 9 newborns were tested serologically. One neonate experienced congenital syphilis because the adequately treated mother developed re-infection after treatment. Within the Swiss population, infectious syphilis cases in women of childbearing age increased substantially from 2006 to 2009.
CONCLUSIONS: The epidemiologic data suggest that congenital syphilis could become a medical problem in Switzerland due to the rise of infectious syphilis cases in women of childbearing age that have been shown to be followed by changes in the congenital syphilis incidence. The persistence of congenital syphilis in Switzerland along with this rise of infectious syphilis in women of childbearing age suggests a potential for improvement of prenatal care and syphilis control programmes.
- Doroshenko A, Sherrard J, Pollard AJ. Syphilis in pregnancy and the neonatal period. Int J STD AIDS. 2006;17(4):221–7; quiz 228.
- Chakraborty R, Luck S. Syphilis is on the increase: the implications for child health. Arch Dis Child. 2008;93(2):105–9.
- Fenton KA, Lowndes CM. Recent trends in the epidemiology of sexually transmitted infections in the European Union. Sex Transm Infect. 2004;80(4):255–63.
- Lautenschlager S. Sexually transmitted infections in Switzerland: return of the classics. Dermatology. 2005;210(2):134–42.
- Sexually transmitted infections (STI) in Switzerland, 1988–2006. Bull Swiss Federal Office of Public Health. 2008;8:140–9.
- Sexually transmitted infections (STI) in Switzerland, until 2010. Bull Swiss Federal Office of Public Health. 2011;12:253–61.
- Frischknecht F, Sell W, Trummer I, et al. Serological testing for infectious diseases in pregnant women: are the guidelines followed? Swiss Med Wkly. 2011;140:w13138.
- WHO. The Global elimination of congenital syphilis: rationale and strategy for action. http://whqlibdoc.who.int/publications/2007/9789241595858_eng.pdf (accessed 24th October 2011).
- Hossain M, Broutet N, Hawkes S. The elimination of congenital syphilis: a comparison of the proposed World Health Organization action plan for the elimination of congenital syphilis with existing national maternal and congenital syphilis policies. Sex Transm Dis. 2007;34(7 Suppl):S22–30.
- Congenital syphilis – United States, 2003–2008. MMWR Morb Mortal Wkly Rep. 2010;59(14):413–7.
- Tucker JD, Chen XS, Peeling RW. Syphilis and social upheaval in China. N Engl J Med. 2010;362(18):1658–61.
- Robert-Koch-Institut. Syphilis in germany in the year 2008. Epid Bull. 2009;49:503–12.
- Abraham S, Toutous-Trellu L, Pechere M, et al. Increased incidence of sexually transmitted infections in Geneva, Switzerland. Dermatology. 2006;212(1):41–6.
- Cheng JQ, Zhou H, Hong FC, et al. Syphilis screening and intervention in 500,000 pregnant women in Shenzhen, the People's Republic of China. Sex Transm Infect. 2007;83(5):347–50.
- Simms I, Broutet N. Congenital syphilis re-emerging. J Dtsch Dermatol Ges. 2008;6(4):269–72.
- Blencowe H, Cousens S, Kamb M, et al. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality. BMC Public Health. 2011;11(Suppl 3):S9.
- Liu JB, Hong FC, Pan P, et al. A risk model for congenital syphilis in infants born to mothers with syphilis treated in gestation: a prospective cohort study. Sex Transm Infect. 2010;86(4):292–6.
- Zhu L, Qin M, Du L, et al. Maternal and congenital syphilis in Shanghai, China, 2002 to 2006. Int J Infect Dis. 2010;14(Suppl 3):e45–8.
- French P, Gomberg M, Janier M, et al. IUSTI: 2008 European Guidelines on the Management of Syphilis. Int J STD AIDS. 2009;20(5):300–9.
- Lautenschlager S. Diagnosis of syphilis: clinical and laboratory problems. J Dtsch Dermatol Ges. 2006;4(12):1058–75.
- Lumbiganon P, Piaggio G, Villar J, et al. The epidemiology of syphilis in pregnancy. Int J STD AIDS. 2002;13(7):486–94.
- Enders M, Knaub I, Gohl M, et al. Congenital syphilis despite prenatal screening? An evaluation of 14 cases. Z Geburtshilfe Neonatol. 2006;210(4):141–6.