Infectious syphilis cases soar among pregnant women in Hamilton

The rate of infectious syphilis has seen a “significant increase” among women of childbearing age in Hamilton.

Hamilton Public Health Services said in a recent press release that it has notified healthcare providers about the alarming trend.

The public health department said syphilis continues to mainly affect men who have sex with men, but local data suggests the rate of infectious syphilis among women has risen four times from 2019 to 2022. In 2022, 33 female cases were confirmed in Hamilton, representing 11 per 100,000 in the population.

Among the cases with women, 74 per cent were those of childbearing age. Because of possible transmission during pregnancy, the number of infants being tested for congenital syphilis has risen. 

A total of seven confirmed cases of congenital syphilis were identified between 2018 to 2022.

Universal screening, safe sex practices recommended

Symptoms may not show up. If symptoms are present, they include chancres (painless ulcers) on the genitals or mouth, a rash, fever and swollen glands. Antibiotics can cure syphilis.

The Public Health Agency of Canada has a number of recommendations, such as universal screening during the first trimester or first pre-natal visit. It advises partners of pregnant women with syphilis to be screened and treated to reduce risk of re-infection. Moreover, it recommends safer sex practices, including reducing the number of sexual partners during pregnancy.

It said individuals at high risk of acquiring syphilis, such as the homeless and sex workers, may be less likely to receive standard prenatal care, so it recommends they get screened in the ER. 

Early treatment ‘can drastically’ reduce risk of congenital syphilis

Congenital syphilis is most commonly transmitted from pregnant individuals with syphilis to the baby during pregnancy. It can also occur at the time of delivery through contact with genital lesions during vaginal birth.

If untreated, it can result in miscarriage, pre-term birth, low birth weight, neonatal death or congenital syphilis.

Treatment of pregnant individuals early on during the pregnancy can “drastically reduce the risk of congenital syphilis,” such as before 16 weeks gestation.

A penicillin-based treatment is provided at least one month before delivery.