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Preventing Congenital Syphilis: A Review of the Current Epidemiology, Screening, and Treatment Options

Taylor, Felicity J. MA, MBBS, MRCPCH

Infectious Diseases in Clinical Practice: May 2013 - Volume 21 - Issue 3 - p 149–154
doi: 10.1097/IPC.0b013e31827e11ff
Review Articles

Successful treatment of venereal syphilis using penicillin has been accepted practice since 1943. Yet, despite the fact that the causative organism is known, and that treatment is both inexpensive and readily available, syphilis continues to generate a heavy burden of morbidity and mortality. Of the 12 million cases of syphilis occurring worldwide, 2 million are in pregnant women: the resultant congenital syphilis kills more than 1 million babies each year. In developing economies, syphilis is largely endemic; and major economic and societal hurdles exist for increasing women’s access to appropriate antenatal testing and care. Developed economies have also seen a rapid increase in syphilis infections during the past 20 years, particularly among women of childbearing age. The historical stigma associated with syphilis means that it has not attracted the same funding and public awareness as other sexually transmitted infections such as human immunodeficiency virus. These factors, along with poor antenatal screening coverage among urban and ethnic populations, have combined to generate a situation where an epidemic of congenital syphilis, not seen since the 1950s, may occur. This review briefly revises the microbiology and clinical features of congenital syphilis and looks at the current prevalence and screening programs in developing and developed economies, using the current situation in the United Kingdom as an example. The current antenatal and infant treatment recommendations are presented, and consideration is given toward future challenges in preventing an epidemic of congenital syphilis.

This review article summarizes the current epidemiology of congenital syphilis in developed and developing economies and highlights the universal health and economic benefits to be gained from effective antenatal screening and treatment programs.

From the London Deanery, London, UK.

Correspondence to: Felicity J. Taylor, MA, MBBS, MRCPCH, London Deanery, London, UK. E-mail:

The author has no funding or conflicts of interest to disclose.

The work that follows has been written by, and is entirely the work of, Felicity J Taylor.

This work is an original contribution and has not been previously published, and is not under consideration for publication elsewhere.

© 2013 Lippincott Williams & Wilkins, Inc.