The incidence of congenital syphilis in the United Kingdom: February 2010 to January 2015

Ian Simms*, P. A. Tookey, B. T. Goh, H. Lyall, Barry Evans, C. L. Townsend, Helen Fifer, Catherine Ison, Fortune Ncube, Louise Logan, Hemanti Patel, Max Courtney-Pillinger, Lynsey Emmett, Josh Forde, Jo Jacomelli, Elizabeth Tempest, Ken Mutton, Anita Turley, James Sedgewick, Catherine SouthwoodJordana Peake, Katy Town, Suzan Trienekens, Cassandra Powers, Malcolm Canvin, Richard Lynn, Helen Friend, Rachel Winch, Jacob Avis, K. Hurtig

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Objective: To estimate the incidence of congenital syphilis in the UK. Design: Prospective study. Setting and population: United Kingdom. Methods: Children born between February 2010 and January 2015 with a suspected diagnosis of congenital syphilis were reported through an active surveillance system. Main outcome measures: Number of congenital syphilis cases and incidence. Results: For all years, reported incidence was below the WHO threshold for elimination (<0.5/1000 live births). Seventeen cases (12 male, five female) were identified. About 50% of infants (8/17) were born preterm (<37 weeks' gestation): median birthweight 2000 g (865–3170 g). Clinical presentation varied from asymptomatic to acute disease, including severe anaemia, hepatosplenomegaly, rhinitis, thrombocytopaenia, skeletal damage, and neurosyphilis. One infant was deaf and blind. Median maternal age was 20 years (17–31) at delivery. Where maternal stage of infection was recorded, 6/10 had primary, 3/10 secondary and 1/10 early latent syphilis. Most mothers were white (13/16). Country of birth was recorded for 12 mothers: UK (n = 6), Eastern Europe (n = 3), Middle East (n = 1), and South East Asia (n = 2). The social circumstances of mothers varied and included drug use and sex work. Some experienced difficulty accessing health care. Conclusion: The incidence of congenital syphilis is controlled and monitored by healthcare services and related surveillance systems, and is now below the WHO elimination threshold. However, reducing the public health impact of this preventable disease in the UK is highly dependent on the successful implementation of WHO elimination standards across Europe. Tweetable abstract: Congenital syphilis incidence in the UK is at a very low level and well below the WHO elimination threshold.

Original languageEnglish
Pages (from-to)72-77
Number of pages6
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume124
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Bibliographical note

Funding Information:
We acknowledge the British Paediatric Surveillance Unit, supported by the Department of Health, for facilitating the data collection and the reporting clinicians, particularly those who completed the questionnaires. Any views expressed (in publications) are those of the investigator and not necessarily those of the BPSU or DH.

Funding Information:
The study was funded by Public Health England. We declare no support from any organisation for the submitted work, no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years, and no other relationships or activities that could appear to have influenced the submitted work.

Funding Information:
We acknowledge the British Paediatric Surveillance Unit, supported by the Department of Health, for facilitating the data collection and the reporting clinicians, particularly those who completed the questionnaires. Any views expressed (in publications) are those of the investigator and not necessarily those of the BPSU or DH. We thank all the clinicians and microbiologists who participated in the study. We also thank Fortune Ncube and Louise Logan (HIV & STI Dept, PHE Colindale), Hemanti Patel (STBRU, PHE Microbiology Services, Colindale), Max Courtney-Pillinger (Surrey and Sussex HPU), Lynsey Emmett (PHE Eastern Field Epidemiology Unit), Josh Forde (PHE London), Jo Jacomelli and Elizabeth Tempest (PHE South West), Ken Mutton (PHE North West), Anita Turley, James Sedgewick and Catherine Southwood (Kent Health Protection Unit), and Jordana Peake, Katy Town, Suzan Trienekens, Cassandra Powers and Malcolm Canvin (HIV & STI Dept, PHE Colindale) for their assistance in identifying and investigating reports; Richard Lynn, Helen Friend, Rachel Winch and Jacob Avis (BPSU, Royal College of Paediatrics and Child Health); and Professor Anna-Karin Hurtig (Ume? University).

Publisher Copyright:
© 2016 Royal College of Obstetricians and Gynaecologists

Keywords

  • Congenital syphilis
  • United Kingdom
  • elimination
  • epidemiology

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