Syphilis cases on the rise for women
Public Health is continuing to see a sizeable proportion of infectious syphilis among women of childbearing age.
Although men have consistently accounted for the vast majority of infectious syphilis cases reported in Ontario between 2014 and 2023, the proportion of cases reported among women has increased almost five-fold during this 10-year period, from 3.8 per cent in 2014 to 18 per cent in 2023. In HPE in the past five years, 21 per cent of infectious syphilis cases diagnosed were in women aged 15 to 44 years.
This demographic shift is being seen across the country and is giving rise to the resurgence of congenital syphilis (CS). CS occurs when people pass syphilis to their babies during pregnancy. CS can result in pregnancy loss and substantial morbidity in newborns.
In Canada over the past four years, rates of infectious syphilis have increased by 109 per cent, while rates of congenital syphilis, have increased by 599 per cent.
Syphilis is preventable.
- Understand your patient’s risk for syphilis and other sexually transmitted infections.
- Encourage syphilis testing for everyone who is sexually active as part of routine screening.
- Consider testing for syphilis in patients that present with symptoms of a new lesion or unexplained rash. *Remember that in people with a vagina, the chancre can occur inside the vagina and go unnoticed.
- Discuss prevention of syphilis and other sexually transmitted infections including the use of condoms and other barrier methods. Free condoms are available at all local public health office.
Congenital syphilis is preventable.
- Universal screening is recommended for pregnant people during the first trimester or at first prenatal visit.
- Repeat screening at 28-32 weeks of pregnancy (or as close to this interval as possible) and again at delivery in the following circumstances:
- In areas with outbreaks or
- For pregnant people at ongoing risk of infection or reinfection
- Consider more frequent screening for pregnant people at high risk.
HEALTH-CARE PROVIDER EDUCATIONAL OPPORTUNITY – March 3, 2025
Addressing rising syphilis rates among women in Canada
Webinar by Catie in partnership with the Public Health Agency of Canada
This webinar explores the rapid increase in syphilis cases among women in Canada over recent years, examining the social determinants of health, systemic barriers to care and intersecting forms of discrimination that drive the epidemic. Speakers will discuss current and historic trends across national and regional contexts, including the similarly steep increase in congenital syphilis, which occurs when the infection is passed to a fetus during pregnancy.
Register here.
Order the Catie Syphilis: What you need to know pamphlet for your patients by visiting catie.ca/client-publication/syphilis-what-you-need-to-know.
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