Syphilis in London - New challenges from an old disease

1 December 2006

Infants are once again at risk of dying from syphilis passed on by their mothers during pregnancy, and the disease is increasing in Britain, a scientific meeting heard today, Friday 1 December 2006, at the Federation of Infection Societies conference in Cardiff.

Many clinics and family doctors may simply be missing cases of infant syphilis because they are unfamiliar with the symptoms of what was once a common disease, but which until recently had become rare. However the disease is now returning in young women of childbearing age, and therefore also in their newborn babies.

“Congenital syphilis is a preventable disease and its re-emergence in the United Kingdom reflects a failure of prenatal care delivery systems, as well as syphilis control programmes”, says Dr Rana Chakraborty of St George’s Hospital in London. “We looked at 12,600 women attending a south London hospital antenatal clinic over 3 years, of whom 70 tested positive for syphilis. We found that of 42 women who were assessed as posing a medium level risk of transmitting infectious syphilis to their child, 26 of them, or 62%, received no follow-up blood tests”.

According to the St George’s researchers, medical guidelines to prevent the spread of the disease exist, but are not being uniformly followed. At the clinic secure procedures were not in place to ensure that women were appropriately referred, investigated, and their disease managed. They fear that as syphilis infection in women of childbearing age increases, this may lead to unrecognised cases of congenital syphilis in the United Kingdom, a disease which is treatable, but can be fatal in infants.

“Our investigation raises concerns about the effectiveness of the present syphilis control strategy”, says Dr Chakraborty. “Anecdotal reports suggest that many more cases of congenital syphilis have been seen than are reported in medical journals, and if control strategies are not improved an increasing number of cases will emerge as the epidemic progresses”.

“Fortunately no infants were born showing symptoms of syphilis during our study, and we hope that when a re-audit is carried out locally we can show an improvement in our management of antenatal syphilis”, says Dr Chakraborty. “However, we are very concerned about how the problem is being managed nationally”.

- ENDS -