The Canadian Pediatric Society has just issued new guidelines to stem the country’s “crisis” of congenital syphilis, which can be transmitted during pregnancy or childbirth. To avoid “catastrophic” consequences, all pregnant women must undergo a screening test at their first pregnancy appointment, then two more thereafter for those at high risk of being infected.
“Since 2018, the diagnosis rate of congenital syphilis that we have observed in Canada has skyrocketed,” laments Dr.r Sergio Fanella, pediatric infectious disease specialist. An “unacceptable” situation, because this disease can lead to miscarriages or have serious and permanent effects on infants. “We are talking, for example, about damage to the brain, bones, hearing or vision problems, or skin lesions. »
To prevent certain cases from falling through the cracks, the Canadian Pediatric Society is therefore issuing new recommendations. She therefore advises that all pregnant women undergo a screening test at the first prenatal appointment, then that those at high risk of being infected undergo a second one between 28 and 32 weeks of pregnancy. For the latter, the association also suggests repeating the procedure at delivery.
Individual and systemic risk factors
In the country, the number of cases of congenital syphilis increased from 7 in 2017 to 96 in 2021, according to a document published in December 2022 by Health Canada. “This is primarily due to a lack of control of syphilis among people of childbearing age in the general population, as well as an insufficient public health resource to address this problem,” says D.r Sergio Fanella.
However, other risk factors for congenital syphilis must be considered, continues the pediatric infectious disease specialist. “Some are more systemic in nature, such as housing difficulties, substance abuse, as well as lack of access to prenatal care due to geographic isolation, for example. »
It is absolutely necessary to detect and treat syphilis in pregnant women, insists Dr Fanella. Especially since it can be effectively cured with antibiotics. “This treatment also makes it possible to limit the risk of spreading the infection to the fetus, without reducing it to zero. In these situations, we must therefore always follow the baby quite often during his first year of life, carrying out blood tests frequently. »
With The Canadian Press