Syphilis: Etiology and epidemiology

This guide is about management of primary, secondary, latent and tertiary syphilis. Some information about neurosyphilis and congenital syphilis is included, however their treatment is outside the scope of this document. Individuals with these conditions should be managed by or in consultation with an infectious disease specialist or an experienced colleague.

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Etiology

Syphilis is a complex systemic disease caused by infection with the spirochete bacterium Treponema pallidum, subspecies pallidum.

Other non-venereal treponemal infections [bejel, yaws (certain African countries) and pinta (Central and South America)] are found in endemic countries.

Epidemiology

Infectious syphilis (primary, secondary and early latent stages) is the third most common nationally notifiable bacterial sexually transmitted infection (STI) in Canada.

The rate of infectious syphilis continues to increase in Canada. Gay, bisexual and other men who have sex with men (gbMSM) are disproportionately affected. Higher rates are still reported in this population, although an increasing number of outbreaks in heterosexual populations have been reported in large urban centers as well as in more rural areas in Canada, since 2017.

Congenital syphilis is also re-emerging in Canada.  Since 2015, rates of congenital syphilis have risen again after years of decreased ratesFootnote 1. In 2018 and 2019, congenital syphilis numbers were the highest ever reported.

More information

Local epidemiological information: Consult with your public health unit

National epidemiological information:

Global epidemiological information: World Health Organization Report on global sexually transmitted infection surveillance

References

Footnote 1

Choudhri Y, Miller J, Sandhu J, Leon A, Aho J. Infectious and congenital syphilis in canada, 2010-2015. Can Commun Dis Rep. 2018;44(2):43-48.

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