The number of babies born with syphilis in Canada is rising at a far faster rate than in the United States or Europe.
Based on data presented by Health Canada, the incidence of early congenital syphilis was only 7 in 2017. But the numbers soared to 96 cases in 2021 – a 1,271 percent increase.
Health Canada defines early congenital syphilis as a laboratory-confirmed Treponema pallidum infection occurring within the first 2 years of birth. Babies with congenital syphilis are at higher risk of low birth weight, bone malformations, and sensory difficulties, according to the World Health Organization (WHO), reports Reuters.
While syphilis has made a global resurgence over the last five years, Canada is an outlier among wealthy nations in its rate of increase, yet congenital syphilis is easily preventable if an infected person gets access to penicillin during their pregnancy, according to CBC Canada News.
Among the G7 wealthier nations, only the United States had a higher incidence of syphilis at birth: 2,677 cases of congenital syphilis in the U.S. in 2021 for a population of 332 million, according to preliminary CDC data. Canada had 96 cases for a population of 38 million, according to Health Canada.
Public health researchers said people experiencing poverty, homelessness and drug use are more likely to get infected through unsafe sex. Those with inadequate access to the health system have the same risk, and they may pass the bacteria to their babies during pregnancy and birth.
“In high-income countries, you see it in pockets of disadvantaged populations. It’s a marker of inequality. It’s a marker of low-quality prenatal care,” Teodora Elvira Wi, who works in the WHO’s HIV, Hepatitis, and sexually transmitted infection program, told Reuters.
What sets Canada apart are its Indigenous populations who experience discrimination and often have poor access to health and social services, said Sean Rourke, a scientist with the Li Ka Shing Knowledge Institute at St. Michael’s Hospital in Toronto.
“It’s just the whole system, and all the things that we’ve done in bad ways not to support Indigenous communities,” he said.
Indigenous populations and substance abuse
Preliminary studies of 165 infants have found that at least two-thirds were born to women reporting a history of substance abuse. Nearly 45 percent of the women identified as Indigenous and another 40 percent had no ethnicity recorded. Indigenous people make up about five percent of the Canadian population, according to census data.
Public health researchers and clinicians said the rates of congenital syphilis began increasing before the pandemic and worsened as public health agencies diverted resources to COVID-19 testing and other pandemic-related health measures.
“All of the social circumstances that contributed to this have just gotten worse over the pandemic,” said Ameeta Singh, an infectious diseases specialist with an HIV/STI practice in Edmonton.
Susanne Nicolay, nurse lead at Wellness Wheel clinic in Regina, Saskatchewan, which serves Indigenous and vulnerable populations, said providers needed to do more to expand access to health care.
“The system always talks about patients that are hard to reach. But I think it’s health providers that are hard to reach,” she said.
