Congenital syphilis

Congenital syphilis is an infection in the fetus or newborn caused by *Treponema pallidum* ^[1]. The infection may be acquired transplacentally during pregnancy or through contact with a maternal lesion at the time of delivery ^[1]. It is a surveillance concept used to monitor the preventable transmission of syphilis from mother to child ^[2].

Clinical presentation at birth ranges from asymptomatic infection to stillbirth or neonatal death ^[1]. Reported manifestations include low birth weight, rash, hepatosplenomegaly, osteolytic bone lesions, pseudoparalysis, central nervous system infection, and long-term disabilities ^[1]. The source material does not provide a more detailed symptom chronology or complication frequency. Because presentation can be broad, clinical recognition depends on linking neonatal findings with maternal infection history and follow-up data ^[1][3].

The condition is reported to be increasing globally, with an estimated 700,000 to 1.5 million cases annually between 2016 and 2023 ^[1]. A U.S. report cited 2,677 cases in 2021 ^[1]. The highest numbers of cases are reported in the African and Eastern Mediterranean regions, while data are least available in those same regions ^[2]. The literature also notes pockets of high-incidence areas in other regions and reports that increases have occurred in some settings that previously had very low case numbers ^[2][3].

Transmission occurs from an infected mother to the fetus during pregnancy or by contact with a maternal lesion at delivery ^[1]. The source material characterizes congenital syphilis as a mother-to-child transmission outcome rather than a disease spread person-to-person in routine community contact ^[2]. No additional route details are supported in the provided sources.

The provided sources do not define a full risk-group profile beyond maternal infection during pregnancy and the emphasis on high-risk mothers in prevention discussions ^[1]. Public-health attention is directed to pregnancies with syphilis infection, settings with limited antenatal screening or treatment access, and populations where detection and follow-up are incomplete ^[1][2][3].

Prevention is described as highly effective through antenatal identification of syphilis infection and treatment with penicillin during pregnancy ^[2]. The sources also emphasize routine antenatal screening, partner tracing and treatment, health education on safe sex practices, and strategies to curb illicit drug use ^[1]. Public health measures to improve early detection in pregnancy and ensure penicillin availability are highlighted as important for reducing future cases ^[1][4].

Surveillance should be interpreted as a measure of preventable mother-to-child transmission, and not solely as a neonatal clinical syndrome, because reported cases may depend heavily on maternal follow-up and completeness of neonatal evaluation ^[3]. The literature notes that reported incidence varies widely by region and that data quality is uneven, especially where the burden appears highest ^[2]. In monitoring contexts, increases in reported cases may reflect improved detection as well as true transmission, so trends should be read alongside antenatal screening coverage and reporting practices ^[2][3].

1. 1 Sankaran D et al. Congenital Syphilis-An Illustrative Review. Children (Basel). 2023 Jul 29. PMID: 37628309. doi: 10.3390/children10081310. PubMed: https://pubmed.ncbi.nlm.nih.gov/37628309/
2. 2 Gilmour LS et al. Congenital Syphilis: a Review of Global Epidemiology. Clin Microbiol Rev. 2023 Jun 21. PMID: 36920205. doi: 10.1128/cmr.00126-22. PubMed: https://pubmed.ncbi.nlm.nih.gov/36920205/
3. 3 Is Congenital Syphilis Really Congenital Syphilis? Infectious Diseases in Obstetrics and Gynecology. 2006. doi: 10.1155/idog/2006/81629. DOI: https://doi.org/10.1155/idog/2006/81629
4. 4 Syphilis and Congenital Syphilis. Rook's Textbook of Dermatology. 2024. doi: 10.1002/9781119709268.rook029. DOI: https://doi.org/10.1002/9781119709268.rook029
5. 5 Syphilis and Congenital Syphilis. Rook's Textbook of Dermatology, Ninth Edition. 2016. doi: 10.1002/9781118441213.rtd0030. DOI: https://doi.org/10.1002/9781118441213.rtd0030
6. 6 Stafford IA et al. Syphilis Complicating Pregnancy and Congenital Syphilis. N Engl J Med. 2024 Jan 18. PMID: 38231625. doi: 10.1056/NEJMra2202762. PubMed: https://pubmed.ncbi.nlm.nih.gov/38231625/

ICD-10

A50

ICD-11

1A70.1

Total cases

12

Peak month

2024-01

Coverage

1 reporting countries · 2005-01-01 → 2026-06-01