Be safe, get tested: Syphilis increase sparks concern for life-threatening impact on unborn babies

Media release

22 March 2023

Manatū Hauora – Ministry of Health and Institute of Environmental Science and Research (ESR) are asking people to take steps to protect themselves and others from syphilis, including people who are pregnant and their partners, as unborn babies are especially at risk.

New data from ESR, released ahead of formal publication, shows a 41 percent increase in Aotearoa New Zealand syphilis cases in the second half of 2022 (from 99 cases in the first quarter to 140 in the fourth quarter). This increase comes after a steady decline in syphilis cases since 2019.

Syphilis is a sexually transmitted infection which, if untreated, can affect the brain, and other organs as well as increasing the risk of getting HIV.

Syphilis in pregnancy can lead to stillbirths, congenital abnormalities, and severe illness in babies.

Early symptoms of non-congenital include a sore or ulcer (called a chancre) at the site of infection, usually the genitals, anus or mouth. Later symptoms can include rashes, sometimes with spots on the palms of the hands and soles of the feet, swollen lymph glands, fever, headaches, tiredness, and warty growths in skin folds.

Syphilis is preventable through practicing safe sex, such as using a condom or oral dam, and having regular STI (Sexually transmitted infections) check-ups to pick up infections and prevent passing them on. A simple blood test can detect the illness and it can be treated with antibiotics. Testing for syphilis in the first trimester of pregnancy should be a part of routine antenatal care for all pregnant women in New Zealand. Early detection and treatment of syphilis in pregnancy is highly effective in protecting babies from infection. Pregnant women who are unsure if they have been tested, or have concerns about STIs, can ask for a syphilis blood test at any time.

“Syphilis is preventable and can be treated”, says Manatū Hauora Director of Public Health Dr Nicholas Jones. “Syphilis infections have been rising globally, including in New Zealand. People need to be aware that there is increased risk of infection during sex and consequences can be serious.

“Many people with syphilis do not have any symptoms or have only minor symptoms that may go unnoticed. Testing and treatment for syphilis is a crucial part of control of the disease, along with condom use. ”

The ESR data shows the rise in cases in late 2022 has been largely among men, with men who have sex with men recording an 81 percent increase in 2022 between Quarter 1 (1 January to 31 March) and Quarter 4 (1 October to 31 December). There was also a spike in syphilis cases among men who have sex with women, with a 76 percent increase between Quarter 1 and Quarter 4 of 2022.

Dr Julia Scott, Public Health Physician at ESR, says that there has been a sharp increase in syphilis cases reported since the second half of 2022.

“One concerning impact of rising cases of syphilis is the possibility of transmission from mother to child during pregnancy, and syphilis in babies, called congenital syphilis. Congenital syphilis is completely preventable, and our aim should be zero cases. In Aotearoa, the number of cases of syphilis identified in pregnancy and in babies remains higher than it should be, with six cases of congenital syphilis reported in 2022. Māori and Pacific people are disproportionally represented in cases of syphilis during pregnancy and congenital syphilis,” says Dr Scott.

Eliminating congenital syphilis is one of the key aims of Manatū Hauora’s Syphilis Action Plan, part of the wider Ngā Pokenga Paipai me Ngā Pokenga Huaketo mā te Toto: Te Rautaki o Aotearoa – The Sexually Transmitted and Blood borne Infections Strategy, published on Sunday 12 March 2023. Other goals include arresting the recent increases, eliminating ethnic inequities, and reducing suffering and poor health outcomes for people infected with syphilis.

To meet these goals, Manatū Hauora is working with Te Whatu Ora and Te Aka Whai Ora to support more equitable and timely access to sexual health and antenatal care for all New Zealanders, which includes testing and treatment for syphilis.

Additional information

Syphilis by the numbers

  • There were 487 cases of infectious syphilis in 2022, with the majority (289) reported in the second half of 2022. This compares with 449 cases in 2021. 
  • Most cases of syphilis continue to be reported in males aged 20–39 years with the majority among European/other ethnicities (174 cases), followed by Māori (167 cases), Pacific people (66 cases), Asian (49 cases), Middle Eastern Latin American and African (13 cases), and Unknown (19 cases).
  • Across the regions, Auckland (309 cases), Waikato (55 cases), and Wellington (35 cases) account for the majority of notified cases.
  • More detailed information from 2022 will be made available on ESR’s website shortly.

How Syphilis surveillance works in Aotearoa

ESR operates the surveillance systems for STIs, including syphilis. For syphilis, there is a clinician notification system in place to collect demographic, laboratory and risk factor information.

ESR’s quarterly STI Dashboard uses rolling 12-month case counts (rates per 100,000) which provide insight into STI trends, and ESR also produces an annual dashboard and report.

Additional resources

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