The numbers of babies born with syphilis in Canada are rising at a far faster rate than recorded in the United States or Europe, an increase public health experts said is driven by increased methamphetamine use and lack of access to the public health system for Indigenous people.
While syphilis has made a global resurgence over the last five years, Canada is an outlier among wealthy nations in its rate of increase: 13-fold over five years, according to Health Canada. The incidence of babies born with syphilis reached 26 per 100,000 live births in 2021, the most recent year available, up from two in 2017, according to the Health Canada data.
That total is on track to increase further in 2022, according to the preliminary government data obtained by Reuters.
Babies with congenital syphilis are at higher risk of low birth weight, bone malformations and sensory difficulties, according to the World Health Organization.
Syphilis in pregnancy is the second-leading cause of stillbirth worldwide, the WHO said.
Yet congenital syphilis is easily preventable if an infected person gets access to penicillin during their pregnancy.
Among the G7 group of wealthier nations for which data is available, only the United States had a higher incidence of syphilis at birth: 74 per 100,000 live births in 2021, triple the rate in 2017, according to preliminary figures from the U.S. Centers for Disease Control and Prevention.
There were 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.
People experiencing poverty, homelessness and drug use, and those with inadequate access to the health system, are more likely to contract syphilis through unsafe sex and pass it to their babies, public health researchers said.
“In high-income countries you see it in pockets of disadvantaged populations,” said Teodora Elvira Wi, who works in the WHO’s HIV, Hepatitis and sexually transmitted infection program.
“It’s a marker of inequality. It’s a marker of low-quality prenatal care.”
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, who focuses on prevention of sexually transmitted disease.
“It’s just the whole system, and all the things that we’ve done in bad ways not to support Indigenous communities,” he said.
Health Canada told Reuters it has dispatched epidemiologists to help provinces contain the increase in congenital syphilis. Spokesperson Joshua Coke said the federal government is expanding testing and treatment access in Indigenous communities.