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Syphilis, an infection caused by the bacterium Treponema pallidum, has been nationally notifiable since 1924. If left untreated, it progresses through different stages, with primary, secondary and early latent (less than one year after the point of infection) stages being infectious. Only these infectious stages are included in national reports. Untreated syphilis will enter into a non-infectious late latent stage of the infection that may lead to serious complications associated with tertiary syphilis. This includes damage to the central nervous system, cardiovascular system, eyes, skin and other internal organs. Untreated syphilis can be fatal1c. Individuals infected with syphilis are at an increased risk of contracting and transmitting HIV2c.
Congenital syphilis is caused by the vertical transmission of Treponema pallidum from an infected mother to her fetus. Congenital syphilis may not be diagnosed until later in life, as the disease can often be asymptomatic for life or may present with symptoms that are not identified in the first few weeks. Only early congenital syphilis cases (diagnosed in those under 2 years of age) are reported nationally.
Reported rates of infectious syphilis in Canada remained stable between 1999 and 2001, then spiked upwards in the following three years, particularly among males. Since 2004, the rates are climbing at a slower rate in both sexes.
Figure 10: Reported Rates of Infectious Syphilis by Sex and Overall, 1993 to 2008, Canada
|Jurisdiction||Male-to-Female Rate Ratio|
|Canada||6.4 : 1.0|
|BC||13.9 : 1.0|
|AB||1.4 : 1.0|
|SK||2.0 : 1.0|
|MB||3.4 : 1.0|
|ON||13.6 : 1.0|
|QC||45.7 : 1.0|
|NB||1.8 : 1.0|
|NT||1.3 : 1.0|
The age-specific distribution of infectious syphilis cases differed from chlamydia and gonorrhea in that reported rates were highest in the older population, particularly in males aged 30 to 39.
Figure 11: Reported Rates of Infectious Syphilis by Sex and Age Group, 2008, Canada
While highest rates of infectious syphilis are reported in males over 30, more recently, the greatest increases were in men 20 to 29 years old.
Figure 12: Reported Rates of Infectious Syphilis in Males by Age Group, 1999 to 2008, Canada
Figure 13: Reported Rates of Infectious Syphilis in Females by Age Group, 1999 to 2008, Canada
The majority of reported cases were concentrated in Canada’s most populous provinces. However, the highest reported rate was in NWT due to a recent outbreak.
|Jurisdiction||Number of Cases||Rate per 100,0003||Rate Change (%)|
1 Rate change calculated using unrounded values.
2 Nunavut did not officially become a territory until 1999; prior to 1999, data for Nunavut was combined with Northwest Territories. Rate change for NT was not calculated since 1999 rates are not comparable with 2008 rates due to the creation of Nunavut.
* The rate change cannot be quantified.
3 Bolded rates indicate rates above national average.
|Year||Total reported cases||Rate (per 100,000 live births)2||Number of reported cases1|
1 Refers to laboratory confirmed case of early congenital syphilis (within 2 years of birth)
2 Source: Statistics Canada, Canadian Vital Statistics, Birth Database