Congenital Syphilis in children under two


Lead investigator 

Dr Ian Simms
Public Health England
Centre for Infections
61 Colindale Avenue
NW9 5EQ            
Email: Dr Ian Simms   


  • Between 2000 and 2007, diagnoses of infectious syphilis in women rose by 474% (from 78 to 448).
  • As incidence has risen, cases of congenital syphilis have emerged.
  • In recent years around six cases have been reported each year through genitourinary medicine clinics, but this probably only represents 30% to 50% of the cases that occur.
  • Cases can be prevented through antenatal screening and appropriate treatment.
  • Control methods are highly cost effective but are dependent on well-structured healthcare pathways.
  • The re-emergence of congenital syphilis reflects a failure of prenatal care delivery systems, as well as syphilis control programmes. Concerns have been raised about the effectiveness of the present control strategies. In particular, control efforts have been restricted by the absence of comprehensive systematic national surveillance of congenital syphilis.
  • This study aims to investigate surveillance of congenital syphilis, in order to accurately estimate the incidence of congenital syphilis, identify factors associated with cases of congenital infection and inform efforts to improve healthcare systems to ensure that women and their babies are managed appropriately.
  • The investigation compliments a study of antenatal screening pathways being undertaken by the Syphilis Task Group, a sub-committee of the National Screening Committee.       

Case definition: Any child under the age of 24 months with a confirmed or presumptive diagnosis of congenital syphilis or acquired syphilis should be reported on the BPSU orange card.

Reporting instructions: Please report any infant seen for the first time in the UK or the Republic of Ireland since January 2010 who satisfies the case definition REGARDLESS OF COUNTRY OF BIRTH.

Duration: January 2010 to December 2014

Funding: Health Protection Agency

Ethical approval: This study has been approved by the London REC (Ref: 09/H0718/44). Public Health England has approval under Section 251 of the NHS Act 2006 under reference  ECC 6- 02(FT12)/2012 to process confidential patient information for public health purposes (see 

Further Information