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Infectious syphilis and congenital syphilis in Canada, 2021

CCDR
Volume 48-11/12, November/December 2022: Antimicrobial Use and Stewardship Download this article as a PDF
Published by: The Public Health Agency of Canada
Issue: Volume 48-11/12, November/December 2022: Antimicrobial Use and Stewardship
Date published: November/December 2022
ISSN: 1481-8531
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Volume 48-11/12, November/December 2022: Antimicrobial Use and Stewardship

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Infectious syphilis and congenital syphilis in Canada, 2021

Figure #. Text version below.

Text description: Infographic
  • In 2021, there were 11,268 cases of infectious syphilis Footnote † reported nationallyFootnote *, for a rate of 30 cases per 100,000 people. The 2021 national infectious syphilis rate was 166% higher than the 2017 rate.
  • From 2017 to 2019, the national rate of infectious syphilis increased by 116%.
  • From 2019 to 2020, however, rates of infectious syphilis remained relatively stable (increased by 2%). This may be partially explained by a decreased demand for and ability to deliver sexually transmitted blood borne infections services during the beginning of the COVID-19 pandemicFootnote ‡.
  • From 2020 to 2021, the national rate of infectious syphilis increased by 20%.
Table 1: Number of cases and rates of reported cases of infectious syphilis by sex in Canada, 2017–2021
Year Number of infectious syphilis cases Rate per 100,000 males Rate per 100,000 females Total rate per 100,000 people
2017 4,132 20.2 2.4 11.3
2018 6,371 27.3 7.0 17.2
2019 9,181 35.0 13.8 24.4
2020 9,498 34.7 15.1 25.0
2021 11,268 39.7 20.2 30.0

Infectious syphilis by sex and sexual orientation:

  • Among females, the 2021 national infectious syphilis rate was 729% higher than the 2017 rate.
  • Among males, the 2021 national infectious syphilis rate was 96% higher than the 2017 rate.
  • Nationally, 1 in 3 cases (34%) were among females in 2021, compared to 11% in 2017.
  • In 2021, six provinces and territories provided sexual orientation data: British Columbia (BC), Alberta (AB), Saskatchewan (SK), Ontario (ON), New Brunswick (NB), and the Yukon Territories (YT). These provinces and territories represented 69% of the Canadian population and 79% of infectious syphilis cases. According to their data, gbMSMFootnote ** cases represented 30% of all reported syphilis cases in 2021.

Infectious syphilis by age group:

  • The 25 to 39 years age group had the highest rate of infectious syphilis in 2021, but the highest observed increase in rate from 2017 to 2021, was in those less than 20 years old.
Table 2: Infectious syphilis rates per 100,000 people in 2017 and 2021 and infectious syphilis rate change (%) from 2017–2021, by age group in Canada
Age group Infectious syphilis rate per 100,000 people in 2017 Infectious syphilis rate per 100,000 people in 2021 Percent rate change from 2017–2021 (%)
<15 years 0.1 0.4 ↑ 698%
15–19 years 5.6 25.6 ↑ 357%
20–24 years 20.2 65.2 ↑ 222%
25–29 years 27.0 79.4 ↑ 194%
30–39 years 24.8 71.5 ↑ 188%
40–59 years 13.8 29.3 ↑ 112%
>60 years 2.5 4.5 ↑ 81%

Social and structural determinants of health and health inequities play a role in the inequitable occurrence of syphilis across different populationsFootnote ††.

Change in rates of reported cases of infectious syphilis comparing 2017 to 2021 rates by province and territory

Table 3: Infectious syphilis rates per 100,000 people in 2017 and 2021 and infectious syphilis rate change (%) from 2017–2021, by province and territory in Canada
Province or territory Infectious syphilis rate per 100,000 people in 2017 Infectious syphilis rate per 100,000 people in 2021 Percent change in infectious syphilis rates from 2017–2021 (%)
BC 10.3 21.5 ↑ 108%
AB 12.6 72.2 ↑ 472%
SK 10.4 150.9 ↑ 1,346%
MB 18.8 98.1 ↑ 422%
ON 11.5 18.9 ↑ 64%
QC 11.0 9.4 ↓ -14%
NB 2.5 3.5 ↑ 43%
NS 2.7 1.2 ↓ -56%
NL 7.4 NAFootnote a NAFootnote a
PE 2.7 NAFootnote a NAFootnote a
YT 0 16.3 NCFootnote b
NT 11.1 215.4 ↑ 1,834%
NU 234.4 111.7 ↓ -52%
Canada 11.3 30.0 ↑ 166%

  • Provinces and territories that had a change in rates of infectious syphilis above the national rate change of 166% included:
    • Northwest Territories (1,834%)
    • Saskatchewan (1,346%)
    • Alberta (472%)
    • Manitoba (422%)
  • Provinces and territories that had a change in rates of infectious syphilis below the national rate change of 166% included:
    • British Columbia (108%)
    • Ontario (64%)
    • New Brunswick (43%)
    • Québec (a decrease of 14%)
    • Nunavut (a decrease of 52%)
    • Nova Scotia (a decrease of 56%)

Congenital syphilis

Table 4: Number of confirmed early congenital syphilis cases and reported infectious syphilis rates among females aged 15–39 years in Canada, from 2017–2021
Year Number of confirmed early congenital syphilis cases Female rate (15–39 years old) per 100,000 females
2017 7 6.2
2018 17 19.4
2019 53 38.0
2020 52 41.6
2021 96 53.8
  • There were 96 cases of confirmed early congenital syphilis in 2021.
  • From 2017 to 2019, the number of cases of early congenital syphilis increased 657%.
  • From 2019 to 2020, the number of cases of early congenital syphilis remained relatively stable.
  • From 2020 to 2021, the number of cases of early congenital syphilis increased 85%.
  • The number of cases of early congenital syphilis has increased in parallel to the observed increases in rates of infectious syphilis in females aged 15 to 39 years.
  • From 2017 to 2021, rates of infectious syphilis among females aged 15 to 39 years increased annually.
  • The 2021 national infectious syphilis rate among females aged 15 to 39 years is 768% higher than the 2017 rate, and the 2021 national number of cases of early congenital syphilis is 1271% higher than in 2017. Rates rose the fastest from 2017 to 2019.

© Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2022 | Cat.: HP40-280/2021E-PDF | ISBN: 978-0-660-45395-8| Pub.: 220412

Footnote †

Infectious syphilis includes the primary, secondary and early latent (less than one year after infection) stages of infection, during which syphilis is transmissible. Early congenital syphilis is defined as a laboratory confirmation of infection by Treponema pallidum occurring within the first 2 years of birth. Case definitions for diseases under national surveillance. Can Comm Dis Rep 2000;26(S3). Retrieved July 2022, from http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/00vol26/26s3/index.html

Return to footnote † referrer

Footnote *

Data were obtained directly from provinces and territories (PTs). Nine PTs submitted data for the full calendar year of 2021, two PTs (PE and NL) did not provide any data and two PTs (NB and NS) provided partial counts; annual counts were estimated. Data for 2021 is preliminary.

Return to footnote * referrer

Footnote ‡

Survey of the impact of COVID-19 on the ability to provide STBBI prevention, testing and treatment including harm reduction services in Canada. Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control. 2021. Retrieved July 2022, from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/survey-impact-covid-19-delivery-stbbi-prevention-testing-treatment.html

Return to footnote ‡ referrer

Footnote **

gbMSM: Gay, bisexual and other men who have sex with men.

Return to footnote ** referrer

Footnote ††

Aho J, Lybeck C, Tetteh A, Issa C, Kouyoumdjian F, Wong J, Anderson A, Popovic N. Rising syphilis rates in Canada, 2011–2020. Can Comm Dis Rep 2022;48(2/3):52–60.

Return to footnote †† referrer

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