Rise in syphilis among Victorian women and babies

3 September 2021 |

Health professionals across Victoria and Australia are seeing a surge in women and men contracting the sexually transmitted infection syphilis, with some women passing it onto their baby during pregnancy.

There has been a 45 per cent increase in cases from 2015 to 2018, with cases in women going up 220 per cent over the same period. Cases of congenital syphilis - where it is transmitted to the unborn baby through the placenta - have also increased, with the first case in 13 years seen in 2017.

Head of Sexual Health and Rapid Access Service at the Royal Women’s Hospital, Dr Alex Marceglia, said the rise in infections was extremely concerning.

“Syphilis has many nasty symptoms including ulcers on the genitalia or in the mouth, rashes on the body and hair loss. For pregnant women the symptoms can also include miscarriage or stillbirth or even some babies being born with syphilis symptoms,” Dr Marceglia said.

“Syphilis can also have no symptoms at all, which can make it harder for people to realise they should have a test. We really need to remind everyone of the fundamentals of being safe while sexually active – including vaginal, oral and anal sex, and even just close intimate contact.

“Our advice is for sexually active people to have a sexual health check annually or when they have a new sexual partner, whichever is more frequent. A sexual health check can be requested from a local GP and is also available at the Women’s if referred.”

To prevent the spread of STIs, it’s also recommended to wear a condom during sex. But people don’t consider using a barrier, such as dental dams, for oral sex as they are not so concerned with pregnancy - which is how some people are being infected with syphilis. 

Dr Marceglia said the demographics of people contracting syphilis had changed, along with the risks of contracting it.

“Syphilis was previously seen as an STI affecting men engaging in sexual activity with other men – now we’re also seeing syphilis in the heterosexual community,” said Dr Marceglia.

“Heterosexual men and women, particularly if they have multiple sexual partners, inject drugs or are returning from places where syphilis is prevalent, are at increased risk of infection. Aboriginal and Torres Strait Islander people are also at greater risk, as are sex workers – especially if diagnosed with another STI.”

Pregnant women also fall into a high-risk group.

“Syphilis during pregnancy can be very harmful to women and their babies – so we all need to be acutely aware of this upsurge in the community,” Dr Stefan Kane, Director of Maternity Services at the Women’s, explained.

“Whether it’s contracted before or during pregnancy, there is a risk of stillbirth or miscarriage. And we have seen babies with low birth weight as well as babies born unwell with the infection.

“The earlier we can catch it the better it will be for mum and baby. Testing for syphilis is a routine part of the many tests we offer to women in early pregnancy. And, for those at high risk of infection, this test should be repeated at 28 and 32 weeks and even at birth. Women can ask for this testing wherever they are having their antenatal care.”

Dr Marceglia added that while awareness is important, syphilis isn’t something we should fear.

“Not only is it completely preventable, but it is treatable and for most people, that’s with a simple prescription of penicillin.”