Increase in congenital syphilis in the European Union and European Economic Area, 2015 to 2024 – time to scale-up public health responses
Otilia Mårdh, Disa Hansson, Katja Siling, Lina Nerlander, Csaba Ködmön,BACKGROUND
Congenital syphilis (CS) is under routine surveillance in the European Union and European Economic Area (EU/EEA). In 2024, notifications reached their highest level in a decade, coinciding with rising syphilis among women.
AIM
We describe CS cases in 2024, trends from 2015 to 2024, associations between CS rates and syphilis among women of reproductive age, and public health implications.
METHODS
Confirmed CS cases and syphilis notifications in 15–44-year-old women reported by EU/EEA countries between 2015 and 2024 were extracted from EpiPulse. For CS cases in 2024, we described key demographics and outcome (alive/deceased). Country-specific CS and syphilis rates per 100,000 were calculated using Eurostat denominators. We assessed associations between CS and syphilis in women using quasi-Poisson regression adjusting for population size and year.
RESULTS
In 2024, 28 EU/EEA countries reported 140 confirmed CS cases, Bulgaria, Hungary and Portugal accounting for 62% (87/140). Most cases were diagnosed neonatally (86/99; 87%), and 11 of 58 were deceased. From 2015 to 2024, CS rates increased from 1.3 to 5.2 per 100,000 live births (23 countries) and syphilis rates among women aged 15–44 years from 1.9 to 5.3 per 100,000 (22 countries). Regression analyses showed significant positive associations between syphilis in women and CS rates in Germany and Hungary, whereas CS increases in Romania and Slovakia remained after adjustment for syphilis among women.
CONCLUSION
The CS increase highlights prevention gaps. Strengthened surveillance, national audits of antenatal screening pathways, and testing policies adapted to evolving epidemiology are needed.