欧盟/欧洲经济区预防先天性梅毒的优先事项

Priorities in the prevention of congenital syphilis in the EU/EEA Monitoring of the responses to sexually transmitted infection epidemics in theEuropean Union and European Economic Area–2024 progress report May2026 Key factsSubtitle •Syphilis is a sexually transmitted bacterial infection, andcongenital syphilisoccurs whenafoetuscontractssyphilisduring pregnancy. Thiscan lead toseverenegativeconsequences for theinfant whenthey areborn.Testing and treating pregnant women for syphilisprevents this fromhappening.•Cases of congenital syphilishaveincreasedby243%in the past decade,from 37 cases in2015to127casesin 2024,amongEU/EEAcountries that consistently reportedthis data.Eleven countries reportedrates above theWHO European Region 2030 elimination target of ≤1 case per 100 000 live births.•Most EU/EEA countrieshave a policy of testing womenfor syphilisin early pregnancy, but few countrieshave data on how manyare actuallytested.•Even if women test negative in early pregnancy, they canstillcontract the diseaselaterin theirpregnancy,andonly about half of countriesin theEU/EEAhave a policytore-test pregnant women.•ECDC recommends thatEU/EEA countries update their syphilis testingpolicyin pregnancy to ensureuniversal and voluntary syphilis screening in the first trimester, repeated testing of pregnant women withidentified risk factors in the third trimester,and testing at delivery ifit hasnotbeendoneearlier.ECDC alsorecommends that countrieshaverobust monitoring systemsin place. Background Syphilis is a sexually transmitted infection (STI) caused by the bacteriumTreponema pallidum.Congenitalsyphilis is an infection that occurs whenTreponema pallidum, thebacterium causingsyphilis, is passed fromapregnant womanwho has syphilisto the foetus during pregnancy, primarily via transplacental transmission or,less commonly, through exposure to infectious lesions at delivery[1]. The term‘congenital’ indicates thattransmission has taken place in utero.Transmission can occur at any stage of maternal syphilis and at any stageof pregnancy; however, the risk is greatest in pregnantwomenwith untreated early syphilis, in whomfoetalinfections occur in approximatively 70–100% of pregnancies,withstillbirthsobservedin up to one third of cases.Althoughtransmissioncan occur at any time during pregnancy, it ismost commonafter 28 weeks of gestation;timely treatmentadministeredbefore this periodandappropriate tothestage of infectionis highly effective inpreventing adverse foetal outcomes. Congenital syphilis cases in infants that meet the laboratory criteria for case confirmation are under EuropeanUnionepidemiological surveillance[1]. Congenital syphilis can be prevented through early and repeated screening during pregnancyandtimelytreatment for pregnant women who test positive with an active syphilis infectionandtreatment fortheir sexpartner(s). TheWHO European Region 2030 targetfor eliminating congenital syphilis by 2030 are set at ≤1 case per 100000 live births, <0.01% syphilis prevalence among women attending antenatal care, and ≥95% coverage ofsyphilis screening and treatment among pregnant women in antenatal care[2].These targets are found withinthe WHO European Regional Action Plan for ending AIDS and the epidemics of viral hepatitis and sexuallytransmitted infections. An increase insyphilisnotification rates among women and heterosexual menwasobserved in 2022, 2023 and2024 in several European Union (EU) and European Economic Area (EEA) countries.Inparalleltherehas beenanincreaseinthe number ofconfirmed cases of congenital syphilissince 2020. In 2024, 14 countries reported140confirmedcongenital syphiliscases, witha further 14 countries reporting no cases[3,4].,Thenumber of casesofcongenital syphilis increasedby243%from 37 cases in2015to 127 cases in2024(Figure 1)among countrieswhichreporteddataconsistently between 2015 and 2024 Source: Country reports from Bulgaria, Croatia, Cyprus, Czechia, Denmark, Estonia, France, Germany, Hungary, Iceland,Ireland, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain,Sweden. In 2024,16 EU/EEA countries that provided data on congenital syphilis had national rates at or below the WHOEuropean Region 2030 elimination target of ≤1 case per 100 000 live births.Eleven countries reported ratesaboveonecase per 100 000 live births, withthehighest rates observed in Portugal (17.5), Hungary (47.9) andBulgaria (52.5)(Figure 2). Early detection and timely treatment of maternal infectionthroughantenatal screening programmes, includinguniversal screening for syphilis, are central to preventing congenital syphilis. Recent increases in congenitalsyphilis in the EU/EEA indicate missed prevention opportunitiesinantenatal care. Evidence from country reportsand the literature shows that most cases occur among pregnant womenwith socio-economical vulnerabilities,andoften in the context ofthem receivingsuboptimal antenatal care. Thesesocio-economicvu