[Syphilis in children--the outcome of lacking vigilance and insufficient diagnostics].
BACKGROUND
In the years from 2000 to 2006 our department managed an increasing number of children exposed to congenital infection or with actual Treponema pallidum infection. Our team analyzed the causes, and published the conclusions addressing pediatricians as well as obstetricians. In the years from 2007 to 2008 we did not find any new cases of syphilis in children. However, despite our educational efforts, 2009 brought an increase of incidence of the disease. The aim of this paper was to establish the causes of new morbidity of congenital syphilis, and consequently spread the obtained information to neonatologists, pediatricians and obstetricians.


METHODS
87 children were hospitalized due to suspicion of congenital syphilis in the years from 2002 to 2009. The analyzed issues were: number of infected children in consecutive years, prevalence of screening to syphilis in pregnancy, and adequacy of treatment according to recommendations of Polish Gynaecological Society (PTG).


RESULTS
From 2000 to 2006 syphilis was confirmed in 13/45 (28.9%) suspected children. In 2007 and 2008 we did not establish any positive diagnoses. In 2009, we confirmed infection in 3/15 (20%) perinatally exposed children. In the following periods: 2002-2006, 2007-2008 and in 2009, consecutively 6/45, 1/27 and 4/15 mothers were not screened to syphilis during pregnancy, 17/45, 11/27 and 4/15 were treated differently than recommended by PTG, 6/45, 9/27 and 5/15 did not receive any treatment. In 7 cases it was not possible to retrace medical management during pregnancy.


CONCLUSIONS
Screening to syphilis in pregnancy in Lower Silesia is insufficient, and in detected cases the treatment is inadequate or completely omitted. There is still need for education, and also for proper data flow from obstetricians to neonatologists and pediatricians about cases of syphilis detected during pregnancy.
Gruszka
Jarosław
J
Katedra i Klinika Pediatrii i Chorób Infekcyjnych Dzieci Akademia Medyczna we Wrocławiu. mjgruszka@O2.pl
Szenborn
Leszek
L
D000328:Adult; D015984:Causality; D005260:Female; D006266:Health Education; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D011297:Prenatal Exposure Delayed Effects; D015996:Survival Rate; D013590:Syphilis, Congenital / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission