Gonorrhoea, chlamydia, syphilis and trichomonas in children under 13 years of age: national surveillance in the UK and Republic of Ireland.
BACKGROUND
Sexually transmitted infections in children ought to raise concerns about sexual abuse. It is not known how frequently they are identified in the UK and Ireland, nor how well they are investigated.


OBJECTIVE
To measure the incidence, mode of presentation, investigations and child protection procedures among children under 13 years and over 12 months of age presenting with infections of Neisseria gonorrhoea, Treponema pallidum, Chlamydia trachomatis or Trichomonas vaginalis in the UK and Republic of Ireland.


METHODS
National surveillance study over 25 months through the British Paediatric Surveillance Unit. All consultant paediatricians in the UK and Republic of Ireland reported laboratory confirmed infections followed by a confidential questionnaire covering clinical details, investigation results and child protection outcomes.


RESULTS
Fifteen cases were reported, giving an overall incidence of these infections of 0.075 cases per 100,000 children per year. Most were identified because they presented with symptoms. Five cases presented with ophthalmic infection. Laboratory investigation and screening for other infections was adequate in most cases. Although only three cases of sexual abuse were confirmed in court or case conference, abuse was suspected in a further seven cases based on clinical factors, family or social history.


CONCLUSIONS
Sexually transmitted infections in children, although rare, are generally well investigated. The findings support current guidance on the management of sexually transmitted infection in young children and the need to maintain a high index of suspicion for sexual abuse. Isolated ophthalmic infection with N gonorrhoeae and C trachomatis occurs beyond infancy, but the mode of transmission is unclear.
Department of Community Paediatrics, Norfolk Community Health & Care NHS Trust, Norwich, UK.
Richard
R
Reading
Sheffield Teaching Hospitals NHS Foundation Trust and Undergraduate Dean, University of Sheffield Medical School, Sheffield, UK.
Karen
K
Rogstad
Department of HIV and STIs, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
Gwenda
G
Hughes
Depatment of General Paediatrics, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.
Geoff
G
Debelle
D002648:Child; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D062665:Epidemiological Monitoring; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007494:Ireland / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology*; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology*; D014245:Trichomonas Infections / Q000175:diagnosis / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology
bpsu; child sexual abuse; sexually transmitted infection