Download Quarterly Report on Syphilis in Ireland

 Quarterly Report on Syphilis in Ireland Quarter 2 2013 (Provisional) Introduction This report summarises notifications of syphilis during Quarter 2 2013 and provides provisional, non validated data for Quarter 1&2 2013. More detailed validated information is contained in annual syphilis reports which can be found on the HPSC website, available here. Starting in January 2013, all laboratory‐diagnosed syphilis notifications are included in the national Computerised Infectious Disease Reporting System, CIDR, and are reported weekly in the weekly STI and HIV report which is available here. This change in the surveillance system has led to more timely and complete notification data and so direct comparison with data from previous years may not be valid. Also, the data notified includes all stages of syphilis infection, including cases which represent infection at some time in the past, rather than current infection. Quarter 2 2013 During quarter 2 2013, there were 187 notifications of syphilis in CIDR. Of these, 13 cases were reported as having a history of previously treated syphilis with no indication of recent infection. These 13 cases were excluded from further analysis. Of the remaining 174 syphilis notifications, 47 were early syphilis (primary, secondary and early latent), 6 were late syphilis, 48 were latent of undetermined duration, 2 were stage unknown and 71 had no stage specified. There were no congenital cases reported in Quarter 2 2013. Table 1 shows a breakdown of the cases in Quarter 2 2013 by HSE area and stage of infection. Table 1: Number of syphilis cases by HSE area and stage of infection, Q2 2013 (excludes 13 cases with a history of treated syphilis). HSE HSE HSE HSE HSE‐
HSE HSE‐
HSE Total E M MW NE NW S SE W Q2 Congenital Syphilis 0 0 0 0 0 0 0 0 0 Primary Secondary Early latent Early syphilis 15 15 10 40 0 1 0 1 2 1 0 3 0 0 0 0 1 0 1 2 0 0 0 0 1 0 0 1 0 0 0 0 19 17 11 47 Late latent Late syphilis 3 3 0 0 0 0 0 0 0 0 1 1 1 1 1 1 6 6 Latent of undetermined duration 48 0 0 0 0 0 0 0 48 Stage unknown Not specified 0 42 0 2 0 2 1 6 0 1 0 16 0 0 1 2 2 71 Total 133 3 5 7 3 17 2 4 174 HSE‐Health Protection Surveillance Centre, 25‐27 Middle Gardiner St., Dublin 1, Ireland, www.hpsc.ie 6/11/2013
Quarterly Report on Syphilis in Ireland Quarter 2 2013 (Provisional) Early Infectious Syphilis There were 47 notifications of early infectious syphilis in Quarter 2 2013, 19 with primary syphilis, 17 with secondary syphilis and 11 with early latent syphilis. Table 2 and figure 1 show the number of early infectious cases by quarter in 2012 and 2013. Table 3 summarises the early infectious cases for Quarter 1&2 2013 and table 4 describes total cases and early infectious cases by the service where first identified in Quarter 1&2 2013. Table 2: Number of early infectious syphilis cases by quarter, Quarter 1 2012 to Quarter 2 20131 2012 Stage of Infection 2013 Primary Secondary Early latent Q1 23 9 2 Q2 17 4 5 Q3 10 11 7 Q4 11 7 10 Q1 28 15 10 Q2 19 17 11 Early infectious syphilis 34 26 28 28 53 47 Notification rate (per 100,000)
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0.8
0.6
0.4
0.2
0
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Q2
Q3
2012
Q4
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2013
Figure 1: Rate of early syphilis notifications per 100,000, Q1 2012 to Q2 20132 1
Data relating to quarters 1‐4 2012, have been updated compared to previously published reports 2
Surveillance system changed in 2013 to include all laboratory notifications within CIDR HSE‐Health Protection Surveillance Centre, 25‐27 Middle Gardiner St., Dublin 1, Ireland, www.hpsc.ie 6/11/2013
Quarterly Report on Syphilis in Ireland Quarter 2 2013 (Provisional) Table 3: Summary of early infectious syphilis cases, Quarter 1‐2 2013 Number of early infectious cases in Quarter 1&2 2013 Gender Age Mode of Transmission Probable country of infection HIV Status Male Female Median age (years) Age Range (years) MSM Hetero Unknown Acquired in Ireland Acquired abroad Unknown HIV positive HIV negative Unknown Number of cases % of early cases 100 98 2 34 20‐73 63 12 25 50 11 39 33 39 28 ‐ 98.0 2.0 ‐ ‐ 63.0 12.0 25.0 50.0 11.0 39.0 33.0 39.0 28.0 Table 4: Total syphilis and early infectious syphilis cases by service where first identified, Quarter 1‐2 2013 Service where case first identified Total syphilis Early infectious syphilis STI clinic 203 82 General practice 51 6 Antenatal/Maternity Hospital 11 0 Other 27 4 Unknown 43 8 Total 335 100 HSE‐Health Protection Surveillance Centre, 25‐27 Middle Gardiner St., Dublin 1, Ireland, www.hpsc.ie 6/11/2013
Quarterly Report on Syphilis in Ireland Quarter 2 2013 (Provisional) Explanatory Note: Syphilis is a sexually transmitted infection (STI) caused by a bacteria, Treponema pallidum. Infection is usually transmitted sexually to and from mucosal skin through tiny abrasions. Untreated, the infection may follow a protracted course over many years. Infection may be diagnosed at an early or late stage. The European case definition defines early as 12 months or less (http://eurlex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:159:0046:01:EN:HTML). Without treatment, infection will progress. Clinical symptoms may appear after an incubation period of 10‐90 days (3 weeks on average), at first a primary lesion at the site of infection (chancre), then a series of eruptions on mucous membranes and skin (secondary syphilis) followed by long periods of latency (latent or tertiary syphilis). The earlier an infection is diagnosed and treated, the greater the chance of preventing onward transmission. Early syphilis relates to the following clinical stages; primary, secondary and early latent. It should be noted that many people with early infectious syphilis may be asymptomatic. Individuals with late latent syphilis or tertiary syphilis are not sexually infectious. This report was prepared by Kate O’Donnell and Derval Igoe, HPSC. Data were extracted from CIDR on 30th October 2013 and were correct at the time of publication. Data are analysed by date of notification on CIDR. Acknowledgements HPSC would like to thank all those who provided data for this report, particularly the STI clinics, laboratories, GPs and Departments of Public Health. /
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