Local Transmission of Imported Endemic Syphilis, Canada, 2011

Sergio Fanella

, Kamran Kadkhoda, Michelle Shuel, and Raymond Tsang

Author affiliations: University of Manitoba, Winnipeg, Manitoba, Canada (S. Fanella); Cadham Provincial Laboratory, Winnipeg (K. Kadkhoda); National Microbiology Laboratory, Winnipeg, (M. Shuel, R. Tsang)

Abstract

Endemic (nonvenereal) syphilis is relatively common in nonindustrialized regions of the world. We describe a case of local transmission in Canada and review tools available for confirming a diagnosis. Improved molecular tools and global clinical awareness are needed to recognize cases of endemic syphilis imported to areas where it is not normally seen.

Treponema pallidum subsp. endemicum is the causative agent of endemic syphilis, also called nonvenereal syphilis. Other diseases caused by nonvenereal treponematoses are yaws (T. pallidum subsp. pertenue) and pinta (T. carateum). The 3 diseases are a substantial cause of illness in the nonindustrialized world, but they are rarely encountered in industrialized areas. Endemic syphilis is encountered in dry, hot regions, including Sahelian areas of western Africa and parts of Botswana, Zimbabwe, and the Arabian Peninsula (1–4). The causative organism is transmitted by direct contact with secretions from lesions or on fomites. The clinical spectrum of these diseases involves various degrees of involvement of the skin, mucous membranes, and skeletal system, depending on the organism (1,2,5,6).